Researchers at Johns Hopkins Bloomberg School of Public Health have studied the impact of HIV and sexually transmitted disease in male clients of the commercial sex industry in China's Sichuan province.
Since 2007, heterosexual transmission has replaced injecting drug use as the primary transmission mode of all HIV infections in China.
"We found a large burden of syphilis infection coupled with high-risk sexual and substance use behaviors among male clients of sex workers," said Cui Yang.
"Without effective interventions to prevent HIV transmission to the male client population, the current epidemic may expand into the general population," he added.
Blood test results indicated that HIV prevalence was 1.5 percent; 5.3 percent were positive for syphilis and 8.7 percent positive for HCV.
The overall prevalence of consistent condom use with female sex workers was 30 percent.
The study also found a significant correlation between syphilis infection among male clients and not having local household registration, snorting heroin and washing genitals after having sex with a female sex worker.
"Our data raises concerns about the future heterosexual transmission of HIV to the general population in China since unprotected sex with female sex workers has become the norm," said Kenrad Nelson at the Bloomberg School of Public Health.
The study is available online in advance of publication in the journal Sexually Transmitted Infections.