title: Risk of sexually transmitted infections and violence among indoor-working female sex workers in London: the effect of migration from Eastern Europe.
abstract: OBJECTIVE
  To examine risk factors associated with HIV and sexually transmitted infections (STIs) and experience of physical and sexual violence among sex workers in London, with a particular focus on differences in risk between migrants from Eastern Europe (EE) or the Former Soviet Union (FSU) and UK-born sex workers.
  
  
  METHODS
  The authors conducted a cross-sectional survey of sex workers born in the UK, EE or FSU (n = 268), collecting behavioural data, testing for antibodies to HIV and Treponema pallidum, and testing for infection with Chlamydia trachomatis or Neisseria gonorrhoea.
  
  
  RESULTS
  Migrants were younger, saw more clients, and were less likely to use contraception; few reported being coerced into sex work. Overall, prevalence of HIV was 1.1% (95% CI -0.1% to 2.4%), prevalence of syphilis was 2.2% (95% CI 0.4 to 4.0%), and prevalence of infection with chlamydia or gonorrhoea was 6.4% (95% CI 3.2% to 9.6%). Risk factors associated with any infection included having no contact with an outreach worker, age, and having a non-paying sex partner. Increased risk of physical violence from clients was associated with a history of imprisonment or arrest and having a non-paying sex partner.
  
  
  CONCLUSIONS
  Findings suggest an association between outreach services and reduced risk of STIs and between having non-paying partners and increased risk of STIs. Findings also suggest an association between enforcement policies, such as arrest or imprisonment, and drug use and increased risk of physical violence. Interventions are needed to expand outreach, improve uptake of contraceptives for migrants, and reduce levels of violence for all women.
authors.affiliation: Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK. lucy.platt@lshtm.ac.uk
authors.forename: Lucy
authors.initials: L
authors.lastname: Platt
authors.forename: Pippa
authors.initials: P
authors.lastname: Grenfell
authors.forename: Chris
authors.initials: C
authors.lastname: Bonell
authors.forename: Sarah
authors.initials: S
authors.lastname: Creighton
authors.forename: Kaye
authors.initials: K
authors.lastname: Wellings
authors.forename: John
authors.initials: J
authors.lastname: Parry
authors.forename: Tim
authors.initials: T
authors.lastname: Rhodes
mesh_terms: D000328:Adult; D000367:Age Factors; D002690:Chlamydia Infections / Q000208:ethnology; D003267:Contraception / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005061:Europe, Eastern / Q000208:ethnology; D005260:Female; D006069:Gonorrhea / Q000208:ethnology; D015658:HIV Infections / Q000208:ethnology; D006801:Humans; D008131:London / Q000453:epidemiology; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000208:ethnology / Q000706:statistics & numerical data; D015995:Prevalence; D012307:Risk Factors; D011477:Sex Work / Q000208:ethnology*; D017406:Sexual Harassment / Q000208:ethnology*; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000208:ethnology*; D013587:Syphilis / Q000208:ethnology; D014171:Transients and Migrants; D047568:Unsafe Sex / Q000706:statistics & numerical data; D014754:Violence / Q000208:ethnology*; D055815:Young Adult