Background In Germany, few data exist about the prevalence of STI in female sex workers (FSW). Especially hard-to-reach populations without regular contact to health services may be at high risk for STI. We measured the prevalence of CT, NG and TV among FSW at their workplace in order to evaluate whether these tests should be routinely offered in this population.

Methods Specialised outreach-workers of local public health authorities (LPHA) screened FSW in North Rhine-Westfalia for the respective STI on basis of self-collected vaginal swabs, using TMA (CT and NG: APTIMA Combo 2^®; TV: APTIMA^® Trichomonas vaginalis Assay). Sociodemographics, sexual behaviour, and medical care situation were surveyed with help of translators and cultural mediators.

Results Up to February 8, 227 FSW were enrolled by 9 LPHA. 10.6% of FSW were born in Germany, 27.8% in Bulgaria, 22.5% in Romania, 39.1% in other countries. 40.9% of non-Germans had no German language skills. German and non-German FSW differed significantly regarding mean age (35 years vs. 30 years, p < 0.01), mean duration of sex work (8.7 years vs. 3.6 years, p < 0.01), existing health insurance for Germany (91.7% vs. 18.6%, p < 0.01), and ever attending a LPHA (62.5% vs. 32.5%, p = 0.016).

Overall prevalences were 7.9% for CT, 12.8% for NG, and 16.3% for TV (table 1).

Conclusion For the first time, hard-to-reach FSW were screened for CT, NG, and TV in a low threshold multicenter approach in Germany. Lacking German language skills, no health insurance, rare contact to LPHA, and mostly foreign origin characterised a large proportion of the study population, but nearly all these factors were independent from being tested positively for STI. We found high prevalences of CT, NG, and TV demonstrating a high need to implement the respective tests routinely, preferably at their workplace. Final data is expected to confirm the present results.