Facilitating condom use with clients during commercial sex in Nevada's legal brothels.

OBJECTIVES: This study examined condom use in legal Nevada brothels. METHODS: Forty female prostitutes in two brothels were interviewed about client resistance to condoms and techniques for facilitating condom use. RESULTS: Of 3290 clients in the previous month, 2.7% (95% confidence interval [CI] = 2.2%,3.4%) were reluctant to use condoms. Of these individuals, 72% ultimately used condoms, while 12% chose nonpenetrative sex without condoms. The remaining 16% left the brothels without services. Condom use rates were markedly lower with nonpaying sex partners (lowers) than with clients. CONCLUSIONS: Brothel prostitutes may be at greater risk for acquiring HIV and other sexually transmitted diseases from lovers than from clients.     

Varied potential risks of HIV infection among prostitutes.

To date, most HIV prevention programs targeting North American prostitutes have focused on individual behaviour change, and in particular, the consistent use of condoms between prostitutes and their clients. The organizational and societal level issues which may influence high risk practices within the working and private spheres have received relatively little attention. In addition, most prevention efforts have been limited to targeting the sub-population of street prostitutes. We outline here three different types of prostitutes (street prostitutes, escorts, and prostitutes who work part time in the service sector, i.e. barmaids and erotic massage therapists) known to work in many North American centres. In doing so, we suggest that potential risks of infection vary according to the type of prostitution, and that prevention programs must recognize the diversity in potential risk practices. Differences in the organization of work and working conditions of varied types of prostitutes may, in particular, influence risk practices while working. Some of the individual, organizational and societal level issues which influence risk practices among different types of prostitutes are presented. Much of the research involving HIV and prostitutes has accessed prostitutes at sites where street prostitutes are over-represented. Other studies are based on potentially baised samples as they have recruited prostitutes from medical clinics. Methodologic problems that influence attempts to obtain a representative sample of the prostitute population are discussed.     

暗娼与性伴之间安全套协商使用情况分析

目的 了解暗娼与嫖客或固定性伴之间安全套协商和使用情况，为暗娼的艾滋病综合干预措施的制定提供参考依据。方法 采用横断面调查，于2018年4－6月在云南省红河哈尼族彝族自治州蒙自市、建水县，依托娱乐服务场所招募≥16岁暗娼，估算样本量需476人，问卷调查收集其人口学特征、安全套协商及使用情况信息。采用logistic回归模型分析暗娼与不愿使用安全套的嫖客协商后安全套使用的影响因素。结果 共调查暗娼852人，年龄（24.29±8.44）岁。最近1个月性行为，有58.6%（499/852）的暗娼每次都要求嫖客使用安全套但嫖客不愿使用，协商后有88.4%（441/499）的暗娼每次与嫖客都使用安全套。有14.4%（99/687）的暗娼每次都要求固定性伴使用安全套，但固定性伴不愿使用，经协商后，54.5%（54/99）暗娼与固定性伴每次都使用安全套。最近1个月，暗娼说服不愿使用安全套的嫖客时，53.3%（266/499）的采用“强制要求”策略，19.4%（97/499）的采用“风险说服”策略，23.1%（115/499）的采用“强制要求及风险说服”策略，4.2%（21/499）的采用其他策略协商。4.4%（22/499）的暗娼感觉说服嫖客使用安全套困难。多因素logistic回归分析结果显示，和感觉说服嫖客使用安全套困难的暗娼相比，难度适中（OR=4.00，95% CI：1.55～10.32）、容易（OR=30.17，95% CI：3.22～282.44）的暗娼更容易成功协商嫖客每次都使用安全套。和采用其他策略与嫖客协商使用安全套的暗娼相比，采用“强制要求”策略者（OR=4.44，95% CI：1.41～14.01）、采用“强制要求及风险说服”策略者（OR=5.52，95% CI：1.55～19.73）更容易成功协商嫖客每次都使用安全套。结论 通过安全套协商策略，可促使不愿使用安全套的嫖客使用安全套。采用“强制要求”策略更容易成功协商嫖客每次都使用安全套，结合“风险说服”策略更有利于成功协商。     

