Sexual activities of patients with STDs in the interval between noticing symptoms and presenting for treatment

Examining the patterns of and reasons for sexual behaviors of patients with sexually transmitted diseases (STDs) while symptomatic may help to develop effective prevention strategies for both STDs and AIDS. However, little is known about patients' sexual activities after noticing STD symptoms in China, where AIDS and STDs are spreading rapidly. We conducted a cross-sectional study at four STD clinics in Hefei, China. Patients' reported sexual activities were queried, using a tape recorder and earphones. A consecutive sample of 406 male patients with STDs were interviewed. One hundred sixty-four (40%) men reported having sex after having STD symptoms; 45% were married, 27% were single, and 47% cohabiting or divorced. Their sex partners included spouses, girlfriends, and prostitutes. Only 10% of patients with STDs who had sex after noticing STDs reported frequently using condoms or using them for every act of sex. Approximately 60% had never used a condom. Logistic regression analysis indicated that having sex after noticing STD symptoms was associated with lower education, having a previous STD episode, having low HIV/STD knowledge, and having other urethral discharge not caused by C. trachomatis or gonorrhea. Our findings suggest that male patients with STDs may serve as a bridge population linking the STD, and potentially, HIV epidemic from individuals at higher risk to the general population. Intervention programs including health education and condom promotion need to target both those at high risk and those at apparently lower risk.