title: Young male sex workers are at high risk for sexually transmitted infections, a cross-sectional study from Dutch STI clinics, the Netherlands, 2006-2012.
abstract: BACKGROUND
  Male sex workers (MSW) are particularly exposed to sexually transmitted infections (STI) including HIV. In the Netherlands, data about STI among MSW are scarce. We estimated chlamydia, gonorrhoea, syphilis and HIV diagnoses among MSW attending STI clinics and determined associated factors to guide prevention policies.
  
  
  METHODS
  Using 2006-2012 cross-sectional national surveillance data from Dutch STI clinics, we calculated the proportion of consultations with a positive test for any of three bacterial STI or HIV among MSW. Associated factors were determined by using Poisson logistic regression with robust variance.
  
  
  RESULTS
  We identified 3,053 consultations involving MSW, of which 18.1 % included at least one positive bacterial STI test and 2.5 % a positive HIV test. Factors associated with bacterial STI and/or HIV diagnoses were respectively age groups < 35 y.o. and self-reporting homo- or bisexual preferences (aRR = 1.6; 95 % CI: 1.3-2.1), and age group 25-34 y.o. (aRR = 2.7; 95 % CI: 1.2-6.5) and self-reporting homo- or bisexual preferences (aRR = 24.4; 95 % CI: 3.4-176.9). Newly diagnosed and pre-existing HIV infection were associated with an increased risk for bacterial STI (aRR = 2.7, 95 % CI: 1.7-2.6 and aRR = 2.1, 95 % CI: 2.2-3.4 respectively). MSW with no history of HIV screening were more likely to be tested positive for HIV compared to those with a previous HIV-negative test (aRR = 2.6, 95 % CI: 1.6-4.3).
  
  
  CONCLUSIONS
  Health promotion activities should target MSW who are young, homo- or bisexual, those who are HIV-infected or who have never been tested for HIV, to increase early diagnosis, prevention and treatment.
authors: Epidemiology and Surveillance Unit, Centre for Infectious Diseases Control, National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA, Bilthoven, The Netherlands. nellyfournet@yahoo.fr.|European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden. nellyfournet@yahoo.fr.
authors: N
authors: N
authors: Fournet
authors: Epidemiology and Surveillance Unit, Centre for Infectious Diseases Control, National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA, Bilthoven, The Netherlands. f.koedijk@ggdtwente.nl.|Public Health Service Twente, Enschede, The Netherlands. f.koedijk@ggdtwente.nl.
authors: F D H
authors: FD
authors: Koedijk
authors: Public Health Service Amsterdam, Amsterdam, The Netherlands. petravanleeuwenap@gmail.com.
authors: A P
authors: AP
authors: van Leeuwen
authors: Public Health Service Amsterdam, Amsterdam, The Netherlands. mvrooijen@ggd.amsterdam.nl.
authors: M S
authors: MS
authors: van Rooijen
authors: Epidemiology and Surveillance Unit, Centre for Infectious Diseases Control, National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA, Bilthoven, The Netherlands. marianne.van.der.sande@rivm.nl.|Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands. marianne.van.der.sande@rivm.nl.
authors: M A B
authors: MA
authors: van der Sande
authors: Public Health Service Amsterdam, Amsterdam, The Netherlands. MvVeen@ggd.amsterdam.nl.
authors: M G
authors: MG
authors: van Veen
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D006069:Gonorrhea / Q000453:epidemiology; D015658:HIV Infections / Q000453:epidemiology; D006801:Humans; D008297:Male; D008403:Mass Screening; D009426:Netherlands / Q000453:epidemiology; D012307:Risk Factors; D012309:Risk-Taking; D060386:Sex Workers / Q000706:statistics & numerical data*; D012725:Sexual Behavior / Q000706:statistics & numerical data; D012749:Sexually Transmitted Diseases / Q000453:epidemiology*; D013587:Syphilis / Q000453:epidemiology; D055815:Young Adult