Skip to main content

Advertisement

SpringerLink
Log in

Acceptability of Circumcision Among Clients of Female Sex Worker in Hong Kong

  • Original Paper
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

Clients of female sex workers (CFSW) are at high risk of HIV transmission. Circumcision reduces the risk of heterosexual transmission of HIV. A total of 353 CFSW were interviewed using a combined interviewer-computer-assisted method. Amongst the participants, 28.0% were circumcised, whilst 63.8% of the uncircumcised participants were willing to take up circumcision (conditioned on being briefed about a 50% potential risk reduction effect). In a stepwise logistic regression model, frequency of patronizing female sex workers and factors related to the Health Belief Model were significantly associated with conditional willingness. Amongst uncircumcised participants, 20.9% anticipated risk compensation (i.e. would use condoms less frequently after being circumcised). Adjusting for background variables, inconsistent condom use during commercial sex and self-reported STD history in the last 6 months were significantly associated with anticipated risk compensation. It is feasible to promote circumcision among CFSW but such programs also need to promote condom use.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Parish WL, Laumann EO, Cohen MS, et al. Population-based study of chlamydial infection in China: a hidden epidemic. JAMA. 2003;289(10):1265–73.

    Article  PubMed  Google Scholar 

  2. Lau JT, Tsui HY. Behavioral surveillance surveys of the male clients of female sex workers in Hong Kong: results of three population-based surveys. Sex Transm Dis. 2003;30(8):620–8.

    Article  PubMed  Google Scholar 

  3. Wang B, Li X, Shanton B, Fang X, Lin D, Mao R. HIV-related risk behaviors and history of sexually transmitted diseases among male migrants who patronize commercial sex in China. Sex Transm Dis. 2007;34(1):1–8.

    Article  PubMed  Google Scholar 

  4. Nguyen NT, Nguyen HT, Trinh HQ, Mills SJ, Detels R. Clients of female sex workers as a bridging population in Vietnam. AIDS Behav. 2009;13(5):881–91.

    Article  PubMed  Google Scholar 

  5. Lau JTF, Tang ASY, Tsui HY. The relationship between condom use, sexually transmitted diseases, and location of commercial sex transaction among male Hong Kong clients. AIDS. 2003;17(1):105–12.

    Article  PubMed  Google Scholar 

  6. Brown T, Peerapatanapokin W. The Asian epidemic model: a process model for exploring HIV policy and programme alternatives in Asia. Sex Transm Infect. 2004;80(suppl 1):i9–24.

    Google Scholar 

  7. Xu JJ, Wang N, Lu L, et al. HIV and STIs in clients and female sex workers in mining regions of Gejiu City, China. Sex Transm Dis. 2008;35(6):558–65.

    Article  PubMed  Google Scholar 

  8. Jin X, Smith K, Chen RY, et al. HIV prevalence and risk behaviors among male clients of female sex workers in Yunnan. China J Acquir Immune Defic Syndr. 2010;53(1):131–5.

    Article  Google Scholar 

  9. Yang C, Latkin C, Luan R, Nelson K. Peer norms and consistent condom use with female sex workers among male clients in Sichuan province, China. Soc Sci Med. 2010;71(4):832–9.

    Article  PubMed  Google Scholar 

  10. Lau JT, Wan SP, Yu XN, et al. Changes in condom use behaviours among clients of female sex workers in China. Sex Transm Infect. 2009;85:376–82.

    Article  PubMed  CAS  Google Scholar 

  11. Ma WJ, Wang JJ, Reilly KH, et al. Estimation of probability of unprotected heterosexual vaginal transmission of HIV-1 from clients to female sex workers in Kaiyuan, Yunnan Province, China. Biomed Environ Sci. 2010;23(4):287–92.

    Article  PubMed  Google Scholar 

  12. Yang C, Latkin C, Luan R, Nelson K. Condom use with female sex workers among male clients in Sichuan Province, China: the role of interpersonal and venue-level factors. J Urban Health. 2010;87(2):292–303.

    Article  PubMed  Google Scholar 

  13. Hong Y, Li X, Fang X, Zhao R. Depressive symptoms and condom use with clients among female sex workers in China. Sex Health. 2007;4(2):99–104.

    Article  PubMed  Google Scholar 

  14. Wang Y, Jiang Y, Lu L, et al. Microbicide acceptability and associated factors among female sex workers and male clients in Kaiyuan county, Yunnan province, China. J Acquir Immune Defic Syndr. 2010;53(Suppl 1):S93–7.

