Sexually transmissible infections (STI) among male sex workers in Sydney, NSW
Female sex workers in Sydney have been documented to have low rates of STIs approaching that of the general population.However, there is little contemporary evidence on the burden of HIV and STIs among male sex workers or their specific health needs.
The Kirketon Road Centre (KRC) is based in Kings Cross, Sydney. Sex workers are a priority population for this service. Demographic, behavioural and STI diagnostic data on male sex workers presenting to the service were collected from 1-5-2007 to 30-4-2013. The crude positivity rate of chlamydia and gonorrhoea (any site), syphilis, and HIV were calculated by dividing the number of individuals testing positive by the number of individuals tested during the time period. results: Over the timeframe 305 male sex workers were seen at KRC. Median age was 28 (range 16-60). 15 (4.9%) identified as Aboriginal or Torres Strait Islander. 71 (23.2%) reported street sex work, and 119 (39.0%) gave a history of injecting drug use. Only 18 (5.9%) reported unprotected sex with clients, but 141 (46.2%) and 103 (33.7%) reported unprotected sex with regular and casual partners respectively. 54 (17.7%) only had sex with women in their personal and private lives; the remainder having male partners. Chlamydia was diagnosed in 42/237 (17.7%), gonorrhoea in 38/233 (16.3%) and syphilis in 16/246 (6.5%). 26/241 (10.7%) were newly diagnosed with HIV infection, and a further 9 (3.0%) were already known to be HIV positive.
High rates of STIs and HIV in this population indicate a higher burden of disease than in female sex workers, and in non-sex working gay men. However consistent condom use at work suggests STI acquisition through regular or casual partners rather than clients. Further multivariate analysis will focus on risk factors for STI diagnosis in order to inform a health promotion response.
