Engagement in sexual healthcare and STI/HIV burden of first- and second-generation migrant and Western-born female sex workers in the Netherlands: A retrospective cohort study

Introduction: Scarcely available European studies suggest that migrant female sex workers (FSW) have a higher likelihood of sexually transmitted infections (STI) but a lower likelihood of HIV compared to non-migrant FSW. This study assessed demographics, STI/HIV burden, and engagement in sexual heal...

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Main Authors: C.M.M. Peters, Y.J. Evers, C.J.G. Kampman, M.J. Theunissen–Lamers, M.A.M. van den Elshout, N.H.T.M. Dukers-Muijrers, C.J.P.A. Hoebe
Format: Article
Language:English
Published: Elsevier 2024-01-01
Series:Journal of Migration and Health
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666623524000709
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author C.M.M. Peters
Y.J. Evers
C.J.G. Kampman
M.J. Theunissen–Lamers
M.A.M. van den Elshout
N.H.T.M. Dukers-Muijrers
C.J.P.A. Hoebe
author_facet C.M.M. Peters
Y.J. Evers
C.J.G. Kampman
M.J. Theunissen–Lamers
M.A.M. van den Elshout
N.H.T.M. Dukers-Muijrers
C.J.P.A. Hoebe
author_sort C.M.M. Peters
collection DOAJ
description Introduction: Scarcely available European studies suggest that migrant female sex workers (FSW) have a higher likelihood of sexually transmitted infections (STI) but a lower likelihood of HIV compared to non-migrant FSW. This study assessed demographics, STI/HIV burden, and engagement in sexual healthcare among first-generation (FGM) and second-generation (SGM) migrant FSW versus Western-born FSW. Methods: This large retrospective cohort study included 27,532 Dutch STI clinic consultations from 11,363 individual FSW between 2016 and 2021. STI diagnoses (chlamydia/gonorrhoea/ infectious syphilis/infectious hepatitis B/HIV) in the first consultation were compared using Chi-squared test. Logistic regression adjusting for age, urbanity and sexual behaviour assessed associations between migration status and STI diagnoses. Incidence of repeat consultation was compared between migration groups using Cox proportional hazards regression, adjusting for age and STI clinic urbanity. Results: FGM FSW (n = 5085) mostly originated from Eastern Europe (50.5 %) and SGM FSW (n = 1309) from Suriname/Netherlands Antilles (36.3 %). Among FGM, SGM and Western-born FSW, 11.4 %, 15.2 % and 13.3 %, respectively (p < 0.001) were diagnosed with any STI. FGM FSW had a lower odds (aOR 0.78, 95 %:CI 0.65–0.94,p < 0.01) of chlamydia or gonorrhoea diagnosis, but a higher aOR (6.38,95 %CI:2.63–15.49,p < 0.001) of HIV, syphilis, or hepatitis B diagnosis in the first consultation. FGM FSW had a lower likelihood of a repeat consultation at any time (aHR:0.73,95 %CI:0.69–0.77,p < 0.001) than Western-born FSW. Conclusion: Migrant FSW versus Western-born FSW demonstrated a varying burden of STI, FGM heightened proportions and odds of infectious syphilis, hepatitis B and HIV and lower likelihood of repeat consultations. Enhancing accessibility and outreach efforts for migrant FSW in sexual healthcare services is imperative.
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spelling doaj-art-9bcc6866fd6d4075a00beebfb49d15362024-12-07T08:28:52ZengElsevierJournal of Migration and Health2666-62352024-01-0110100281Engagement in sexual healthcare and STI/HIV burden of first- and second-generation migrant and Western-born female sex workers in the Netherlands: A retrospective cohort studyC.M.M. Peters0Y.J. Evers1C.J.G. Kampman2M.J. Theunissen–Lamers3M.A.M. van den Elshout4N.H.T.M. Dukers-Muijrers5C.J.P.A. Hoebe6Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University/Maastricht UMC+, PO Box 616, 6200 MD Maastricht, the Netherlands; Department of Sexual Health, Infectious Diseases and Environmental Health, Living Lab Public Health Mosa, South Limburg Public Health Service, PO Box 33, 6400 AA, Heerlen, the Netherlands; Corresponding author.Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University/Maastricht UMC+, PO Box 616, 6200 MD Maastricht, the Netherlands; Department of Sexual Health, Infectious Diseases and Environmental Health, Living Lab Public Health Mosa, South Limburg Public Health Service, PO Box 33, 6400 AA, Heerlen, the NetherlandsPublic Health Service Twente, PO Box 1400, 7511 JM Enschede, the NetherlandsDepartment of Sexual Health, Public Health Service Brabant-Zuidoost, P.O Box 8684, 5605 KR Eindhoven, the NetherlandsDepartment of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands; Department of Sexual Health, Public Health Service of the Utrecht Region, Utrecht, the NetherlandsDepartment of Sexual Health, Infectious Diseases and Environmental Health, Living