Journal of Urban Health

, Volume 88, Issue 3, pp 533–544 | Cite as

Bridging Populations—Sexual Risk Behaviors and HIV Prevalence in Clients and Partners of Female Sex Workers, Bangkok, Thailand 2007

  • Neha S. Shah
  • Ray W. Shiraishi
  • Wonchart Subhachaturas
  • Abhijeet Anand
  • Sara J. Whitehead
  • Suvimon Tanpradech
  • Chomnad Manopaiboon
  • Keith M. Sabin
  • Kimberley K. Fox
  • Andrea Y. Kim


The aim of this study is to estimate HIV prevalence and assess sexual behaviors in a high-risk and difficult-to-reach population of clients of female sex workers (FSWs). A modified variation of respondent-driven sampling was conducted among FSWs in Bangkok, where FSWs recruited 3 FSW peers, 1 client, and 1 nonpaying partner. After informed consent was obtained, participants completed a questionnaire, were HIV-tested, and were asked to return for results. Analyses were weighted to control for the design of the survey. Among 540 FSWs, 188 (35%) recruited 1 client, and 88 (16%) recruited 1 nonpaying partner. Clients’ median age was 38 years. HIV prevalence was 20% and was associated with younger age at first sexual experience [relative risk (RR) = 3.10, 95% confidence interval (CI) 1.16–8.24] and condom use during last sexual encounter with regular partner (RR = 3.97, 95% CI 1.09–14.61). Median age of nonpaying partners was 34 years, and HIV prevalence was 15.1%. There were 56 discordant FSW–client pairs and 14 discordant FSW–nonpaying partner pairs. Condom use was relatively high among discordant FSW–client pairs (90.1%) compared to discordant FSW–nonpaying partner pairs (18.7%). Results suggest that sexual partners of FSWs have a high HIV prevalence and can be a bridge for HIV transmission to other populations. Findings also highlight the importance of initiating surveillance and targeted programs for FSW partners, and demonstrate a recruitment method for hard-to-reach populations.


Female sex workers Thailand Bridge population Male clients HIV 


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Copyright information

© The New York Academy of Medicine (outside the USA) 2011

Authors and Affiliations

  • Neha S. Shah
    • 1
  • Ray W. Shiraishi
    • 1
  • Wonchart Subhachaturas
    • 2
  • Abhijeet Anand
    • 1
  • Sara J. Whitehead
    • 1
    • 3
  • Suvimon Tanpradech
    • 3
  • Chomnad Manopaiboon
    • 3
  • Keith M. Sabin
    • 1
  • Kimberley K. Fox
    • 1
    • 3
  • Andrea Y. Kim
    • 1
  1. 1.Global AIDS Program, National Center for HIV, Viral Hepatitis, STD and TB PreventionCenters for Disease Control and PreventionAtlantaUSA
  2. 2.Bangkok Metropolitan AdministrationBangkokThailand
  3. 3.Thailand MOPH – U.S. Centers for Disease Control and Prevention CollaborationBangkokThailand

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