Young male sex workers are at high risk for sexually transmitted infections, a cross-sectional study from Dutch STI clinics, the Netherlands, 2006–2012

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.

Selling Sex: What Determines Rates and Popularity? An Analysis of 11.5 Thousand Online Profiles

“…As such, these populations may face greater exposure to STIs and health risks. These findings are consistent with Fournet et al (2016), which finds that young male sex workers who identify as bisexual or gay have a high risk of exposure to STIs.…”

Preventing sexually transmitted and blood borne infections (STBBIs) among sex workers: a critical review of the evidence on determinants and interventions in high-income countries

“…Male sex workers (MSWs) in Europe report injecting drugs significantly longer than other men who inject drugs, with a higher proportion sharing needles (23% vs. 14%), and MSWs reported incarceration at a significantly younger age than their non-sex worker counterparts [37]. In the Netherlands, younger men were more than twice as likely to test positive for STBBIs, and identifying as gay or bisexual significantly increased risk [22].…”

“…Among the limited available data among MSWs, research from the UK found that rates of both unprotected sex and gonorrhoea both increased steadily over the study period (1994–2003) [21]. Among MSWs in the Netherlands, the rate of STIs (syphilis, chlamydia, gonorrhoea) increased from 15.2 to 21.1% between 2006 and 2010 and then dropped to 18.3% in 2012 [22].…”

An Update on the Global Epidemiology of Syphilis

“…Among Dutch blood donations that were screened for transfusion-transmissible infections from 1995 to 2014, the prevalence of syphilis increased by 50% from the period of 1995 to 2002 (22.3 positive tests per 100,000 new donors) to 2003 to 2014 (32.8 positive tests per 100,000 new donors) [131]. Among 3,052 consultations for male sex workers in Dutch STI clinics from 2006 to 2012, 2.6% of male sex workers tested positive for syphilis, with no significant change in prevalence throughout the study [132]. Among 36,296 consultations for female sex workers from 2006 to 2013, the syphilis positivity rate decreased from 0.6% in 2006 to 0.1% in 2013 [133].…”