Consequences of cocaine use among prostitutes

OBJECTIVE: To describe the circumstances and consequences of cocaine use in the setting of prostitution. MATERIAL AND METHOD: We performed a qualitative study with fieldwork in 6 Spanish cities. Semi-structured interviews were carried out to 60 persons aged between 18 and 50 years old involved in prostitution in different settings: street, flat and brothel. RESULTS: The main substances used in prostitution were alcohol and cocaine. Consumption was occasional and instrumental and helped to reduce psychological barriers or inhibition and increase tolerance to long hours of sex work with different clients, thus increasing earnings. Cocaine use was also associated with providing clients with company without having to perform sexual services. Among the consequences of drug use in prostitutes were unprotected sex and a higher risk of violence by clients. Prostitutes developed harm reduction strategies for drug use: dose reduction, simulated drug use, and selection of clients who were users. CONCLUSIONS: This study shows that there is connection between drug use and the provision of sexual services. Drug use can pose a health risk as consumption is associated with unprotected sex.     

娱乐场所女性服务人员性传播疾病感染调查及干预效果评价

目的　通过调查了解克拉玛依市娱乐场所女性服务人员性病 (STD)感染状况、艾滋病的有关知识、态度和行为 ,避孕套使用情况等 ,探索在该人群中开展行为干预的方法与措施。　方法　对娱乐场所女性服务人员进行性病检测及采用授课、观看 VCD和定性访谈等方法进行干预。　结果　娱乐场所女性服务人员 STD感染率由干预前的 30 .9%下降至干预后的 12 .7%。干预后对性病艾滋病预防知识有一定的了解 ,但对艾滋病仍存在恐惧心理。与嫖客性交时认为有必要和实际使用避孕套者分别由干预前的 6 4 .4 %、18.6 %上升到干预后的 10 0 %、72 .0 %,与丈夫或男友性交时认为有必要和实际使用避孕套者分别由干预前的 4 9.5 %、9.6 %上升到干预后的 5 9.0 %、13.7%。调查发现该类人群愿意接受性病艾滋病防治知识 ,改变其危险行为 ,提高自我保护意识。　结论　我市娱乐场所存在着传播性病艾滋病的高危行为 ,在干预活动中不仅要提供性病艾滋病的防病知识 ,还要采取其它更有针对性的干预措施 ,尤其是考虑在娱乐场所中提供质量可靠的避孕套。     

Constraints faced by sex workers in use of female and male condoms for safer sex in urban Zimbabwe

We investigated whether female condoms are acceptable to sex workers in Harare and whether improved access to male and female condoms increases the proportion of protected sex episodes with clients and boyfriends. Sex workers were randomly placed in groups to receive either male and female condoms (group A, n=99) or male condoms only (group B, n=50) and were followed prospectively for about 3 months each. We found a considerable burden of human immunodeficiency virus (HIV) and sexually transmitted infections (STIs) in our cohort at enrollment (86% tested HIV positive and 34% had at least one STI). Consistent male condom use with clients increased from 0% to 52% in group A and from 0% to 82% in group B between enrollment and first follow-up 2 weeks later and remained high throughout the study. Few women in group A reported using female condoms with clients consistently (3%–9%), and use of either condom was less common with boyfriends than with clients throughout the study (8%–39%) for different study groups, visits, and types of condom). Unprotected sex still took place, as evidenced by an STI incidence of 16 episodes per 100 woman-months of follow-up. Our questionnaire data indicated high self-reported acceptability of female condoms, but focus group discussions revealed that a main obstacle to female condom use was client distrust of unfamiliar methods. This study shows that a simple intervention of improving access to condoms can lead to more protected sex episodes between sex workers and clients. However, more work is needed to help sex workers achieve safer sex in noncommercial relationships.     

Condom breakage during commercial sex in Chiang Mai, Thailand

Used condoms in 30 female brothels in Chiang Mai, Thailand, during the period from August 1992 to October 1992 were examined for breakage. Data were also collected by interviewing 326 prostitutes who accounted for 65 percent of the total prostitutes providing condoms. The prostitutes had a mean age of 20.6 ± 3.2 years. Sixty-one percent had no formal education. The median duration of prostitution was 13 months. The average number of clients per day in the past 24 hours and in the past 3 months was 4.4 ± 2.5 and 5.5 ± 2.2, respectively. Eighty-eight percent charged between $2 and less than $8 for their sexual service. All refused to practice oral or anal sex during the past 24 hours. Of 5,559 condoms, 298 were used two at a time and 15 were used three at a time. The breakage rate per act of intercourse was 5.9 percent (95% CI = 5.3, 6.5). The breakage per total condoms examined was 5.7 percent (95% CI = 5.1, 6.3). Breakage relating to manufacturing defect, i.e., pinholes, and that relating to use was 0.8 percent (95% CI = 0.6, 1.0) and 5.0 percent (95% CI = 4.4, 5.6), respectively. The probability of breakage when using two condoms at the same time was 3.4 percent (95 % CI = 0.5, 6.3). Most of the breakage occurred at the distal part of the condom. There was no difference between the breakage rates of condoms provided by the brothels and those brought by the client; nor was there any difference between manufacturing defect or use. The breakage rate per client as estimated by prostitutes in the past 24 hours corroborated with that assessed by examination.     

