Sexual bridging by Cambodian men: potential importance for general population spread of STD and HIV epidemics.

Linkages between sexual networks influence sexually transmitted disease (STD) and HIV epidemics. This study quantifies male sexual “bridging” and associated factors in Cambodias 1997 behavioral surveillance survey. Among persons randomly selected from clusters of military police and motorcycle taxi drivers in five cities associations between individual characteristics behaviors social context and “active bridging” were tested using logistic regression analyses. The authors defined 20.5% 15.7% and 14.7% of military police and motorcycle taxi drivers as active bridgers (men who have unprotected sex with high- and low-risk partners). Among the military and police logistic regression revealed that age (odds ratio [OR] 1.05) age of first sexual intercourse (OR 0.89) having friends who frequent sex workers (OR 3.31) and residence in the port city (OR 3.34) were associated with active bridging. Among motorcycle taxi drivers residence in the border city (OR 2.23) or the port city (OR 2.84) was associated with active bridging. STD symptoms during the past year were significantly associated with active bridging. Social characteristics influence sexual bridging more than individual ones. The pervasiveness of bridging and the association with STD symptoms underscore the potential of men who are active bridgers to spread STD and HIV in Cambodia beyond high-risk groups. (authors)