In China, prevention of sexually transmitted HIV has become the key to the success in controlling the spread of the AIDS epidemic. Using data from sample surveys of the enrollees in two re-education camps in Shanghai, this paper examines the HIV-related knowledge and attitudes and risk factors of unprotected commercial sex among “female sex workers” (FSWs) and their male clients. The descriptive results suggest that FSWs in Shanghai are predominantly rural-urban migrants, characterized by poor education, little knowledge about HIV and its transmission, widespread unprotected commercial sex, and high prevalence of STDs. Multivariate logistic regression analyses suggest that for both FSWs and their male clients, lack of self-efficacy in condom use is the common and most significant independent predictor of unprotected commercial sex. Being married, belief in incorrect prevention practices, and lack of relationship power in commercial sex are the additional independent risk factors of unprotected commercial sex among FSWs, whereas poor education and not knowing the protective function of consistent condom use are the additional risk factors for male clients. The results challenge sociology in theory building and empirical study of commercial sex and call for attention to the importance of context-specific factors and social underpinnings of unprotected commercial sex and disease transmission. The findings provide both theoretical guidance and empirical evidence for designing culture and population sensitive AIDS behavioral intervention.
