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

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

Journal of Migration and Health (Jan 2024)

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

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

Affiliations

C.M.M. Peters: 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 Netherlands; Corresponding author.
Y.J. Evers: 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 Netherlands
C.J.G. Kampman: Public Health Service Twente, PO Box 1400, 7511 JM Enschede, the Netherlands
M.J. Theunissen–Lamers: Department of Sexual Health, Public Health Service Brabant-Zuidoost, P.O Box 8684, 5605 KR Eindhoven, the Netherlands
M.A.M. van den Elshout: Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands; Department of Sexual Health, Public Health Service of the Utrecht Region, Utrecht, the Netherlands
N.H.T.M. Dukers-Muijrers: 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 Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University/Maastricht UMC+, PO Box 616, 6200 MD Maastricht, the Netherlands
C.J.P.A. Hoebe: 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 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 Netherlands

Journal volume & issue: Vol. 10
p. 100281

Abstract

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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.

Published in Journal of Migration and Health

ISSN: 2666-6235 (Online)
Publisher: Elsevier
Country of publisher: United Kingdom
LCC subjects: Medicine: Public aspects of medicine; Political science: Colonies and colonization. Emigration and immigration. International migration
Website: https://www.journals.elsevier.com/journal-of-migration-and-health

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