A cross-sectional survey of attitudes to HIV risk and rapid HIV testing among clients of sex workers in Switzerland.
OBJECTIVE
To assess attitudes to HIV risk and acceptability of rapid HIV testing among clients of street-based female sex workers (FSW) in Lausanne, Switzerland, where HIV prevalence in the general population is 0.4%.


METHODS
The authors conducted a cross-sectional study in the red light district of Lausanne for five nights in September of 2008, 2009 and 2010. Clients of FSW were invited to complete a questionnaire in the street assessing demographic characteristics, attitudes to HIV risk and HIV testing history. All clients interviewed were then offered anonymous finger stick rapid HIV testing in a van parked on-site.


RESULTS
The authors interviewed 112, 127 and 79 clients in 2008, 2009 and 2010, respectively. All were men, average age 32-37 years old; 40-60% were in a stable relationship. History of unprotected sex was higher with non-commercial partners (33-50%) than with FSW (6-11%); 29-46% of clients had never undergone an HIV test. Anonymous rapid HIV testing was accepted by 45-50% of clients. Out of 109 HIV tests conducted during the three study periods, none was reactive.


CONCLUSIONS
On-site HIV counselling and testing is acceptable among clients of FSW in this urban setting. These individuals represent an unquantified population, a proportion of which has an incomplete understanding of HIV risk in the face of high-risk behaviour, with implications for potential onward transmission to non-commercial sexual partners.
Infectious Diseases Service, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland. katharine.darling@chuv.ch
Katharine E A
KE
Darling
Esther-Amélie
EA
Diserens
Chantal
C
N'garambe
Anne
A
Ansermet-Pagot
Eric
E
Masserey
Matthias
M
Cavassini
Patrick
P
Bodenmann
D000328:Adult; D003430:Cross-Sectional Studies; D015658:HIV Infections / Q000175:diagnosis* / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D060386:Sex Workers; D011795:Surveys and Questionnaires; D013557:Switzerland