Introduction: Prevalence of sexually transmitted infections STIs is increasing in Belgium in recent years. Clients of sex workers form a key population for acquisition of STIs, due to their sexual relations, with or without a condom, with sex workers.
Therefore, we offered STI-testing to clients of sex workers during outreach sessions in Antwerp. Methods: Time location sampling TLS was used to improve representativeness of the sample during ten test sessions in the red light district, Antwerp in May and September by using a passive approach. Individuals that were interested to get tested for STIs could enter the study.
Participants completed an online survey and samples for STI testing were collected. Test results were communicated via a cell phone message for negative test results or by phone for positive test results. Results: In total, male clients of sex workers with a median age of 38 participated. A total of eight Ct and one Ng infections were detected.
No new HIV nor syphilis infections were detected. Using univariate analysis, testing positive for STI was associated with younger age and anorectal sex with a sex worker. Using multivariate analysis, an STI-positive test result was associated with being younger, having non-Belgian nationality, and being in a relationship. It is difficult to compare results due to the lack of reference material. Moreover, our relatively small convenience sample limits generalizability of results.
However, phone counseling for positive test results was accepted, linkage to care was provided, and partner notification was facilitated. Some male clients of sex workers visit a sex worker as their sole sexual activity, others have sexual contacts with sex workers complementary to the sexual relations with their steady or casual partners.
