Sexually transmissible infections among female sex workers in Amsterdam between 2011 and 2016: does risk vary by work location?
Eline van Dulm
A D , Elske Marra A , Michelle M. Kroone A , Anna E. van Dijk A , Arjan A. Hogewoning A B and Maarten F. Schim van der Loeff A C
+ Author Affiliations
- Author Affiliations
A Department of Infectious Diseases, Public Health Service Amsterdam, Nieuwe Achtergracht 100, 1018WT, Amsterdam, The Netherlands.
B Department of Dermatology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands.
C Amsterdam Infection and Immunity Institute (AI&I), Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands.
D Corresponding author. Email: evdulm@ggd.amsterdam.nl
Sexual Health 17(4) 368-376 https://doi.org/10.1071/SH19153
Submitted: 10 September 2019 Accepted: 11 June 2020 Published: 31 July 2020
Abstract
Background: Female sex workers (FSW) are at risk for sexually transmissible infections (STI). This study aimed to investigate whether the risk for chlamydia and gonorrhoea differs by work location among FSW in Amsterdam. Additionally, trends in STI positivity rates between 2011 and 2016 were assessed. Methods: This was a retrospective analysis of routinely collected clinical data during STI consultations of FSW by the Prostitution and Healthcare Centre (P&G292). Work location was categorised as window prostitution, escorts/homeworkers, clubs/brothels/private houses/massage salons and other. Results: In total, 7558 STI consultations of 2529 FSW in the period 2011–16 were included. Positivity rates for chlamydia and gonorrhoea were 6.6% and 2.0%, respectively. Infectious hepatitis B virus, syphilis and HIV were diagnosed in <0.2% of consultations. Positivity rates of chlamydia and rectal gonorrhoea differed significantly by work location (P < 0.001). Genital and rectal chlamydia and rectal gonorrhoea were significantly less likely among women working in window prostitution, except for the other-group. Risk factors for STI did not vary by work location. Among women working in window prostitution, positivity rates for oropharyngeal and genital chlamydia and genital gonorrhoea were significantly decreasing between 2011 and 2016 (P trend <0.05). Conclusions: The higher STI positivity among escorts/homeworkers and FSW in clubs/brothels/private houses/massage salons emphasises the need for extra attention to improve condom use and STI testing in this group. Factors associated with STI did not vary by work location, thus interventions, including those used by P&G292, to reduce STI risk, can be used for women at all work locations.
Additional keywords: chlamydia, female sex workers, gonorrhoea, prevalence, risk factors, work location.
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