The sexual health of female sex workers compared with other women in England: analysis of cross-sectional data from genitourinary medicine clinics

Abstract

BackgroundWhile female sex workers (FSWs) are assumed to be at increased risk of sexually transmitted infections (STIs), there are limited comparative data with other population groups available. Using routine STI surveillance data, we investigated differences in sexual health between FSWs and other female attendees at genitourinary medicine (GUM) clinics in England.MethodsDemographic characteristics, STI prevalence and service usage among FSWs and other attendees in 2011 were compared using logistic regression.ResultsIn 2011, 2704 FSWs made 8411 recorded visits to 131/208 GUM clinics, (primarily large, FSW-specialist centres in London). FSWs used a variety of services, however, 10% did not have an STI/HIV test at presentation. By comparison with other female attendees, FSWs travelled further for their care and had increased risk of certain STIs (eg, gonorrhoea ORadj: 2.76, 95% CI 2.16 to 3.54, p<0.001). Migrant FSWs had better sexual health outcomes than UK-born FSWs (eg, period prevalence of chlamydia among those tested: 8.5% vs 13.5%, p<0.001) but were more likely to experience non-STI outcomes (eg, pelvic inflammatory disease ORadj: 2.92, 95% CI 1.57 to 5.41, p<0.001).ConclusionsFSWs in England have access to high-quality care through the GUM clinic network, but there is evidence of geographical inequality in access to these services. A minority do not appear to access STI/HIV testing through clinics, and some STIs are more prevalent among FSWs than other female attendees. Targeted interventions aimed at improving uptake of testing in FSWs should be developed, and need to be culturally sensitive to the needs of this predominantly migrant population.

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

“…Unfortunately, we did not assess staff resources and consultation hours; thus the impact of accessibility should be subject of future studies. Acceptance of healthcare services and hence frequent utilisation of LPHD might be enhanced by embedding STI tests into general gynaecological care and offering services tailored to FSW as it has been observed in the UK [16]. …”

Recent im/migration to Canada linked to unmet health needs among sex workers in Vancouver, Canada: Findings of a longitudinal study

“…In addition to sex work-related barriers to health access, im/migrants in sex work may face additional barriers related to language differences, unfamiliarity with or lack of information regarding local health systems, concerns regarding legal immigration status, lack of insurance coverage for recent arrivals, financial barriers, isolation from health services, and differing cultural perceptions of health (Asanin & Wilson, 2008; Campbell, Klei, Hodges, Fisman, & Kitto, 2012; Deering et al, 2014; Goldenberg, Chettiar, Nguyen, et al, 2014; Kalich, Heinemann, & Ghahari, 2015; Mc Grath-Lone, Marsh, Hughes, & Ward, 2014; Wu et al, 2005). …”

Syphilis of prevalence in women sex professionals: integrative review / Prevalência de sífilis em mulheres profissionais do sexo: revisão integrativa / La prevalencia de sífilis en las mujeres profesionales del sexo: revisión integradora

“…A sífilis é motivo de preocupação em razão da transmissibilidade e magnitude elevada. A doença pode acometer todas as faixas etárias e ambos os sexos, apresenta-se prevalências mais elevadas em populações mais vulneráveis, como por exemplo, Mulheres Profissioanis do Sexo (MPS), considerandose os vários fatores de risco para as Infeccçoes Sexualmente Transmissíveis (IST) em que estão expostas (1) . Assim, medidas de controle e prevenção dessa infecção são essenciais, tendo como base os fatores culturais e comportamentais (2) .…”