Interviews with senegalese commercial sex trade workers and implications for social programming

The purpose of the study was to assess the efficacy of the Senegalese pubic policy toward registered sex workers through an interview process examining their backgrounds and evaluating their knowledge of sexual health. Sixty registered sex workers in Dakar, Senegal, were interviews at the Institute d'Hygiene Social (IHS) to investigate patient knowledge of contraceptives and sexually transmitted infections (STIs). Ninety-eight percent of the women reported that, as a result of their visits to the clinic, they had increased precaution in their trade by demanding their clients use condoms and refusing clients who did not comply. Nearly 96% of the women were able to define the three main ways by which HIV is contracted, while 100% of the women reported that they used male condoms with their clients and would refuse clients who rejected the use of condoms. Senegal's proactive policy toward the safeguarding of women's health and the containment of HIV/AIDS through the legalization and monitoring of sex workers can serve as an example for successful strategies in the fight against the global spread of HIV/AIDS.     

A comparison of HIV-related risk behaviour and risk reduction between female street working prostitutes and male rent boys in Glasgow

In this paper we provide an early report of two continuing ethnographic studies of prostitution. We compare female streetworking prostitutes and male rent boys in Glasgow in terms of risks of HIV infection and practice of safer sex. It is shown that a considerable proportion of streetworking female prostitutes in Glasgow were injecting drug users but that drug use was much less common among rent boys. Although condom use appeared to be widespread amongst the women it was less common among the rent boys. We then examine the nature of the relationship established with clients. It is shown that the rent boys were much less directive in relation to clients - much less likely to insist on safer sexual practices than were the female prostitutes. It is suggested that this lack of directiveness is associated with retrospective payment - payment after the commercial sex act takes place. In a final section we look at the policy implications of our work.     

HIV and Sexual Risk Behavior among Commercial Sex Workers in the Netherlands

In 2002–2005, a cross-sectional study to assess the potential for HIV transmission was carried out among 557 female and male-to-female transgender commercial sex workers (CSW) in three cities in the Netherlands. Female CSW (F-CSW), drug-using female CSW (DU), and transgender sex workers were recruited in street-based and establishment-based sites. An anonymous questionnaire was administrated by interviewers and a saliva sample was collected for HIV antibody testing. The overall HIV prevalence was 5.7% (31/547; 10 samples were excluded because of “intermediate” test results). HIV was more prevalent among transgender (18.8%, 13/69) and DU (13.6%, 12/88) sex workers than among F-CSW (1.5%, 6/390). Of the HIV positive CSW, 74% were unaware of their infection. Consistent condom use with clients was 81%. Regular condom failure with clients was reported by 39%. In multivariate analyses, transgender sex workers (OR = 22.9), drug-using CSW who ever injected drugs (OR = 31.1), African (OR = 19.0), and South European ethnicity (OR = 7.2) were independently associated with HIV. Condom failure (PRR = 2.0), anal sex (PRR = 2.1), and drug use (PRR = 3.8) were associated with inconsistent condom use with clients. There is a potential risk for further spread of HIV, through clients and (private) partners of sex workers, to the general population. Targeted health promotion activities are indicated for transgender sex workers and drug-using female CSW; active HIV testing must be continued.     