Lab Public Health Mosa, South Limburg Public Health Service, PO Box 33, 6400 AA, Heerlen, the Netherlands; Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University/Maastricht UMC+, PO Box 616, 6200 MD Maastricht, the NetherlandsDepartment of Social Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University/Maastricht UMC+, PO Box 616, 6200 MD Maastricht, the Netherlands; Department of Sexual Health, Infectious Diseases and Environmental Health, Living Lab Public Health Mosa, South Limburg Public Health Service, PO Box 33, 6400 AA, Heerlen, the Netherlands; Department of Medical Microbiology, Infectious Diseases and Infection Prevention, Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Centre (MUMC+), PO Box 5800, 6202 AZ Maastricht, the NetherlandsIntroduction: Scarcely available European studies suggest that migrant female sex workers (FSW) have a higher likelihood of sexually transmitted infections (STI) but a lower likelihood of HIV compared to non-migrant FSW. This study assessed demographics, STI/HIV burden, and engagement in sexual healthcare among first-generation (FGM) and second-generation (SGM) migrant FSW versus Western-born FSW. Methods: This large retrospective cohort study included 27,532 Dutch STI clinic consultations from 11,363 individual FSW between 2016 and 2021. STI diagnoses (chlamydia/gonorrhoea/ infectious syphilis/infectious hepatitis B/HIV) in the first consultation were compared using Chi-squared test. Logistic regression adjusting for age, urbanity and sexual behaviour assessed associations between migration status and STI diagnoses. Incidence of repeat consultation was compared between migration groups using Cox proportional hazards regression, adjusting for age and STI clinic urbanity. Results: FGM FSW (n = 5085) mostly originated from Eastern Europe (50.5 %) and SGM FSW (n = 1309) from Suriname/Netherlands Antilles (36.3 %). Among FGM, SGM and Western-born FSW, 11.4 %, 15.2 % and 13.3 %, respectively (p < 0.001) were diagnosed with any STI. FGM FSW had a lower odds (aOR 0.78, 95 %:CI 0.65–0.94,p < 0.01) of chlamydia or gonorrhoea diagnosis, but a higher aOR (6.38,95 %CI:2.63–15.49,p < 0.001) of HIV, syphilis, or hepatitis B diagnosis in the first consultation. FGM FSW had a lower likelihood of a repeat consultation at any time (aHR:0.73,95 %CI:0.69–0.77,p < 0.001) than Western-born FSW. Conclusion: Migrant FSW versus Western-born FSW demonstrated a varying burden of STI, FGM heightened proportions and odds of infectious syphilis, hepatitis B and HIV and lower likelihood of repeat consultations. Enhancing accessibility and outreach efforts for migrant FSW in sexual healthcare services is imperative.http://www.sciencedirect.com/science/article/pii/S2666623524000709Female sex workersSexually transmitted infectionsHealthcare-seeking behaviourMigrationMigrant sex workersWestern Europe
spellingShingle C.M.M. Peters
Y.J. Evers
C.J.G. Kampman
M.J. Theunissen–Lamers
M.A.M. van den Elshout
N.H.T.M. Dukers-Muijrers
C.J.P.A. Hoebe
Engagement in sexual healthcare and STI/HIV burden of first- and second-generation migrant and Western-born female sex workers in the Netherlands: A retrospective cohort study
Journal of Migration and Health
Female sex workers
Sexually transmitted infections
Healthcare-seeking behaviour
Migration
Migrant sex workers
Western Europe
title Engagement in sexual healthcare and STI/HIV burden of first- and second-generation migrant and Western-born female sex workers in the Netherlands: A retrospective cohort study
title_full Engagement in sexual healthcare and STI/HIV burden of first- and second-generation migrant and Western-born female sex workers in the Netherlands: A retrospective cohort study
title_fullStr Engagement in sexual healthcare and STI/HIV burden of first- and second-generation migrant and Western-born female sex workers in the Netherlands: A retrospective cohort study
title_full_unstemmed Engagement in sexual healthcare and STI/HIV burden of first- and second-generation migrant and Western-born female sex workers in the Netherlands: A retrospective cohort study
title_short Engagement in sexual healthcare and STI/HIV burden of first- and second-generation migrant and Western-born female sex workers in the Netherlands: A retrospective cohort study
title_sort engagement in sexual healthcare and sti hiv burden of first and second generation migrant and western born female sex workers in the netherlands a retrospective cohort study
topic Female sex workers
Sexually transmitted infections
Healthcare-seeking behaviour
Migration
Migrant sex workers
Western Europe
url http://www.sciencedirect.com/science/article/pii/S2666623524000709
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