Key points
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2664 clients of female sex workers (FSW) were taken into analysis to determine whether making cross-border visits was a risk factor for STI.
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Most clients visited the Netherlands (82.4%), followed by visits to another country (9.9%) and cross-border visits (7.8%).
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Overall STI positivity among male heterosexual clients of an FSW was 10.4%.
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Making cross-border visits was an independent risk factor for STI positivity (OR = 1.7).
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Other independent risk factors for STI positivity were having multiple sex partners (OR = 2.9), being young (OR = 0.6, 25–44 years and OR = 0.5, > 45 years) and not using an condom (OR = 2.2).
Background
Methods
Study design and population
Data analysis
Results
Study population
Clients visiting the Netherlands N = 2194 | Clients with cross-border visits N = 207 | Clients visiting another country N = 263 | All visited countries N = 2664 | |
---|---|---|---|---|
N(%) | N(%) | N(%) | N(%) | |
Age | ||||
< 25 years | 434 (19.8) | 38 (18.4) | 54 (20.5) | 526 (19.7) |
25–44 years | 1173 (53.5) | 103 (49.8) | 148 (56.3) | 1424 (53.5) |
> 45 years | 587 (26.8) | 66 (31.9) | 61 (23.2) | 714 (26.8) |
Country of birth | ||||
Netherlands | 1848 (84.2) | 174 (84.1) | 215 (81.7) | 2237 (84.0) |
Other | 346 (15.8) | 33 (15.9) | 48 (18.3) | 427 (16.0) |
Number of sex partners last 6 months (FSW and non-FSW) | ||||
0–2 | 780 (35.6) | 58 (28.0) | 92 (35.0) | 930 (34.9) |
3–5 | 788 (35.9) | 67 (32.4) | 95 (36.1) | 950 (35.7) |
6–20 | 379 (17.3) | 55 (26.6) | 49 (18.6) | 483 (18.1) |
> 20 | 147 (7.9) | 24 (11.6) | 23 (8.7) | 221 (8.3) |
Missings | 73 (3.3) | 3 (1.4) | 4 (1.5) | 80 (3.0) |
Condom used during last sexual contact | ||||
Yes | 929 (42.3) | 95 (45.9) | 107 (40.7) | 1131 (42.5) |
No | 1246 (56.8) | 108 (52.2) | 149 (56.7) | 1503 (56.4) |
Missings | 19 (0.9) | 4 (1.9) | 7 (2.7) | 30 (1.1) |
STI diagnosed at consultation | ||||
Yes | 223 (10.2) | 32 (15.5) | 22 (8.4) | 277 (10.4) |
No | 1971 (89.8) | 175 (84.5) | 241 (91.6) | 2387 (89.6) |
Continent/country of FSW visita | N(%) | STI positivity N(%) | ||
Other European | 66 (25.1) | 6 (9.1) | ||
Asia | 122 (46.4) | 11 (9.0) | ||
Africa | 29 (11.0) | 2 (6.9) | ||
Oceania | 1 (0.4) | 0 (0.0) | ||
North America | 7 (2.7) | 0 (0.0) | ||
South America | 17 (6.5) | 1 (5.9) | ||
Multiple continents | 9 (3.4) | 2 (22.2) |
STI positivity and predictors
Univariable regression analysis OR(95%CI) | Multivariable regression analysis OR(95%) | |
---|---|---|
Age, median years (IQR) | ||
< 25 years | ref | ref |
25–44 years | 0.5 (0.4–0.7) | 0.6 (0.4–0.8) |
> 45 years | 0.5 (0.3.0.7) | 0.5 (0.4–0.7) |
Country of birth | ||
Netherlands | ref | ns |
Other | 1.3 (0.9–1.8) | |
Number of sex partners last 6 months (FSW and non-FSW) | ||
0–2 | ref | ref |
3–5 | 1.4 (1.0–1.9) | 1.3 (0.9–1.8) |
6–20 | 1.3 (0.9–1.9) | 1.3 (0.9–1.9) |
> 20 | 2.9 (2.0–4.4) | 2.9 (1.9–4.4) |
Condom used during last sexual contact | ||
Yes | ref | ref |
No | 2.2 (1.6–2.9) | 2.2 (1.6–2.9) |
Country of FSW visit | ||
Netherlands | ref | ref |
Cross-border | 1.7 (1.1–2.5) | 1.7 (1.1–2.6) |
Another country | 0.8 (0.5–1.3) | 0.8 (0.5–1.2) |