title: A cross-sectional study of HIV and STIs among male sex workers attending Australian sexual health clinics.
abstract: Although sex work is frequently characterised as a practice with high risk for HIV and other STIs, little is known about the epidemiology of these infections among men who sell sex in Australia. This study reports the prevalence of chlamydia, gonorrhoea, infectious syphilis and HIV among men who have sex with men attending Australian publicly funded sexual health clinics and compares prevalence between sex workers and non-sex workers.
  
  
  
  From 2011 to 2014, de-identified patient data were extracted from 40 sexual health clinics in four Australian jurisdictions. The χ2and multiple logistic regression analyses were used to compare the prevalence of HIV and STIs among men attending these services who did and did not report sex work in the 12 months prior to consultation. All analyses were restricted to men who reported sex with other men and to each patient's first consultation at participating services.
  
  
  
  In total, 27 469 gay, bisexual and other men who have sex with men attended participating clinics; 443 (1.6%) reported sex work. At first consultation, 18% of sex workers and 17% of non-sex workers were diagnosed with HIV or an STI (p=0.4): 13% of sex workers were newly diagnosed with chlamydia, 15% with gonorrhoea, 0.5% with infectious syphilis and 0.6% with HIV. After controlling for demographic and behavioural factors, sex work was not independently associated with an HIV or STI diagnosis.
  
  
  
  These findings provide estimates of HIV and STI prevalence among men who sell sex in Australia and they challenge assumptions of sex work as inherently risky to the sexual health of gay bisexual and other men who have sex with men.
authors: The Kirby Institute, UNSW Australia, Sydney, New South Wales, Australia.
authors: Denton
authors: D
authors: Callander
authors: The Kirby Institute, UNSW Australia, Sydney, New South Wales, Australia.|Kirketon Road Centre, Sydney, New South Wales, Australia.
authors: Phillip
authors: P
authors: Read
authors: The Kirby Institute, UNSW Australia, Sydney, New South Wales, Australia.|The Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Victoria, Australia.
authors: Garrett
authors: G
authors: Prestage
authors: The Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Victoria, Australia.
authors: Victor
authors: V
authors: Minichiello
authors: Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia.|Faculty of Medicine, Nursing and Health Sciences, Central Clinical School, Monash University, Melbourne, Victoria, Australia.
authors: Eric P F
authors: EPF
authors: Chow
authors: Western Sydney Sexual Health Centre, Parramatta, New South Wales, Australia.|Centre for Infectious Diseases and Microbiology & Marie Bashir Institute for Infectious Diseases and Biosecurity, Westmead Clinical School, University of Sydney, Sydney, New South Wales, Australia.
authors: David A
authors: DA
authors: Lewis
authors: Sydney Sexual Health Centre, Sydney Hospital, Sydney, New South Wales, Australia.
authors: Anna
authors: A
authors: McNulty
authors: The Kirby Institute, UNSW Australia, Sydney, New South Wales, Australia.
authors: Hammad
authors: H
authors: Ali
authors: Burnet Institute, Melbourne, Victoria, Australia.|Infectious Disease Unit, Alfred Hospital, Melbourne, Victoria, Australia.
authors: Margaret
authors: M
authors: Hellard
authors: The Kirby Institute, UNSW Australia, Sydney, New South Wales, Australia.
authors: Rebecca
authors: R
authors: Guy
authors: The Kirby Institute, UNSW Australia, Sydney, New South Wales, Australia.|Sydney Sexual Health Centre, Sydney Hospital, Sydney, New South Wales, Australia.
authors: Basil
authors: B
authors: Donovan
mesh_terms: D000328:Adult; D001315:Australia / Q000453:epidemiology; D003430:Cross-Sectional Studies; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D015995:Prevalence; D012307:Risk Factors; D060386:Sex Workers / Q000706:statistics & numerical data; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000175:diagnosis / Q000453:epidemiology*; D055815:Young Adult
keywords: EPIDEMIOLOGY (CLINICAL); GAY MEN; HIV; PROSTITUTION; SEXUAL HEALTH