Sociodemographic characteristics and HIV risk behaviour patterns of male sex workers in Madrid, Spain

This paper describes the sociodemographic and work characteristics, prevale nce of HIV infection and associated risk behaviours among male sex workers (MSWs) in Madrid (Spain). Using an anonymous semi-structured questionnaire, educators attached to a mobile unit under a street-based prostitution prog ramme surveyed 84 MSWs from several Madrid areas. Of the total surveyed: 35 % were immigrants, mean age was 23 years, mean period in prostitution was f our years; 21% had no primary education; 16% had injected drugs at some tim e; 11% reported private sexual relationships exclusively with women; 89% al ways used condoms in anal practices with clients; and 41% were in sexual re lationships with their partners. Only 11% had ever used fortified condoms. In the preceding month, 37% had experienced condom failure, 82% without hav ing used any lubricant. In all, 67% reported having undergone HIV testing, with a higher percentage of positive results among injecting (60%) versus n on-injecting drug users (17%). Immigrants had a lower level of education, m ade less use of condoms, had more condom failures and, in their private liv es, a greater proportion reported sexual relationships exclusively with wom en. In Spain, MSWs should be included in HIV prevention programmes, which o ught to be specifically adapted to immigrants. Priority should be given to reducing the condom failure rate in anal intercourse, by improving access t o fortified condoms.