How to reach clients of female sex workers: a survey by surprise in brothels in Dakar,Senegal

OBJECTIVE: To describe the sampling techniques and survey procedures used in identifying male clients who frequent brothels to buy sexual services from female sex workers in Dakar, Senegal, with the aim of measuring the prevalence of human immunodeficiency virus (HIV) infection and investigating related risk behaviours. METHODS: Surveys were conducted in seven brothels in Dakar, Senegal. Clients were identified "by surprise" and interviewed and requested to donate saliva for HIV testing. RESULTS: Of the 1450 clients of prostitutes who were solicited to enter the study, 1140 (79.8%) agreed to be interviewed; 1083 (95%) of these clients provided saliva samples for testing. Of the samples tested, 47 were positive for HIV-1 or HIV-2, giving an HIV prevalence of 4.4%. CONCLUSION: The procedures adopted were successful in reaching the target population. Men present in the brothels could not deny being there, and it proved possible to explain the purpose of the study and to gain their confidence. Collection of saliva samples was shown to be an excellent method for performing HIV testing in difficult field conditions where it is hard to gain access to the population under study. The surveying of prostitution sites is recommended as a means of identifying core groups for HIV infection with a view to targeting education programmes more effectively. In countries such as Senegal, where the prevalence of HIV infection is still low, interventions among commercial sex workers and their clients may substantially delay the onset of a larger epidemic in the general population.     

HIV risk profile and prostitution among female street youths

The objective of this study was to compare human immunodeficiency virus (HIV) risk factors among female street youths involved in prostitution and those with no history of prostitution. Youths aged 14 to 25 years were recruited into the Montreal Street Youth Cohort. Semiannually, youths completed an interviewer-administered questionnaire. Statistical analyses comparing characteristics and HIV risk factors for girls involved in prostitution and those never involved were carried out using parametric and nonparametric methods. Of the girls, 88 (27%) reported involvement in prostitution, and 177 girls reported no history of prostitution at the baseline interview. Girls involved in prostitution were two times and five times more likely to have reported bingeing on alcohol and on drugs, respectively. A history of injection drug use was four times more likely to have been reported by girls involved in prostitution. Further, these girls were 2.5 times more likely to have reported injected cocaine as their drug of choice. Girls involved in prostitution were younger the first time they had consensual sex and were twice as likely to have reported anal sex. Consistent condom use for anal, vaginal, and oral sex was low for all girls. Girls involved in prostitution reported more risky sexual partners. In conclusion, girls involved in prostitution may be at increased risk of HIV infection due to their injection drug use and risky sexual behaviors. Unique intervention strategies are necessary for reducing HIV infection among female street youths involved in prostitution.     

Interviews with Senegalese Commercial Sex Trade Workers and Implications for Social Programming

Abstract

The purpose of the study was to assess the efficacy of the Senegalese public policy toward registered sex workers through an interview process examining their backgrounds and evaluating their knowledge of sexual health. Sixty registered sex workers in Dakar, Senegal, were interviewed at the Institut d'Hygiene Social (IHS) to investigate patient knowledge of contraceptives and sexually transmitted infections (STIs). Ninety-eight percent of the women reported that, as a result of their visits to the clinic, they had increased precaution in their trade by demanding their clients use condoms and refusing clients who did not comply. Nearly 96% of the women were able to define the three main ways by which HIV is contracted, while 100% of the women reported that they used male condoms with their clients and would refuse clients who rejected the use of condoms. Senegal's proactive policy toward the safeguarding of women's health and the containment of HIV/AIDS through the legalization and monitoring of sex workers can serve as an example for success-ful strategies in the fight against the global spread of HIV/AIDS.     

越南籍跨境暗娼艾滋病性病感染及危险因素调查

目的 了解越南籍跨境暗娼人群艾滋病(acquired immunodeficiency syndrome, AIDS)性病(sexually transmitted diseases,STD)感染情况,高危行为特征及危险因素,为制定有针对性的预防控制措施提供依据。 方法 采用"滚雪球、同伴推动"等方法,由经培训懂双语的外展人员对越南籍跨境暗娼人群进行面对面问卷调查,调查内容包括人口学特征、艾滋病知识、高危行为、安全套使用情况等,并采集静脉血3～5 ml进行艾滋病病毒(human immunodeficiency virus,HIV)、梅毒抗体检测,应用SPSS 19.0 软件分析其中HIV、梅毒感染状况及探讨影响越南籍跨境暗娼人群商业性行为不使用安全套的可能因素。 结果 92例调查对象中,未发现HIV抗体阳性者,梅毒抗体阳性1例,阳性率为1.09%。调查对象均存在有多国商业性伴情况,每日接客数量为3个及以上者高达60.87%,最近1次和最近1个月商业性行为每次都使用安全套的比例分别为80.44%和68.48%;有54.35%的调查对象,在最近1个月内与固定性伴(熟客)发生过性关系, 最近1次和最近1个月每次性行为均无人使用安全套。通过多因素logistic回归分析显示,高档/中档服务场所(OR=15.021, 95%CI:2.820～80.023)是越南跨境暗娼商业性行为使用安全套的保护因素,首次性服务年龄≥30岁(OR=0.165, 95%CI:0.042～0.651)、每日接客数量≥3个(OR=0.129, 95%CI:0.023～0.737)是越南跨境暗娼商业性行为使用安全套的主要危险因素。 结论 越南籍跨境暗娼人群普遍存在多国商业性伴情况,低档服务场所、每日接客数量较多、高年龄组的暗娼安全套使用频率较低。提示在今后干预工作中,应充分考虑不同档次高危娱乐场所和高危性行为特征,开展有针对性的综合干预工作。     

