Abstract
BackgroundClients of street sex workers may be at higher risk for HIV infection than the general population. Furthermore, there is a lack of knowledge regarding HIV testing of clients of sex workers in developed countries.MethodThis pilot study assessed the feasibility and acceptance of rapid HIV testing by the clients of street-based sex workers in Lausanne, Switzerland. For 5 evenings, clients in cars were stopped by trained field staff for face-to-face interviews focusing on sex-related HIV risk behaviors and HIV testing history. The clients were then offered a free anonymous rapid HIV test in a bus parked nearby. Rapid HIV testing and counselling were performed by experienced nurse practitioners. Clients with reactive tests were offered confirmatory testing, medical evaluation, and care in our HIV clinic.ResultWe intercepted 144 men, 112 (77.8%) agreed to be interviewed. Among them, 50 (46.6%) had never been tested for HIV. A total of 31 (27.7%) rapid HIV tests were performed, 16 (51.6%) in clients who had not previously been tested. None were reactive. Initially, 19 (16.9%) additional clients agreed to HIV testing but later declined due to the 40-minute queue for testing.ConclusionThis pilot study showed that rapid HIV testing in the red light district of Lausanne was feasible, and that the clients of sex workers accepted testing at an unexpectedly high rate. This setting seems particularly appropriate for targeted HIV screening, since more than 40% of the clients had not previously been tested for HIV even though they engaged in sex-related HIV risk behaviour.
Highlights
Clients of street sex workers may be at higher risk for HIV infection than the general population
19 (16.9%) additional clients agreed to HIV testing but later declined due to the 40-minute queue for testing. This pilot study showed that rapid HIV testing in the red light district of Lausanne was feasible, and that the clients of sex workers accepted testing at an unexpectedly high rate
This setting seems appropriate for targeted HIV screening, since more than 40% of the clients had not previously been tested for HIV even though they engaged in sex-related HIV risk behaviour
Summary
Clients of street sex workers may be at higher risk for HIV infection than the general population. There is a lack of knowledge regarding HIV testing of clients of sex workers in developed countries. The prevalence of HIV in sex workers in Switzerland is unknown; the prevalence is presumed to be higher than in the general population due to multiple risk factors. The prevalence of HIV in the clients of sex workers in Switzerland is unknown. This lack of knowledge stems from the difficulty of contacting clients in western countries; in addition, there is little epidemiological information about men who pay for sex [4,5]. Previous studies in Kenya, Benin, China, Peru and India have reported a high prevalence of HIV infection, STDs, and risk behaviours among clients of sex workers; such clients could serve as a bridge population for HIV/ STD transmission [6,7,8,9,10,11,12]
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