Risky Sexual Behavior Among Male 
Clients Of Tijuana Sex Workers Heightens Risk Of HIV Transmission
A study by a bi-national team of global health researchers at the University of California, San Diego School of Medicine, examining HIV infection among male clients of female sex workers in Tijuana, has found that over half of male clients had recently had unprotected sex. They also reported a high prevalence of drug use.
"Targeted intervention among male clients is necessary to prevent the spread of HIV and other sexually transmitted infections – intervention that doesn't solely place the onus on female sex workers," said lead author Thomas L. Patterson, of UC San Diego's Department of Psychiatry and the Veterans Administration Health Care System, San Diego.
Tijuana, located in Baja California, directly across the border with San Diego, has a thriving sex industry and is a popular destination for U.S. and foreign sex tourists. While the city's health service does license female sex workers, on condition that they are regularly tested for HIV and other sexually transmitted diseases (STIs), only about half of them are indeed licensed. In addition, Baja California has the second highest cumulative AIDS incidence of any Mexican state and, in 2006, the HIV prevalence among female sex workers in Tijuana was six percent. It has been estimated that as many as one in 112 persons aged 15-49 living in Tijuana is HIV-infected.
"Male clients of female sex workers in the San Diego-Tijuana border region act as a bridge that can potentially transmit HIV and other STIs to sex partners, including their wives," said co-author Manual Gallardo, M.D, Patronato Pro-COMUSIDA in Tijuana. "However, given that only 59% of clients reported regularly using condoms with a female sex worker, there appears to be some level of complacency that urgently needs to be addressed."
Earlier reports by UCSD researchers suggested that interactions with clients can be a critical barrier to the adaptation of safe sex practices among female sex workers, who reported that some clients are willing to pay double for unprotected sex.
"Our new data suggests an urgent need to develop behavioral interventions to improve the clients' knowledge of the risk of HIV," said co-author Steffanie Strathdee, PhD, associate dean for Global Health Sciences at UC San Diego. "Intensified efforts to 'test and treat' should reach out to this high-risk group in ways that are culturally sensitive, recognizing that some men fail to realize that sexual health is a shared responsibility."
reference
Correlates of HIV, sexually transmitted infections, and associated high-risk behaviors among male clients of female sex workers in Tijuana, Mexico
Patterson, Thomas L et al
AIDS, 3 July 2009 doi: 10.1097/QAD.0b013e32832f08a1
Link to AIDS abstract
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