    PubMed  Google Scholar 

  15. Lau JTF, Tsui HY, Cheng S, Pang M. A randomized controlled trial to evaluate the relative efficacy of adding voluntary counseling and testing (VCT) to information dissemination in reducing HIV-related risk behaviors among Hong Kong male cross-border truck drivers. AIDS Care. 2010;22(1):17–28.

    Article  PubMed  Google Scholar 

  16. Auvert B, Taljaard D, Lagarde E, Sobngwi–Tambekou J, Sitta R, Puren A. Randomized, controlled intervention trial of male circumcision for reduction of HIV infection risk: the ANRS 1265 Trial. PLoS Med. 2005;2(11):e298.

    Article  PubMed  Google Scholar 

  17. Bailey RC, Moses S, Parker CB, et al. Male circumcision for HIV prevention in young men in Kisumu, Kenya: a randomised controlled trial. Lancet. 2007;369(9562):643–56.

    Article  PubMed  Google Scholar 

  18. Gray RH, Kigozi G, Serwadda D, et al. Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial. Lancet. 2007;369(9562):657–66.

    Article  PubMed  Google Scholar 

  19. Siegfried N, Muller M, Deeks JJ, Volmink J. Male circumcision for prevention of heterosexual acquisition of HIV in men. Cochrane Database Syst Rev. 2009;2:CD003362.

    Google Scholar 

  20. Tobian AA, Serwadda D, Quinn TC, et al. Male circumcision for the prevention of HSV-2 and HPV infections and Syphilis. N Eng Med. 2009;360:1298–309.

    Article  CAS  Google Scholar 

  21. Weiss HA, Thomas SL, Munabi SK, Hayes RJ. Male circumcision and risk of syphilis, chancroid, and genital herpes: a systematic review and meta-analysis. Sex Transm Infect. 2006;82:101–10.

    Article  PubMed  CAS  Google Scholar 

  22. Fan YM, Ma ZL, Wu ZH, Li SF, Chen QX. Combination of circumcision and microwave in treatment of genital warts in uncircumcised patients. Chin J Sex Transm infect. 2003;3:17–21.

    Google Scholar 

  23. Jerath VP, Mahajan VK. Does circumcision influence recurrences in herpes genitalis? Indian J Dermatol Venereol Leprol. 2009;75(6):575–8.

    Article  PubMed  CAS  Google Scholar 

  24. Gray RH, Kigozi G, Serwadda D, et al. The effects of male circumcision on female partners’ genital tract symptoms and vaginal infections in a randomized trial in Rakai, Uganda. Am J Obstet Gynecol. 2009; 200(1): 42 e1-7.

    Google Scholar 

  25. WHO/UNAIDS Technical Consultation. Male circumcision and HIV prevention: Research implications for policy and programming montreux, 6–8 March 2007.

  26. Feng N, Lu F, Zeng G, et al. Acceptability and related factors on male circumcision among young men with Yi ethnicity in one country of Sichuan province. Zhonghua Liu Xing Bing Xue Za Zhi. 2010;31(3):281–5.

    PubMed  Google Scholar 

  27. Ruan YH, Qian HZ, Li DL, et al. Willingness to be circumcised for preventing HIV among Chinese men who sex with men. AIDS Patient Care STDs. 2009;23(5):315–21.

    Article  PubMed  Google Scholar 

  28. Lau JTF, Yan HJ, Lin CQ, et al. How willing are men who sex with men in China to be circumcised for the sake of protecting his female sex partner? J Sex Med. 2010. doi:10.1111/j.1743-6109. 2010. 02050. x [Epub ahead of print].

  29. Tieu HV, Phanuphak N, Ananworanich J, et al. Acceptability of male circumcision for the prevention of HIV among high-risk heterosexual men in Thailand. Sex Transm Dis. 2010;37(6):352–5.

    PubMed  Google Scholar 

  30. Westercamp N, Bailey RC. Acceptability of male circumcision for Prevention of HIV/AIDS in Sub-Saharan Africa: a review. AIDS Behav. 2007;11:341–55.

    Article  PubMed  CAS  Google Scholar 

  31. Brito MO, Caso LM, Balbuena H, Bailey RC. Acceptability of Male circumcision for prevention of HIV/AIDS in Dominican Republic. PloS ONE. 2009;4(11):e7687.

    Article  PubMed  Google Scholar 

  32. Riess TH, Achieng’ MM, Otieno S, Ndinya-Achola JO, Bailey RC. When I was circumcised I was taught certain things: risk compensation and protective sexual behavior among circumcised men in Kisumu, Kenya. PLoS ONE. 2010;5(8):e12366.

