Abstract
BackgroundSome male heterosexual clients prefer to visit a cross-border Female Sex Worker (FSW) because of cheaper sex and unsafe sex practices, and may therefore be at risk for sexually transmitted infections (STI). The objective of this study was to assess whether having commercial cross-border sex is an independent risk factor for being diagnosed with a STI.MethodsAn observational retrospective study was performed using data of 8 Dutch STI clinics bordering Germany, between 2011 and 2013. All male heterosexual clients of FSWs were selected and data on country of FSW visit and occurrence of STI were used for multivariable regression analysis.ResultsThe study population consisted of 2664 clients of FSW. Most clients visited the Netherlands (82.4%), followed by visits to another country (beyond cross-border) (9.9%) and cross-border visits (7.8%). Clients of FSW were less likely to be STI positive when they were younger than 25 years(OR = 0.6, 95%CI 0.4 to 0.8 25–44 years and OR = 0.5, 95%CI 0.4 to 0.7 older than 45 years), and more likely when they had 20 or more sex partners in the last 6 months (OR = 2.9, 95%CI 1.9 to 4.4), did not use a condom during last sexual contact (OR = 2.2, 95%CI 1.6 to 2.9) and made cross-border visits (OR = 1.7, 95%CI 1.1 to 2.6).ConclusionsAs cross-border visits appears to be a novel independent risk factor for STI in clients of FSW, this group should therefore be advised on STI prevention.
Highlights
Some male heterosexual clients prefer to visit a cross-border Female Sex Worker (FSW) because of cheaper sex and unsafe sex practices, and may be at risk for sexually transmitted infections (STI)
Another British study found that men who paid for sex (MPS) were more likely to meet sex partners abroad than non-MPS (54% versus 12%) and were more likely to report having had an STI (9% of MPS, versus 3% non-MPS) [7]
This study aims to assess whether having cross-border sex is an independent risk factor for being diagnosed with an STI for clients of FSW living in the Netherlands
Summary
Some male heterosexual clients prefer to visit a cross-border Female Sex Worker (FSW) because of cheaper sex and unsafe sex practices, and may be at risk for sexually transmitted infections (STI). Female sex workers (FSW) are considered a high risk group for acquiring sexually transmitted infections (STI), due to factors associated with their work and life, which makes them socially and physically more vulnerable. These include factors such as history of multiple sex partners, inconsistent condom use or co-infection with other STI and factors related to their life such as substance abuse, trauma and poverty [1, 2]. Those acquiring HIV infection abroad were significantly more likely to have acquired it heterosexually and to have reported sex with a commercial sex worker [8]
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