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Heterosexual men who patronise entertainment establishments versus brothels in an Asian urban setting - which group practises riskier sexual behaviours?
BMC Public Health. 2015 Aug 14; 15:777.BP

Abstract

BACKGROUND

Sex work has shifted from brothels to entertainment establishments (EEs) in Asia. Men who patronise EEs could act as a bridging population for human immunodeficiency virus (HIV) and sexually transmitted infection (STI) transmission through unprotected sex with the female EE workers to their spouses and regular partners. The aim of this study was to compare the prevalence and factors associated with risky sexual behaviours among the heterosexual men who patronised the EEs and brothels in Singapore.

METHODS

This was a cross-sectional survey involving 569 heterosexual men (297 recruited from brothels and 272 from EEs). A 2-stage sampling involving proportional stratified random sampling of the brothels and EEs, followed by time location sampling of the men, was conducted. For multivariable analysis, we used a mixed effects logistic model with backward elimination to account for clustering by venue and to obtain the adjusted odds ratio (aOR) for the association of various factors with consistent condom use in vaginal and oral sex respectively.

RESULTS

Men who patronised EEs were younger, more likely to be single, more highly-educated and comprised more professionals compared to the brothel group. On multivariable analysis, consistent condom use for vaginal sex decreased at the EE setting (aOR 0.64; 95 % CI: 0.42 -0.97) and with alcohol use before sex (aOR 0.67; 95 % CI: 0.46 - 0.98) and increased with perceived high risk of getting HIV/STIs from partner (aOR 2.08; 95 % CI: 1.30 - 3.32) and partner's request for condom use (aOR 5.48; 95 % CI: 1.20 - 25.11). For consistent condom use with oral sex, this decreased at the EE setting (aOR 0.64; 95 % CI: 0.39 - 0.98) and with alcohol use before sex (aOR 0.50; 95 % CI: 0.31 - 0.81) and increased with partner's request for condom use (aOR 5.19; 95 % CI: 1.38 - 19.57).

CONCLUSIONS

Men who patronised EEs practised risker sexual behaviours compared to the brothel group. Priority should be given for intervention programmes to target men who patronise EEs, which could involve the female EE workers, the EE owners as well as the managers for effective HIV/STI prevention.

Authors+Show Affiliations

Saw Swee Hock School of Public Health, National University of Singapore, Tahir Foundation Building, 12 Science Drive 2, 117549, Singapore, Singapore. raymondlim1302@gmail.com.Saw Swee Hock School of Public Health, National University of Singapore, Tahir Foundation Building, 12 Science Drive 2, 117549, Singapore, Singapore. ephwml@nus.edu.sg.Duke-National University of Singapore Graduate Medical School, 8 College Road, 169857, Singapore, Singapore. calvin.tan@duke-nus.edu.sg.Health Promotion Board, 3 Second Hospital Avenue, 168937, Singapore, Singapore. mandy_govender@hpb.gov.sg.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26272078

Citation

Lim, Raymond Boon Tar, et al. "Heterosexual Men Who Patronise Entertainment Establishments Versus Brothels in an Asian Urban Setting - Which Group Practises Riskier Sexual Behaviours?" BMC Public Health, vol. 15, 2015, p. 777.
Lim RB, Wong ML, Tan PH, et al. Heterosexual men who patronise entertainment establishments versus brothels in an Asian urban setting - which group practises riskier sexual behaviours? BMC Public Health. 2015;15:777.
Lim, R. B., Wong, M. L., Tan, P. H., & Govender, M. (2015). Heterosexual men who patronise entertainment establishments versus brothels in an Asian urban setting - which group practises riskier sexual behaviours? BMC Public Health, 15, 777. https://doi.org/10.1186/s12889-015-2132-4
Lim RB, et al. Heterosexual Men Who Patronise Entertainment Establishments Versus Brothels in an Asian Urban Setting - Which Group Practises Riskier Sexual Behaviours. BMC Public Health. 2015 Aug 14;15:777. PubMed PMID: 26272078.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Heterosexual men who patronise entertainment establishments versus brothels in an Asian urban setting - which group practises riskier sexual behaviours? AU - Lim,Raymond Boon Tar, AU - Wong,Mee Lian, AU - Tan,Poh Huat, AU - Govender,Mandy, Y1 - 2015/08/14/ PY - 2014/12/31/received PY - 2015/08/10/accepted PY - 2015/8/15/entrez PY - 2015/8/15/pubmed PY - 2016/2/19/medline SP - 777 EP - 777 JF - BMC public health JO - BMC Public Health VL - 15 N2 - BACKGROUND: Sex work has shifted from brothels to entertainment establishments (EEs) in Asia. Men who patronise EEs could act as a bridging population for human immunodeficiency virus (HIV) and sexually transmitted infection (STI) transmission through unprotected sex with the female EE workers to their spouses and regular partners. The aim of this study was to compare the prevalence and factors associated with risky sexual behaviours among the heterosexual men who patronised the EEs and brothels in Singapore. METHODS: This was a cross-sectional survey involving 569 heterosexual men (297 recruited from brothels and 272 from EEs). A 2-stage sampling involving proportional stratified random sampling of the brothels and EEs, followed by time location sampling of the men, was conducted. For multivariable analysis, we used a mixed effects logistic model with backward elimination to account for clustering by venue and to obtain the adjusted odds ratio (aOR) for the association of various factors with consistent condom use in vaginal and oral sex respectively. RESULTS: Men who patronised EEs were younger, more likely to be single, more highly-educated and comprised more professionals compared to the brothel group. On multivariable analysis, consistent condom use for vaginal sex decreased at the EE setting (aOR 0.64; 95 % CI: 0.42 -0.97) and with alcohol use before sex (aOR 0.67; 95 % CI: 0.46 - 0.98) and increased with perceived high risk of getting HIV/STIs from partner (aOR 2.08; 95 % CI: 1.30 - 3.32) and partner's request for condom use (aOR 5.48; 95 % CI: 1.20 - 25.11). For consistent condom use with oral sex, this decreased at the EE setting (aOR 0.64; 95 % CI: 0.39 - 0.98) and with alcohol use before sex (aOR 0.50; 95 % CI: 0.31 - 0.81) and increased with partner's request for condom use (aOR 5.19; 95 % CI: 1.38 - 19.57). CONCLUSIONS: Men who patronised EEs practised risker sexual behaviours compared to the brothel group. Priority should be given for intervention programmes to target men who patronise EEs, which could involve the female EE workers, the EE owners as well as the managers for effective HIV/STI prevention. SN - 1471-2458 UR - https://www.unboundmedicine.com/medline/citation/26272078/Heterosexual_men_who_patronise_entertainment_establishments_versus_brothels_in_an_Asian_urban_setting___which_group_practises_riskier_sexual_behaviours L2 - https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-015-2132-4 DB - PRIME DP - Unbound Medicine ER -