Sexually transmitted infections among female sex workers tested at STI clinics in the Netherlands, 2006–2013

Abstract

BackgroundSpecialised sexually transmitted infection (STI) clinics in the Netherlands provide STI care for high-risk groups, including female sex workers (FSW), at the clinic and by outreach visiting commercial sex workplaces with a permit. The objective was to investigate the STI positivity rate and determinants of an STI diagnosis among FSW tested by STI clinics in the Netherlands.MethodsSexually transmitted infection clinics report demographic, behavioural and diagnostic information of every consultation to the National Institute for Public Health and the Environment. We analysed all consultations of FSW between 2006 and 2013. Trends in STI positivity rate (chlamydia, gonorrhoea, infectious syphilis, HIV and hepatitis B) were analysed using χ2 for trend and logistic regression was used to analyse determinants associated with an STI diagnosis. Differences between consultations at the STI clinic and consultations during outreach were analysed using χ2 tests.ResultsThe positivity rate for any STI (overall 9.5 %) was stable from 2006 to 2013. Chlamydia positivity rate (overall 7.1 %) decreased (p < 0.001) and gonorrhoea positivity rate (overall 2.6 %) increased (p < 0.001). For gonorrhoea, the highest positivity rate was found oropharyngeal (2.0 %). Characteristics associated with STI were a younger age [adjusted odds ratio (aOR) 0.96, 95 % confidence interval (CI) 0.95–0.97 per year], a previous STI diagnosis (aOR 1.63, 95 % CI 1.38–1.92) and being notified for an STI by partner notification (aOR 2.61, 95 % CI 2.0–3.40). The STI positivity rate was significantly lower among FSW tested at outreach locations (8.6 %) compared to FSW tested at the STI clinic (11.7 %, p < 0.001).ConclusionsThe STI positivity rate among FSW remained stable, but underlying this was a decreasing chlamydia trend and an increasing gonorrhoea trend, suggesting a shift in STI risks among FSW over time. Condom use during oral sex should be promoted since oropharyngeal gonorrhoea was frequently diagnosed and because of the potential spread of antimicrobial resistant gonococci.Electronic supplementary materialThe online version of this article (doi:10.1186/s12982-015-0034-7) contains supplementary material, which is available to authorized users.

STI tests and proportion of positive tests in female sex workers attending local public health departments in Germany in 2010/11

“…Higher HIV prevalence was found in a study of indoor-working FSW in the UK (1.1%) and in a convenience sample of FSW in Catalonia (1.5%) [1, 18]. On the other hand, newer data from Spanish HIV/STI clinics and data from STI clinics in the Netherlands show 0.8 and 0.1%, of FSW infected with HIV, respectively [19, 20]. These differences between studies may reflect a real difference in HIV incidence and prevalence, as the reported incidence of HIV infections in females in 2011 was higher in the UK and Spain than in the Netherlands and Germany [21].…”

“…FSW who do not have any access to health care may have a higher HIV prevalence as suggested by findings in Peru [23]. In the Netherlands, Verscheijden et al observed a lower STI prevalence during outreach activities than at STI clinics, but this may explained by the fact that outreach activities mainly targeted FSW working in legal establishments [19, 23]. …”

Prevalence of Trichomoniasis in Asymptomatic Pregnant Women Population in Bandung, West Java, Indonesia

“…Trichomonas vaginalis infection can be a marker of high-risk sexual behavior. 30 Early coitarche may increase the risk of greater cumulative sexual exposure, thus increasing the risk of becoming infected with TV. 23 In a study by Madhivanan et al 23 in 2006 in South India, twothirds of the women who had positive trichomoniasis had coitarche when less than 19 years old.…”

“…Smoking is thought to affect the condition of the vagina to become susceptible to infection, 16 whereas alcohol consumption may increase the risk of STI infection because the effects after taking it can increase sexual desire. 30 Most (90%) of the study participants had no history of smoking, alcohol consumption, or other drugs. This explains the participants in this study were at low risk of trichomoniasis.…”

Knowledge About and Health Practices on Sexually Transmitted Infections among Commercial Sex Workers in an Urban Community

“…Sex workers working in bars, clubs, and spa are at increased risk of sexually transmitted infections (STIs) (McGrath-Lone, Marsh, Hughes, & Ward, 2014) especially work like a history of multiple sex partners, inconsistent condom use, and co-infection with other STIs (Verscheijden et al, 2015).…”