Article Text
Abstract
Background/introduction Commercial Sex Workers (CSW) are at increased risk of STIs including Hepatitis B virus (HBV) and, for some, Hepatitis C virus (HCV) and sexual assault. These risks can be reduced by vaccination, post-exposure prophylaxis (PEP) awareness and condoms.
Aim(s)/objectives To audit management against clinic policy with respect to documentation of: HBV status; offering vaccination (vacc.) to HBV negative; HCV test; HIV test; PEP information/awareness and offer of condoms. Additional data was collected on new/prior STIs, recreational drugs, and same sex contact.
Methods Casenotes of all attenders between 01/01/12 and 30/09/15 with a SW code were reviewed and additional data collected regarding vaccine uptake.
Results 56 (7 males (12.5%), 49 females (87.5%)) individuals with a total of 243 episodes, with a median of 3 (1–17) visits, were identified. Median age of 30 (range 18–63) with 51 (91%) of white British ethnicity. 38 (67.9%) reported an STI diagnosis prior to the period audited and 13 (23.2%) had ≥1 new STI during this period, median 1 (1–3). 21 (37.5%) reported current/recent use of recreational drugs and 31/54 (57.4%) documented same sex contact, (including MSM contact for females). PEPSE was issued at 2/243 (0.8%) of episodes.
Discussion/conclusion The main limitation of the audit was dependence on SW code. Performance was good (>95%) for HBV documentation at first/subsequent visits, offer of HIV test, whilst HCV testing and documentation re. condoms and PEPSE awareness were suboptimal (45–80%). None were IVDU, and policy re. HCV testing in CSW will be reviewed given the low positivity rate.