Background The prevalence of HIV in the UK is increasing steadily, particularly in higher-risk populations. Male sex-workers (MSW) are a particularly vulnerable group, often engaging in high-risk sexual activities with multiple partners, with increased barriers to accessing care. The objective of this study was to determine how the prevalence of HIV in patients attending a specialist MSW clinic in London has changed over the last ten years.

Methods Total attendances of MSW attending a dedicated clinic in Central London were collected, and records reviewed for two time periods (1/1/2002–31/12/2012 and 1/1/2012–31/12/2012). HIV status of MSW was determined by attendance at the HIV unit at the Central London Hospital. Details of CD4 count, HAART, viral load (VL), sexual practises and condom use were obtained and compared.

Results 292 men attended the clinic in 2002 and 257 in 2012. 5 (1.7%) were known HIV positive in 2002, 33 (12.8%) in 2012. In 2002, 1 patient (20%) was on HAART with an undetectable VL and 4 had CD4 counts above treatment threshold. In 2012, 18 patients (55%) were on HAART, 12 of which (67% of total) had an undetectable VL. 12 patients (36%) were not on HAART and had a CD4 count of > 350. 3 transferred care.

Conclusions There has been a dramatic increase in the prevalence of HIV in MSW attending a dedicated clinic in London over the last decade (1.7% in 2002, 12.8% in 2012). This may be due, in part, to increased uptake through the introduction of ‘opt-out’ testing for HIV in GUM clinics in recent years. This increasing prevalence of HIV reflects the high-risk status of MSW highlighting the importance of specialised clinics providing risk reduction strategies such as promotion of condom use, regular STI screening, post-exposure prophylaxis and HAART to reduce outwards transmission in this cohort.