Vu Francis, Cavassini Matthias, D'Acremont Valérie, Greub Gilbert, Jaton Katia, Masserey Eric, Pongelli Silvia, Bouche Laurence, Ngarambe Chantal, Bize Raphaël, Bodenmann Patrick
Department of Vulnerable Populations and Social Medicine, Centre for Primary Care and Public Health, Lausanne, Switzerland.
Department of Infectious Diseases, Lausanne University Hospital (CHUV), Switzerland.
Swiss Med Wkly. 2020 Dec 30;150:w20357. doi: 10.4414/smw.2020.20357. eCollection 2020 Dec 14.
Female sex workers are often considered highly vulnerable to sexually transmitted infections (STIs). However, data on STI epidemiology in female sex workers are lacking in Switzerland. Our main goal was to evaluate the prevalence of six STIs (human immunodeficiency virus [HIV], hepatitis B, hepatitis C, Chlamydia trachomatis, Neisseria gonorrhoeae and syphilis) among local female sex workers in Lausanne. A local, exploratory, cross-sectional study was conducted on a convenience sample of adult (≥18 years) Female sex workers in Lausanne, Switzerland, from 1 April 2015 to 31 December 2016. female sex workers who worked in street sex venues, massage parlours and brothels were approached for recruitment by a local non-governmental organisation. They were then invited to present at the Lausanne University Hospital, where they were offered a free STI screening and hepatitis A and B vaccination. We enrolled 96 female sex workers. They were predominantly undocumented immigrants (60%) from Africa and Eastern Europe with no health insurance; only one participant (1%) was Swiss born. During the study, 15 (16%; 95% confidence interval [CI] 9–23%) participants were newly confirmed to have an STI: six (6%; 95% CI 1–11%) had C. trachomatis, five (5%; 95% CI 0.6-9%) latent syphilis and four (4%; 95% CI 0.1–8%) hepatitis B (three with chronic active infection and one with past exposure). No human immunodeficiency virus (HIV) infections were newly diagnosed among the participants. Nineteen (20%) of the female sex workers were already vaccinated against hepatitis B, and 73 (76%) initiated vaccination against hepatitis A and hepatitis B during the study. Forty-four (46%) of the female sex workers required translation and assistance from social services.
女性性工作者通常被认为极易感染性传播感染（STIs）。然而，瑞士缺乏关于女性性工作者性传播感染流行病学的数据。我们的主要目标是评估洛桑当地女性性工作者中六种性传播感染（人类免疫缺陷病毒[HIV]、乙型肝炎、丙型肝炎、沙眼衣原体、淋病奈瑟菌和梅毒）的患病率。2015年4月1日至2016年12月31日，在瑞士洛桑对成年（≥18岁）女性性工作者的便利样本进行了一项本地探索性横断面研究。当地一个非政府组织接触了在街头性交易场所、按摩院和妓院工作的女性性工作者以招募她们。然后邀请她们到洛桑大学医院，在那里为她们提供免费的性传播感染筛查以及甲型和乙型肝炎疫苗接种。我们招募了96名女性性工作者。她们主要是来自非洲和东欧的无证件移民（60%），没有医疗保险；只有一名参与者（1%）是在瑞士出生的。在研究期间，15名（16%；95%置信区间[CI] 9 - 23%）参与者新被确诊患有性传播感染：6名（6%；95% CI 1 - 11%）患有沙眼衣原体，5名（5%；95% CI 0.6 - 9%）患有潜伏梅毒，4名（4%；95% CI 0.1 - 8%）患有乙型肝炎（3名患有慢性活动性感染，1名有既往接触史）。参与者中没有新诊断出人类免疫缺陷病毒（HIV）感染。19名（20%）女性性工作者已经接种了乙型肝炎疫苗，73名（76%）在研究期间开始接种甲型和乙型肝炎疫苗。44名（46%）女性性工作者需要社会服务的翻译和协助。