    Article  PubMed  Google Scholar 

  33. Eaton LA, Kalichman SC. Risk compensation in HIV Prevention: Implication for vaccine, Microbicides, and Other Biomedical HIV Prevention Technologies. Curr HIV/AIDS Rep. 2007;4(4):165–72.

    Article  PubMed  Google Scholar 

  34. Hogben M, Liddon N. Disinhibition and risk compensation, scope, definitions, and perspective. Sex Transm Dis. 2008;35(12):1009–10.

    PubMed  Google Scholar 

  35. Mausbach BT, Semple SJ, Strathdee SA, Patterson TJ. Predictors of safer sex intentions and protected sex among heterosexual HIV-negative methamphetamine users: an expanded model of theory of planned behavior. AIDS Care. 2009;21(1):17–24.

    Article  PubMed  Google Scholar 

  36. Janz NK, Becker MH. The health belief model: a decade later. Health Educ Behav. 1984;11(1):1–47.

    Article  CAS  Google Scholar 

  37. Lau JT, Thomas J, Liu JL. Mobile phone and interactive computer interviewing to measure HIV-related risk behaviours: the impacts of data collection methods on research results. AIDS. 2000;14(9):1277–9.

    Article  PubMed  CAS  Google Scholar 

  38. Ben KL, Xu JC, Lu L, et al. Promoting male circumcision in China for preventing HIV infection and improving reproductive health. ZhongHuaNanKeXue. 2008;14(4):291–7.

    Google Scholar 

  39. Sullivan PS, Kilmarx PH, Peterman TA, et al. Male circumcision for prevention of HIV transmission: what the new data mean for HIV prevention in the United States. PLOS Med. 2007;4(7):1162–6.

    Article  Google Scholar 

  40. Castro JG, Jones DL, Lopez MR, Deeb K, Barradas I, Weiss SM. Acceptability of neonatal circumcision by Hispanics in South Florida. Int J STD AIDS. 2010;21:591–4.

    Article  PubMed  CAS  Google Scholar 

  41. Lukobo MD, Bailey RC. Acceptability of male circumcision for prevention of HIV infection in Zambia. AIDS Care. 2007;19(4):471–7.

    Article  PubMed  CAS  Google Scholar 

  42. Ruan FF. Changing attitudes toward sex in China today. In: Ruan FF, editor. Sex in China: studies in sexology in Chinese culture. New York: Plenum Press; 1991.

    Google Scholar 

  43. Cassell MM, Halperin DT, Shelton JD, Standton D. Risk Compensation: the Achilles’ heel of innovation in HIV prevention? BMJ. 2006;332:605–7.

    Article  PubMed  Google Scholar 

  44. Rotheram–Borus MJ, Swendeman D, Chovnicl G. The past, present, and future of HIV prevention: Integrating behavioral, biomedical, and structural intervention strategies for the next generation of HIV prevention. Annu Rev Clin Psychol. 2009;5:143–67.

    Article  PubMed  Google Scholar 

  45. Prata N, Morris L, Mazive E, Vahidnia F, Stehr M. Relationship between HIV risk perception and condom use: Evidence from a population-based survey in Mozambique. Int Fam Plan Perspect. 2006;32(4):192–200.

    Article  PubMed  Google Scholar 

  46. Maharaj P, Cleland J. Risk perception and condom use among married or cohabiting couples in KwaZulu-Natal, South Africa. Int Fam Plan Perspect. 2005;31(1):24–9.

    Article  PubMed  Google Scholar 

  47. Bengel J, Belz-merk M, Farin E. The role of risk perception and efficacy cognitions in the prediction of HIV-related preventive behavior and condom use. Psychol Health. 1996;11(4):505–25.

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

The author would like to thank all respondents for their participation in the study. The study was supported by the Hong Kong Council for the AIDS Trust Fund.

Author information

Authors and Affiliations

  1. Division of Health Improvement, School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China

    Zixin Wang & Joseph T. F. Lau

  2. School of Public Health, Sun Yat-sen University, Guangzhou, China

    Jing Gu

  3. Centre for Medical Anthropology and Behavioral Health, Sun Yat-sen University, Guangzhou, China

    Joseph T. F. Lau & Jing Gu

  4. 5/F, School of Public Health and Primary Care, Centre for Health Behaviours Research, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, NT, China

    Joseph T. F. Lau

Authors
  1. Zixin Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Joseph T. F. Lau
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jing Gu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Joseph T. F. Lau.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Wang, Z., Lau, J.T.F. & Gu, J. Acceptability of Circumcision Among Clients of Female Sex Worker in Hong Kong. AIDS Behav 16, 1836–1845 (2012). https://doi.org/10.1007/s10461-011-0088-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-011-0088-7

Keywords

Search

Navigation