Male clients of brothel prostitutes as a bridge for HIV infection between high risk and low risk groups of women in Senegal.

OBJECTIVE To explore the extent to which male clients of prostitutes have a role as a bridge in the spread of HIV into the general population of Dakar, Senegal. METHODS A sexual behaviour HIV prevalence survey was carried out among clients of female prostitutes working in brothels recruited outside the prostitutes' rooms after the encounter. All men entering the house and leaving the women's rooms were asked to answer the questions and to donate saliva for HIV-1 and HIV-2 testing. RESULTS Findings suggest that a proportion of clients form a potential bridge for HIV transmission between prostitutes and partners from the general population. They have unprotected sexual contacts with both brothel prostitutes, and steady and casual partners, and expose both unmarried and married women to HIV infection. Findings also indicate that wives are more exposed to HIV than other categories of women in the population. CONCLUSIONS Clients of brothels' prostitutes have a significant potential for spreading HIV beyond the initial high risk behaviour groups in Senegal. Efforts should be provided to target specific groups at higher risk for HIV infection, such as young men from the densely populated working class neighbourhoods of Dakar, and women outside the commercial sex networks for HIV education and prevention.