Response to letter to the editor-Re: Travelling to China for the Beijing Olympic and Paralympic Games: Internal migration of the commercial sex workforce may be an important HIV risk factor for travellers

[Extract]We wish to thank Smith and Wei¹ for the opportunity to raise further awareness of the problem of human immunodeficiency virus (HIV) for those travelling to the Beijing Olympic and Paralympic Games. Our paper² does not purport to give an in-depth analysis of every issue confronting travellers; none-the-less, a sub-section was devoted to this important topic. Smith and Wei¹ correctly refer to the problem with estimates of HIV figures³ and we included generally accepted estimates from the World Health Organization. Smith and Wei¹ also discuss the problem of casual sex amongst travellers, as highlighted by a number of surveys, as well as the problem of itinerate workers and internal migration of the commercial sex workforce in China potentially being a source of spread of HIV within China, as has been the case in other countries. It is not known to what extent this will present an issue for short-term travellers to China, but it is certainly likely that a significant proportion of travellers to the Beijing Games will engage in casual sex, either with other travellers or with members of the local population. Steffen et al⁴ estimated that the risk of HIV infection amongst Swiss travellers travelling to developing countries was approximately 0.01% per 100,000 per month, which is relatively small compared to other travel health and safety-related concerns. In addition, education concerning protection against HIV and other sexually transmitted infections, including personal protective measures, has been an integral part of the pre-travel health consultation for many years,⁵ as these diseases are prevalent worldwide. Therefore, the paramount issue for travellers and athletes going to the Beijing Olympic and Paralympic Games will be to ensure that they seek pre-travel health advice, in the first instance, so that they will have the opportunity to be informed on the range of issues that may confront them during their travel to China and the region, including HIV.