title: Health Services Use and HIV Prevalence Among Migrant and National Female Sex Workers in Portugal: Are We Providing the Services Needed?
abstract: This cross-sectional bio-behavioral survey conducted with 853 female sex workers (FSW) aimed to examine differences in use of HIV health services, testing and prevalence among migrant and national FSW. A quarter of undocumented FSW had never used National Health Service (NHS) and 15 % never tested for HIV, significantly more than nationals (p < 0.001 and p = 0.024, respectively). HIV infection was self-reported by 11.9 % of nationals, 1.8 % of documented and 0.8 % of undocumented migrants (p < 0.001). The HIV rapid test was reactive in 13.6 % of undocumented, 8.0 % of nationals and 2.3 % of documented. A higher proportion of migrants were unaware of their positive serostatus compared to nationals. Ever had HIV testing was less likely among undocumented, who never used the NHS and who didn't know where to go if suspected being HIV-infected. Promoting early diagnosis with linkage to care among migrant FSW should be supported, while developing health services better tailored to their needs.
authors.affiliation: Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical/Universidade Nova de Lisboa (IHMT/UNL), Rua da Junqueira N 100, 1349-008, Lisbon, Portugal. sfdias@ihmt.unl.pt.
authors.forename: Sónia
authors.initials: S
authors.lastname: Dias
authors.affiliation: Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical/Universidade Nova de Lisboa (IHMT/UNL), Rua da Junqueira N 100, 1349-008, Lisbon, Portugal.
authors.forename: Ana
authors.initials: A
authors.lastname: Gama
authors.affiliation: Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical/Universidade Nova de Lisboa (IHMT/UNL), Rua da Junqueira N 100, 1349-008, Lisbon, Portugal.
authors.forename: Marta
authors.initials: M
authors.lastname: Pingarilho
authors.affiliation: GAT - Grupo de Ativistas em Tratamentos, Lisbon, Portugal.
authors.forename: Daniel
authors.initials: D
authors.lastname: Simões
authors.affiliation: GAT - Grupo de Ativistas em Tratamentos, Lisbon, Portugal.
authors.forename: Luís
authors.initials: L
authors.lastname: Mendão
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D011174:Portugal / Q000453:epidemiology; D015995:Prevalence; D060386:Sex Workers / Q000706:statistics & numerical data*; D013222:State Medicine; D014171:Transients and Migrants / Q000706:statistics & numerical data*
keywords: HIV infection; HIV testing; Health services use; Migrants; Sex workers