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A cross-sectional survey of attitudes to HIV risk and rapid HIV testing among clients of sex workers in Switzerland
  1. Katharine E A Darling1,
  2. Esther-Amélie Diserens2,3,
  3. Chantal N'Garambe2,
  4. Anne Ansermet-Pagot3,
  5. Eric Masserey4,
  6. Matthias Cavassini1,
  7. Patrick Bodenmann2
  1. 1Infectious Diseases Service, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland
  2. 2Department of Ambulatory Care and Community Medicine, University of Lausanne, Lausanne, Switzerland
  3. 3Association Fleur de Pavé, Lausanne, Switzerland
  4. 4Department of Public Health, Lausanne, Switzerland
  1. Correspondence to Dr Katharine E A Darling, Service des Maladies Infectieuses, Centre Hospitalier Universitaire Vaudois, Rue du Bugnon 46, 1011 Lausanne, Switzerland; katharine.darling{at}


Objectives To assess attitudes to HIV risk and acceptability of rapid HIV testing among clients of street-based female sex workers (FSW) in Lausanne, Switzerland, where HIV prevalence in the general population is 0.4%.

Methods The authors conducted a cross-sectional study in the red light district of Lausanne for five nights in September of 2008, 2009 and 2010. Clients of FSW were invited to complete a questionnaire in the street assessing demographic characteristics, attitudes to HIV risk and HIV testing history. All clients interviewed were then offered anonymous finger stick rapid HIV testing in a van parked on-site.

Results The authors interviewed 112, 127 and 79 clients in 2008, 2009 and 2010, respectively. All were men, average age 32–37 years old; 40–60% were in a stable relationship. History of unprotected sex was higher with non-commercial partners (33–50%) than with FSW (6–11%); 29–46% of clients had never undergone an HIV test. Anonymous rapid HIV testing was accepted by 45–50% of clients. Out of 109 HIV tests conducted during the three study periods, none was reactive.

Conclusions On-site HIV counselling and testing is acceptable among clients of FSW in this urban setting. These individuals represent an unquantified population, a proportion of which has an incomplete understanding of HIV risk in the face of high-risk behaviour, with implications for potential onward transmission to non-commercial sexual partners.

  • Clients
  • sex workers
  • rapid HIV testing
  • Switzerland
  • HIV testing
  • infectious diseases
  • migration

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  • MC and PB contributed equally to this work.

  • Funding This study was funded by Vaud Public Health Service. The funders had no role in designing the study, collecting, analysing or interpreting the data, or in drafting this manuscript.

  • Competing interests None.

  • Ethics approval Ethics approval was provided by the Ethics Committee of the University of Lausanne, Switzerland.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Additional unpublished data from the study are available to readers of the journal upon contacting the corresponding author.