Population Growth within Regional Pattern of Population Change and Male Clients of Sex Workers in U.S. Metropolitan Areas

Maria A. Villarroel, Johns Hopkins Bloomberg School of Public Health

Places undergoing population growth are altering their economic, physical and social environments which may influence the pattern of sexual risk behavior. Male clients of sex workers are at high-risk of HIV and are a key group in the spread of sexually transmitted infections to the general population. This study examined the relationship between county population growth within its metropolitan context of population change with male clients. A sample of 303 adult men embedded in a 1999-2000 national probability telephone survey was linked to 1990 to 2000 county Census data. County population change relative to its metropolitan area was quantified using location quotient. Poisson regression was used to obtain prevalence ratio. The prevalence of male clients was 17.5%. Clients were significantly more likely to reside in counties that experienced population growth similar or better than their metropolitan areas versus a slower growth after adjusting for individual characteristics and the county composition.