Information about male customers of male prostitutes, including sociodemographic and life-style characteristics, sexual and drug use behaviors, and knowledge about HIV infection were collected from a convenience sample of 211 male street prostitutes and a convenience sample of 15 male customers as part of a feasibility study. Data from these two groups indicate that despite knowledge of HIV infection and its transmission, customers engage in high-risk sexual and drug use behaviors with prostitutes. Because there is a high HIV infection rate within the male prostitute sample (175/1000) and because these customers for the most part describe themselves as bisexual or heterosexual, it is likely that male customers of male prostitutes serve as a vector of transmission of HIV infection to their other partners including the heterosexual population.
PIP: A sample of 211 adult male street prostitutes and a sample of 15 male customers of male prostitutes were recruited from the Greater New Orleans metropolitan area at the Louisiana State University Medical Center. The prostitutes were tested for HIV using the enzyme-linked immunosorbent assay and the Western Blot. Sociodemographic characteristics, sexual behavior patterns, drug use patterns, knowledge of safer sex, safe drug practices, and HIV transmission data were obtained by interviews. The prostitutes were equally distributed across age 25 and age 25 and IV vs. non-IV drug use. 105 were White, and 196 were Black. Educational level ranged from completion of Grade 1 to college. The customers include 8 Blacks and 7 Whites with an age range of 19-49 years. 7 had never been married, 4 were currently married, and 4 were either separated or divorced. The prostitutes were positive that at least 40% of their customers were married at the time of their encounters. 8 of the customers were bisexual. 6 saw themselves as heterosexual, while 1 identified himself as homosexual. 99% of the prostitutes indicated that they perform oral-genital sex with their customers. When the customer was the insertive partner, the prostitutes states that 46% wore a condom. When the prostitute was the insertive partner in anal sex, 67% of their customers did not request use of a condom. Almost 30% of the prostitutes perceived that customers solicited them for high-risk sexual acts. 8 of the customers reported that they never wore a condom. The other 7 customers said that they never work them with their regular sexual partner(s). 57% of the prostitutes reported using alcohol and drugs with their customer. Among IV drug-using prostitutes, 28% injected drugs and shared needles with their customers. Customers exhibited an accurate knowledge of AIDS, modes of HIV transmission, and safer sex practices, 11 customers said that they had been tested previously for antibodies to HIV. One indicated that he was HIV seropositive, 9 said that they were negative, and 1 subject had not yet received his test results.