Risk factors associated with HIV infection among male prostitutes.

OBJECTIVES. This study documents the human immunodeficiency virus (HIV) and sexually transmitted disease seroprevalence rate for male prostitutes, identifies the risk factors for HIV, and provides baseline information for the development and implementation of appropriate prevention and intervention strategies. METHODS. Structured interviews were conducted with and blood samples were collected from 235 actively working male prostitutes in Atlanta, Georgia, from July 1988 through July 1991. RESULTS. The HIV seroprevalence was 29.4%; 25.1% of the sample had seromarker for syphilis and 58.3% for hepatitis B. Multivariate logistic regression analysis showed the following significant HIV risk factors: history of receptive anal sex with nonpaying partners, serologic history of hepatitis B or syphilis, and history of childhood physical abuse. CONCLUSIONS. The reported seroprevalence rates among these male prostitutes indicate they are a high-risk group. The striking difference in HIV seroprevalence by sexual orientation may warrant special attention. Considering the public health consequences, there is a clear need for innovative HIV prevention and intervention among these men.