How Bachelorhood and Migration Increase the HIV Transmission Risk Through Commercial Sex in China?

In China, the serious involuntary bachelorhood due to sex ratio imbalance in decades is expected to dramatically increase the spread of HIV through heterosexual contact. However, the higher HIV transmission risk and its correlates among never married men in rural China are not well understood. This study explored whether and how bachelorhood and migration increased the HIV transmission risk through commercial sex. By combining two cross-sectional survey data from never married men in rural areas and male migrants (including both married and unmarried men) in urban areas, a total of 1030 participants who were never married and age 28 and above or married male migrants were included in this study. The results show that both bachelorhood and migration put the never married male migrants at particularly higher HIV transmission risk by increasing both the possibility of engaging in commercial sex, and the frequency and inconsistency of condom use in commercial sex. Selection bias into marriage and neighborhood characteristics associated with exposure to commercial sexual risk may partly explain why male migrants that never married had a higher commercial sex related risk than that of married male migrants and never married non-migrant males.