Understanding the diversity of male clients of sex workers in China and the implications for HIV prevention programmes

Abstract

Male clients of sex workers have been overlooked in China's HIV prevention efforts. This study aims to examine men's practices and attitudes toward extramarital sexual relationships, motivations for visiting female sex workers (FSWs), perceptions of sexually transmitted infection (STI)/HIV risk and risk prevention strategies used. One hundred and eighty-six clients of FSWs with varying socio-economic statuses were interviewed in different sex work settings. Men described no conflict between their role as a client and a responsible family provider. They described social pressure from peers and business partners to visit FSWs, sexual pleasure and companionship as motivators to seek commercial sex. While some men reported no risks associated with visiting FSWs, others identified risks such as being arrested by the police, robbed by gangs and threatening the health of their families by contracting a STI. This study underscores the diversity of FSW clients and the need to understand the beliefs and behaviours of different client types to develop appropriate HIV prevention programmes. It also demonstrates the feasibility of recruiting different types of male clients, a hard-to-reach population for Chinese HIV prevention efforts.

Keywords:

• male client
• STI/HIV
• sex work
• gender
• risk perception

Acknowledgements

This research was supported by the Fundamental Research Funds for the Central Universities, the Research Funds of Renmin University of China (10XNK041, PI: Huang Y.Y.) and the National Institute of Child and Human Development grant, ‘Partnership for Social Science Research on HIV/AIDS in China’ (R24 HD056670). We appreciate Laurie Abler's and University of North Carolina's Center for AIDS Research's (P30 AI50410) help with final editing. The other team members are: Liu Zhongyi and Wangjie.