跨性别女性的特征及艾滋病相关知识行为调查

目的 了解跨性别女性(male-to-female,MTF)的性别特征、对艾滋病知识的知晓情况及其艾滋病相关行为状况。方法 2014年在济南市采用滚雪球法招募MTF进行问卷调查,采用描述性流行病学的方法分析该人群的艾滋病知识知晓情况及其相关行为状况。结果 共调查了55名MTF,均为生理性别男性,心理性别女性,性别冲突比较严重的27人(占49.1%),非常严重的8人(占14.5%)。以男性装扮从事社会生活的30人(占54.5%),以女性装扮从事社会生活的25人(占45.5%)。艾滋病基本知识平均知晓率为57.9%(22/38),对于该人群常见的多性伴、肛交等艾滋病相关的性行为知识了解很少。对于恋人或性伴的选择、交往过的恋人或发生性行为的对象、最近一次发生性行为的对象,选择男性的分别占58.2%(32/55)、50.9%(28/55)、63.6%(35/55)。最近一次发生性行为的对象为偶然性伴(网友和一夜情伴侣)的占56.3%(31/55)。性行为时从不使用安全套者18人(占32.7%),偶尔使用的29人(占52.7%),经常使用的4人(占7.3%),每次都用的4人(占7.3%)。结论 MTF人群中艾滋病知识匮乏,无保护性接受性肛交行为普遍存在,多性伴、性生活频繁、安全套使用率低。该人群为艾滋病高危人群,亟需开展针对该人群的艾滋病干预预防措施。     

贵州省凯里市2006～2010年暗娼艾滋病行为监测分析

目的了解暗娼人群中艾滋病相关行为现状及变化趋势,解释艾滋病流行的变化趋势,为艾滋病流行提供早期预警;为艾滋病的干预措施和干预效果评价提供相关信息和依据。方法采用横断面调查方法及SPSS17.0分析软件。结果暗娼年龄偏小,主要集中在15～29岁之间。15～19岁暗娼呈逐年增多。暗娼未婚同居和在婚者比例呈逐年上升趋势。暗娼流动性大,在本地工作时间1~6月者所占比例均为46.75%。首次商业性行为平均年龄在16～24岁之间。2006～2010年,最近1个月商业性行为安全套的坚持使用率分别为65.00%,76.50%,68.75%和64.25%,与固定性伴的安全套使用率为25.45%,12.50%,12.62%和15.29%。商业性行为未使用安全套的最主要原因中嫖客不愿使用,其次是身边没有安全套。吸毒比例近年来逐渐上升。出现生殖道感染症状后,半数以上选择到私人诊所诊疗和自己购买药。结论暗娼年龄及首次商业性行为年龄偏小;知识与行为分离;暗娼未使用套的最主要原因是嫖客不愿用;暗娼及其固定性伴吸毒逐渐增高,性病就医情况不佳。     

Changes in condom use among a cohort of prostitutes]

OBJECTIVE: To describe changes in condom use among prostitutes enrolled in a prospective cohort study in Alicante (Spain), and to identify those factors associated with changes in this behaviour.Methods: Data from this study come from a prospective cohort study of women working at prostitution enrolled in a center for AIDS preventive at Alicante from 1986 to 1996. The proportion of condom use by prostitutes with their clients was recorded during the first visit and the last one, and changes in condom use were estimated as the difference between them. Two logistic regression analyses were done to identify those factors associated with positive or negative changes in condom use. RESULTS: A statistically significant increase in the prevalence of condom use was observed between the first, 69,2%, and the last visit, 83,9% (p < 0,001). Prostitutes working private increased the condom use more than five time than those working in clubs or at the street. The higher the follow-up time the higher the prevalence of condom user, OR > 6 years = 7,6 (95% CI: 2,2-26,0). No variable was associated with a negative change in condom use. CONCLUSION: This study shows an overall increase of condom use in a cohort of prostitutes after 10 years of follow-up. Relapse in risk behavior has been infrequent. In the future, preventive strategies to increase the use of condoms among prostitutes should be adapted to the new forms of sexual commerce.     

