P1-S2.11 High prevalence of HIV, other sexually transmitted infections and risk profile in male commercial sex workers who have sex with men in the Netherlands

Abstract

Background: Little is known about the epidemiology and burden of sexually transmitted infections (STI) in male commercial sex workers who have sex with men (MSM-CSWs) in the Netherlands and otherWestern countries. MSM-CSWs are often hard to reach for prevention and STI testing. This feasibility study aimed to reach MSM-CSWs, assess their socio-demographics and prevalence of HIV and other STI, and their risk profile. Methods: Retrospective, cross sectional study. Demographic and STI diagnosis data were retrieved from standardised medical records of MSM-CSWs consulted during outreach activities by a public health service in Southern Limburg, The Netherlands (2009 and 2010). Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) were diagnosed by NAATand serology was performed for HIV (HIV-Ag/ Ab), syphilis (TPPA, FTA-ABS, VDRL) and hepatitis B (anti-HBc and HBsAg). Results: In 2009 and 2010 139 consultations by 99 MSM-CSW were performed. Their median age was 23.6 years; 56{%} of participants were of Romanian nationality, 20{%} of other (East) European nationality, 16{%} of South American nationality and 8{%} of Dutch nationality. Of participants, 50{%} self identified as homosexual, 33{%} as bisexual and 17{%} as heterosexual. All MSM-CSWs were tested for STI. Resultsof testing at first time consultation revealed that 45.5{%} was diagnosed with at least one STI-infection with CTwas most prevalent (18.2{%}), followed by infection with NG (12.1{%}) and HIV (11.1{%}). Of participants, 24.2{%} had evidence of exposure to Treponema pallidum; half was infectious at time of diagnosis. Of participants, 28.3{%} had evidence of previous exposure to hepatitis B virus (anti-HBc positive); 8.1{%} was infectious at time of diagnosis (HBsAg positive). 24.2{%} was fully vaccinated against hepatitis B. Conclusions: Identification and recruitment for STI testing and prevention of this population at high risk for HIV and STI is shown to be feasible. Follow-up and retention appears to be a challenge. MSM-CSWs who have sex with men pose a serious STI acquisition and transmission risk regarding MSM-CSWs users. Further research is urgently required to address the needs of MSM-CSWs and explore prevention strategies. Furthermore, targeted health education to encourage safer sex is needed.