Abstract
BackgroundMale sex workers (MSW) are particularly exposed to sexually transmitted infections (STI) including HIV. In the Netherlands, data about STI among MSW are scarce. We estimated chlamydia, gonorrhoea, syphilis and HIV diagnoses among MSW attending STI clinics and determined associated factors to guide prevention policies.MethodsUsing 2006–2012 cross-sectional national surveillance data from Dutch STI clinics, we calculated the proportion of consultations with a positive test for any of three bacterial STI or HIV among MSW. Associated factors were determined by using Poisson logistic regression with robust variance.ResultsWe identified 3,053 consultations involving MSW, of which 18.1 % included at least one positive bacterial STI test and 2.5 % a positive HIV test. Factors associated with bacterial STI and/or HIV diagnoses were respectively age groups < 35 y.o. and self-reporting homo- or bisexual preferences (aRR = 1.6; 95 % CI: 1.3–2.1), and age group 25–34 y.o. (aRR = 2.7; 95 % CI: 1.2–6.5) and self-reporting homo- or bisexual preferences (aRR = 24.4; 95 % CI: 3.4–176.9). Newly diagnosed and pre-existing HIV infection were associated with an increased risk for bacterial STI (aRR = 2.7, 95 % CI: 1.7–2.6 and aRR = 2.1, 95 % CI: 2.2–3.4 respectively). MSW with no history of HIV screening were more likely to be tested positive for HIV compared to those with a previous HIV-negative test (aRR = 2.6, 95 % CI: 1.6–4.3).ConclusionHealth promotion activities should target MSW who are young, homo- or bisexual, those who are HIV-infected or who have never been tested for HIV, to increase early diagnosis, prevention and treatment.
Highlights
Male sex workers (MSW) are exposed to sexually transmitted infections (STI) including human immunodeficiency virus (HIV)
For bacterial STI outcome, we studied the association with HIV status considering the following three modalities collected during consultation: negative HIV test/ new positive HIV diagnosis/known HIV infection
History of previous HIV testing was reported in 78 % of consultations involving MSW and a positive HIV test result was reported in 9 % of previously tested MSW
Summary
Male sex workers (MSW) are exposed to sexually transmitted infections (STI) including HIV. Studies about risk for acquiring bacterial STI and HIV among MSW are limited but suggest a high risk among. Studies in Belgium [6] and Australia [3] reported that almost one-third of MSW had one or more STI. These higher prevalences of STI and HIV among MSW than among FSW can be explained by differences in sexual behaviours and characteristics. The male sex work industry seems markedly different from the female sex work sector It is less organised and MSW tend to hide their commercial sexual practices [5, 15]. Additional studies suggest that MSW are difficult to reach by education and intervention programmes [5, 15]
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