Homosexual prostitution among male drug users and its risk for HIV infection.

Objective: to assess whether male prostitution is an independent risk factor for HIV infection among male (intravenous and nonintravenous) drug users.
Design: a cross-sectional study.
Setting: various low-threshold methadone clinics and the sexually transmitted diseases clinic of the Municipal Health Service in Amsterdam and a drug-treatment centre in The Hague.
Participants: 343 male intravenous drug users and 106 male non-intravenous drug users.
Main Outcome Measures: characteristics concerning drug use behaviour, sexual behaviour, and sociodemography, related to prostitution and HIV-antibodies.
Results: of the 449 study participants, 88 (20%) reported a history of prostitution; no differences were found between intravenous and non-intravenous drug users. Younger age, West German nationality, and having had private homosexual sex contacts, were independent predictors of a history of prostitution. Independent predictors of HIV infection were (1) longer residency in Amsterdam; (2) having had predominantly homosexual private sex contacts; (3) longer duration of intravenous drug use; and (4) frequent needle sharing.
Conclusion: no evidence was found to suggest that male prostitution in itself contributed to the risk of HIV infection.