Male sex workers in Córdoba, Argentina: sociodemographic characteristics and sex work experiences.

OBJECTIVE: To report on the sociodemographic characteristics and work experiences of 31 male sex workers (MSWs) in the city of Córdoba, Argentina. METHODS: Information on each of the MSWs was collected using a questionnaire that covered his personal characteristics and his work background, self-assessed general health status, and use of health and social services. Scales were included in order to assess attitudes towards condom use, knowledge about safe sex, perceptions about the risk of getting HIV, individual self-efficacy, and locus of control. The questionnaire also asked each respondent to rank his level of agreement with interactive strategies for gaining client compliance with safe sex practices. RESULTS: In terms of their self-identity, out of the 30 MSWs who answered the question, 10 of them (33.3%) self-identified as heterosexual and 9 (30%) as bisexual. Alcohol and drug consumption and unsafe sexual practices were relatively low among the MSWs. Of the 31 MSWs responding, 21 of them (67.7%) reported that they had been tested for HIV, but only 13 of them (41.9%) said they had been vaccinated for either hepatitis A or hepatitis B. A variety of differences were found between the study's 17 street sex workers (sex workers who offer their services in public places such as streets and parks) and the 14 independent sex workers (sex workers who are self-employed, advertise and manage their own business, and have an exclusive location for their commercial sex work). The street MSWs were younger and had less formal education. Independent MSWs were economically more settled, had been working longer in the sex industry, and were more comfortable about having sex with men. Independent MSWs were also more likely to report a gay sexual orientation and less likely to report using alcohol, marijuana, or other substances. CONCLUSIONS: The differences between street MSWs and independent MSWs are important since they could influence the negotiating of safer sex practices with clients. Programs aimed at preventing the spread of HIV and other sexually transmitted infections and promoting responsible self-care among MSWs in Córdoba should be introduced. Such programs could increase the proportion of MSWs who know their HIV serostatus and could make MSWs more aware of the risk of different sex acts performed in commercial sex encounters. Given the differences that we found between street MSWs and independent MSWs, specific strategies and educational materials should be developed for those two subgroups within the MSW population.     

Toronto street youth and HIV/AIDS: prevalence, demographics, and risks.

PURPOSE: The purposes of this study were: (a) to identify human immunodeficiency virus (HIV) prevalence in Toronto street youth through paired blood and saliva specimens; (b) to identify the HIV risk and prevention behaviors of street involved youth; and (c) to identify demographic or other factors that may contribute to the risk of street youth becoming infected with HIV/acquired immunodeficiency syndrome (AIDS) in the future. METHODS: This was a cross-sectional convenience study of street-involved youth aged 14-25 years. The youth participated in interviews to identify HIV-related knowledge and personal risk and preventive behaviors. Following interviews, they were asked to provide a saliva sample, blood spot, or both. They could refuse one or both samples without jeopardizing their involvement or receiving an honorarium. Two males were the only participants who declined to provide a sample. RESULTS: Fifteen of 695 (2.2%) youth tested positive for HIV infection. All were male, ranging in age from 18 to 25 years. Same and opposite sex, intravenous (IV) drug use, prostitution, and incarceration were risk factors associated with positive HIV test results. The rate of HIV infection was seven times greater for the group 20 years of age and older (20-25) compared to the younger group aged 14-9 years. The proportion testing positive for HIV from small cities, towns, and rural communities in Ontario was 40%; yet, they represented 21% of the study population. Most (57%) youth had been on their own for no more than 3 years and had moved frequently. Nearly two thirds (60%) had stayed in hostels or homeless shelters in the previous 6 months. CONCLUSION: Street youth in Canada are at high risk of HIV infection with their risk increasing with age. Unprotected (same and opposite) sex, IV drug use, prostitution and incarceration were linked to their HIV infections. The high level of mobility identified by street youth challenges governments, communities, and public health officials to develop appropriate prevention strategies and to carefully monitor the spread of HIV infection in this vulnerable population.