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A cross-sectional study of HIV and STIs among male sex workers attending Australian sexual health clinics
  1. Denton Callander1,
  2. Phillip Read1,2,
  3. Garrett Prestage1,3,
  4. Victor Minichiello3,
  5. Eric P F Chow4,5,
  6. David A Lewis6,7,
  7. Anna McNulty8,
  8. Hammad Ali1,
  9. Margaret Hellard9,10,
  10. Rebecca Guy1,
  11. Basil Donovan1,8
  1. 1The Kirby Institute, UNSW Australia, Sydney, New South Wales, Australia
  2. 2Kirketon Road Centre, Sydney, New South Wales, Australia
  3. 3The Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Victoria, Australia
  4. 4Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia
  5. 5Faculty of Medicine, Nursing and Health Sciences, Central Clinical School, Monash University, Melbourne, Victoria, Australia
  6. 6Western Sydney Sexual Health Centre, Parramatta, New South Wales, Australia
  7. 7Centre for Infectious Diseases and Microbiology & Marie Bashir Institute for Infectious Diseases and Biosecurity, Westmead Clinical School, University of Sydney, Sydney, New South Wales, Australia
  8. 8Sydney Sexual Health Centre, Sydney Hospital, Sydney, New South Wales, Australia
  9. 9Burnet Institute, Melbourne, Victoria, Australia
  10. 10Infectious Disease Unit, Alfred Hospital, Melbourne, Victoria, Australia
  1. Correspondence to Denton Callander, Level 6 Wallace Wurth Building UNSW Australia, Sydney, NSW 2052, Australia; d.callander{at}unsw.edu.au

Abstract

Objectives Although sex work is frequently characterised as a practice with high risk for HIV and other STIs, little is known about the epidemiology of these infections among men who sell sex in Australia. This study reports the prevalence of chlamydia, gonorrhoea, infectious syphilis and HIV among men who have sex with men attending Australian publicly funded sexual health clinics and compares prevalence between sex workers and non-sex workers.

Methods From 2011 to 2014, de-identified patient data were extracted from 40 sexual health clinics in four Australian jurisdictions. The χ2 and multiple logistic regression analyses were used to compare the prevalence of HIV and STIs among men attending these services who did and did not report sex work in the 12 months prior to consultation. All analyses were restricted to men who reported sex with other men and to each patient's first consultation at participating services.

Results In total, 27 469 gay, bisexual and other men who have sex with men attended participating clinics; 443 (1.6%) reported sex work. At first consultation, 18% of sex workers and 17% of non-sex workers were diagnosed with HIV or an STI (p=0.4): 13% of sex workers were newly diagnosed with chlamydia, 15% with gonorrhoea, 0.5% with infectious syphilis and 0.6% with HIV. After controlling for demographic and behavioural factors, sex work was not independently associated with an HIV or STI diagnosis.

Conclusions These findings provide estimates of HIV and STI prevalence among men who sell sex in Australia and they challenge assumptions of sex work as inherently risky to the sexual health of gay bisexual and other men who have sex with men.

  • PROSTITUTION
  • SEXUAL HEALTH
  • EPIDEMIOLOGY (CLINICAL)
  • HIV
  • GAY MEN

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