Assessment of HIV-related sexual risk behaviors among the general female population in Hong Kong.

This study examined sexual practices among the female population in Hong Kong. A total of 2,076 women between 18 and 50 years were interviewed by using a computerized telephone survey method. Sexually active women (59.3%) were classified into the "Husband Only Group" (HOG, n = 1,005), the "Steady Boyfriend Only Group" (SBG, n = 192), and the "Higher Risk Group" (HRG, n = 35). Over 60% of the HRG members did not perceive condom use as an efficacious means for HIV/AIDS prevention. Within the HOG and SBG, 30.0% and 41.1% reported that they always used condoms (25.7% in the HRG). Condom use was often suggested by both men and women of the SBG, but was often initiated by the women only in the HRG. "Trust" and "lack of necessity" were common reasons for not using condoms. About 85% of the respondents would ask their partners to use condoms if they suspected their partners having engaged in commercial sex; however, only 75% would have the final control. The HRG members seemed to be less able to insist on using condoms (55.6%, OR = 0.41, p < .05) and were more likely than the HOG to perceive some chance of contracting HIV (OR = 10.88, p < .01). The prevalence of high risk behaviors among women in Hong Kong was not high; however, those at risk were often inconsistent condom users and they had weak control over condom use. Women in Hong Kong had low awareness of HIV-related risk.

Behavioral surveillance and factors associated with condom use and std incidences among the male commercial sex client population in Hong Kong--results of two surveys.

The present study compared the results of behavioral surveillance data obtained on the male clients of female sex workers (FSWs) population in Hong Kong. Two surveys, using an identical method, were completed in 1998 and 2000. Respectively, 1,020 and 2,074 respondents aged 18-60 who were randomly selected from the general population participated in the study. About 12% of the respondents had patronized FSWs in the past 6 months in 2000 as compared with 14% in 1998 (p = .143). Crossing the border for sex and purchasing sex in multiple geographic areas was very common and a higher percentage of respondents reported having patronized FSWs in mainland China in 2000 than in 1998 (p = .003). About 25% of the respondents in both surveys had not always been using condoms (i.e., not used condoms every time) when having sexual intercourse with FSWs. Those who practiced commercial sex in mainland China were less likely to have always been using condoms with FSWs (p < .01) and were more likely to have ever contracted STD in the past 6 months (p < .05), when compared with those who had purchased sex only in Hong Kong or in other places.

A study of the STD/AIDS related attitudes and behaviors of men who have sex with men in Hong Kong.

A random population based study was carried out to understand HIV-related attitudes and behaviors and self-reported sexually transmitted diseases (STDs) among men who have had sex with men (MSM) in Hong Kong. A special computerized telephone survey method was used and 85 MSM were identified (from a total sample of 2,074 men), 47.1% of whom had at least one male sex partner in the past 6 months. Among these 85 MSM, 29.4% had multiple partners and 37.5% had had anal sex in the last 6 months (67% of them were inconsistent condom users). MSM were more likely to have contracted at least one STD in the last 6 months (10.6%) and were less likely to perceive susceptibility for contracting HIV (62.4%) than those other respondents who visited a female sex worker (FSW) in the past 6 months (4.3% and 43%, respectively). About 45% of the MSM did not perceive condom use to be efficacious for HIV prevention (vs. 30% for male clients of FSW). The study is limited by its small number; however, it suggests that MSM in Hong Kong may be at high risk of contracting HIV. Prevention programs should attempt to change attitudes (e.g., perceived efficacy of condom use, perceived susceptibility, awareness of risk involved, etc.) as well as behaviors. The feasibility for establishing a behavioral surveillance system for this population was demonstrated.

A study on female sex workers in southern China (Shenzhen): HIV-related knowledge, condom use and STD history.

The present study aims to investigate the perspective relations between HIV/AIDS and condom-related knowledge, condom use, history of sexually transmitted diseases (STDs) and predictive factors of condom use by female sex workers (FSW) who were sent to the Women Re-education Center (WRC) in Shenzhen, People's Republic of China. Seven hundred and one FSW were interviewed. Whereas respondents had attained certain accurate knowledge about the HIV transmission routes, misconceptions were still commonly reported. Level of condom related knowledge was not high. The prevalence of using condoms with clients was relatively low-15%- 22% reported not using condoms consistently. One of the major obstacles was 'Refusal by clients'. Significant predictive factors associated with consistency of condom use with clients were age, educational background, average number of client intakes per day, capacity in determining the use of condoms and past STD history. The respondents may have developed a false sense of safety by subjectively assessing whether their clients had a STD but they were unaware that HIV carriers may show no obvious symptoms at all. The data has confirmed the worries regarding the potential 'bridging effect' of HIV transmission as resulted by cross-border commercial sex-networking activities.

Behavioural surveillance of sexually-related risk behaviours of the Chinese male general population in Hong Kong: a benchmark study.

The objective of the study was to establish a behavioural surveillance system (BSS) for sexually-related risk behaviours of the Hong Kong adult male general population. Benchmark data were obtained by interviewing 1,020 male respondents, age 18 to 60. The results showed that: (1) 14% of the respondents had engaged in commercial sex in the past six months, (2) 27% of the male commercial sex clients did not always use condoms when having sexual intercourse with commercial sex workers (CSWs), (3) 1.5% of the respondents had contracted sexually transmitted diseases (STDs) in the past six months, (4) 6.1% of respondents had only ever had sex with a man, (5) 0.8% of the respondents had practised unprotected anal intercourse with a man in a six-month period, (6) 4.4% of respondents practised sexually-related high risk behaviours, defined as unprotected sex with a CSW or unprotected anal intercourse with a man, and (7) 36.4% of those who engaged in commercial sex had not used condoms with their regular sex partners. Commercial sex was often practised outside Hong Kong, very commonly in Mainland China or Macau, and was often practised at multiple locations by the same client. Effective programmes have to be able to reduce the size of the at-risk population. This study together with future ones, will form the first BSS in Hong Kong for the general male population and will provide a relevant yardstick for programme evaluation.