Psychosexual and social-cognitive correlates of sexual risk behavior among male clients of female sex workers in Tijuana, Mexico

Abstract

Male clients of female sex workers (FSWs) may act as a bridge to the general population contributing to the spread of HIV and other sexually transmitted infections (STIs) in the USA and Mexico. This study used cross-sectional data to identify psychosexual and social-cognitive factors associated with sexual risk behavior in a bi-national sample of 300 male clients of FSWs recruited in Tijuana, Mexico from June to October 2008. In a multiple regression analysis, the number of unprotected vaginal sex acts with FSWs was associated with higher sexual compulsivity scores, lower self-efficacy for condom use, greater use of illicit drugs, and more financial need. Behavioral interventions are urgently needed to assist clients of FSWs in reducing high-risk behaviors in an effort to prevent the spread of HIV/STIs in this high-risk population and their sexual partners.

Keywords:

• male clients
• female sex workers
• sexual risk behavior
• US–Mexico border

Acknowledgements

This research was supported by the International Pilot Program of the UCSD Center for AIDS Research, grant number P30AI036214 (D. Richman, Director) from the National Institute of Allergy and Infectious Diseases. Additional support was received from an administrative supplement to NIH grant number R01DA23877 (S. Strathdee, P.I.) from the National Institute of Drug Abuse. The authors would also like to thank the study staff for their efforts and participants for their time; Brian Kelly for editing assistance; and the following organizations for their cooperation: the Municipal and State Health Department of Tijuana, Baja California; Patronato Pro-COMUSIDA, Tijuana; and the County Health Department of San Diego for its assistance with STI and HIV testing.