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HIV and Sexual Risk Behavior among Commercial Sex Workers in the Netherlands

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Abstract

In 2002–2005, a cross-sectional study to assess the potential for HIV transmission was carried out among 557 female and male-to-female transgender commercial sex workers (CSW) in three cities in the Netherlands. Female CSW (F-CSW), drug-using female CSW (DU), and transgender sex workers were recruited in street-based and establishment-based sites. An anonymous questionnaire was administrated by interviewers and a saliva sample was collected for HIV antibody testing. The overall HIV prevalence was 5.7% (31/547; 10 samples were excluded because of “intermediate” test results). HIV was more prevalent among transgender (18.8%, 13/69) and DU (13.6%, 12/88) sex workers than among F-CSW (1.5%, 6/390). Of the HIV positive CSW, 74% were unaware of their infection. Consistent condom use with clients was 81%. Regular condom failure with clients was reported by 39%. In multivariate analyses, transgender sex workers (OR = 22.9), drug-using CSW who ever injected drugs (OR = 31.1), African (OR = 19.0), and South European ethnicity (OR = 7.2) were independently associated with HIV. Condom failure (PRR = 2.0), anal sex (PRR = 2.1), and drug use (PRR = 3.8) were associated with inconsistent condom use with clients. There is a potential risk for further spread of HIV, through clients and (private) partners of sex workers, to the general population. Targeted health promotion activities are indicated for transgender sex workers and drug-using female CSW; active HIV testing must be continued.

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Acknowledgements

The authors acknowledge all participants in this study for their willingness to cooperate. We thank the interviewers for their efforts and we also thank Therese van der Helm, Han Fennema, Lies Tonino, Anja Franken, and Marja de Koster for their contribution to the survey. Roel Coutinho and Marianne van der Sande are acknowledged for their comments on an earlier version of the article.

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Authors and Affiliations

  1. Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720BA, Bilthoven, The Netherlands

    Maaike G. van Veen & Marita J. W. van de Laar

  2. Rotterdam-Rijnmond Health Service, Rotterdam, The Netherlands

    Hannelore M. Götz

  3. The Hague Municipal Health Service, The Hague, The Netherlands

    Petra A. van Leeuwen

  4. Amsterdam Health Service, Amsterdam, The Netherlands

    Maria Prins

  5. Center for Infection and Immunity Amsterdam, Academic Medical Centre, Amsterdam, The Netherlands

    Maria Prins

  6. European Centre for Disease Control, Stockholm, Sweden

    Marita J. W. van de Laar

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  1. Maaike G. van Veen
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  2. Hannelore M. Götz
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  3. Petra A. van Leeuwen
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  5. Marita J. W. van de Laar
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Correspondence to Maaike G. van Veen.

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van Veen, M.G., Götz, H.M., van Leeuwen, P.A. et al. HIV and Sexual Risk Behavior among Commercial Sex Workers in the Netherlands. Arch Sex Behav 39, 714–723 (2010). https://doi.org/10.1007/s10508-008-9396-z

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