Background Sex workers (SWs) are assumed to be at increased risk of sexually transmitted infections (STIs), but there are limited comparative data with other population groups. Previously, SW sexual health data were only available from special studies, but it is now gathered routinely as part of the Genitourinary Medicine Clinic Activity Dataset (GUMCAD), a national STI surveillance system.
Methods Twelve months of GUMCAD data were analysed descriptively with the prevalence of STIs among SWs and other genitourinary (GUM) clinic attendees investigated. The increased risk of STI in SWs was estimated using logistic regression.
Results In 2011, 3,192 SWs (2,704 females, 488 males) were recorded as making 10,481 visits to GUM clinics. These visits were reported from a minority of clinics (primarily large, specialist centres in London). SWs utilised a variety of services including sexual health screens, HIV tests and vaccination; however, a minority of SWs were not recorded as having STI/HIV tests. Disparities in sexual health were observed among SWs. Male SWs had worse sexual health outcomes than female SWs (e.g. period prevalence of gonorrhoea among those tested: 17.6% vs. 2.7%) and migrant female SWs had better outcomes than UK-born female SWs (e.g. period prevalence of chlamydia among those tested: 8.5% vs. 13.5%). SWs also had an increased risk of STI when compared with other attendees, with the greatest risks in male SWs (Chlamydia: ORadj:3.98, 95% CI: 3.05–5.18, p < 0.001).
Conclusions Routinely-gathered GUMCAD data can be used to assess the sexual health of SWs in England. Disparities in sexual health and differences in service utilisation appear to exist between different groups of SWs. Some STIs are more prevalent among SWs than the general public. However, these results should be interpreted with caution as the identifying SW code is new and inconsistencies in the way SWs are identified were observed.
- Sex worker
- sexual health
- STI surveillance