Knowledge, risk perceptions and condom usage in male sex workers from three Australian cities

The study identifies factors associated with knowledge and perception of risk of HIV/AIDS, as well as attitudes to and usage of condoms by a sample of male sex workers (MSW). One hundred and eighty-five male sex workers completed a self-reported questionnaire, including knowledge about HIV transmission, attitudes to condom use and perceptions and personal susceptibility to HIV and sexually transmitted infection (STI) risk, and a two-week diary recording use of condom during commercial sex encounters. The findings reveal that condom use was found in 77.7% of the encounters with clients and the majority of the respondents perceived themselves to be at no risk for HIV because of sex work. Independent sex workers from Melbourne and workers who owned their place of residence used condoms in a significant lower proportion. Generally speaking, knowledge about the risks associated with AIDS was high, with respondents showing lower knowledge about the risks associated with unprotected receptive or active oral sex. Participants held a positive attitude to condom use; most considered the provisions of condoms to be their responsibility rather than clients; and they were more worried about contracting an STI than HIV. Those who scored higher on the knowledge scale had more positive attitudes to condom use and those who had a more positive attitude to condom use recorded a perceived lower risk of contracting STI but not HIV. The study discusses the relevance of these findings for public health risk reduction and sexual health education campaigns.