OBJECTIVETo monitor the current HIV prevalence, related risk behaviors and factors for HIV infection among the elderly male clients of the commercial female sex-workers (CFSW)in Guangxi.

METHODSFace to face interview on male clients aged ≥40 years old was carried out in April to July, 2012. Information on demography, awareness of HIV prevention, related risk behaviors, history on HIV testing etc. were collected, with 3-5 ml full blood collected for testing on HIV. Data was analyzed by SPSS 18.0 software.

RESULTS4260 clients were surveyed at 14 surveillance sites in which 82.1% had received secondary or lower education, 72.0% experienced commercial sex in places with low-class sex trade. HIV awareness rate of clients was 74.2% in which the rate of clients who were HIV positive was 65.8%. Among all the clients, 73 were detected as HIV positive, with the HIV positive rate as 1.40% . Samples from voluntary counseling and testing sites showed higher risk to HIV infection than from other sources (OR = 23.672, 95%CI:4.984-112.434). Samples from middle class population showed lower risk to HIV infection than those at low class (OR = 0.410, 95%CI:0.190-0.885). Among those who were syphilis negative (OR = 0.255, 95%CI: 0.132-0.491) or hepatitis C virus (HCV)negative (OR = 0.154, 95% CI:0.059-0.401), the risk of getting HIV infected seemed to be low. Rate on condom use was low for clients among all of the sex-related behaviors regardless of the marriage status. In those lower-class sex trade places, lower rate on the condom use was seen. Rate for previous HIV testing for clients was only 4.6% . Among 41 clients who had received CD4 testing, 80.5% of them showed CD4 under 350 cell/µl, 61.0% were under 200 cell/µl.

CONCLUSIONThe HIV positive rate for elderly male clients of the CFSWs was high in Guangxi. Unprotective sexual contact with low class sex workers was the most important risk factor for HIV infection.