荷兰第一代和第二代移民及在西方出生的女性性工作者的性健康护理参与情况与性传播感染/艾滋病毒负担：一项回顾性队列研究。
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.
作者信息
Peters C M M, Evers Y J, Kampman C J G, Theunissen-Lamers M J, van den Elshout M A M, Dukers-Muijrers N H T M, Hoebe C J P A
机构信息
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.
出版信息
J Migr Health. 2024 Oct 31;10:100281. doi: 10.1016/j.jmh.2024.100281. eCollection 2024.
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 ( = 5085) mostly originated from Eastern Europe (50.5 %) and SGM FSW ( = 1309) from Suriname/Netherlands Antilles (36.3 %). Among FGM, SGM and Western-born FSW, 11.4 %, 15.2 % and 13.3 %, respectively ( < 0.001) were diagnosed with any STI. FGM FSW had a lower odds (aOR 0.78, 95 %:CI 0.65-0.94, < 0.01) of chlamydia or gonorrhoea diagnosis, but a higher aOR (6.38,95 %CI:2.63-15.49, < 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, < 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.
引言
为数不多的欧洲研究表明，与非移民女性性工作者相比，移民女性性工作者感染性传播感染（STI）的可能性更高，但感染艾滋病毒的可能性更低。本研究评估了第一代（FGM）和第二代（SGM）移民女性性工作者与在西方出生的女性性工作者的人口统计学特征、性传播感染/艾滋病毒负担以及在性健康保健方面的参与情况。
方法
这项大型回顾性队列研究纳入了2016年至2021年间11363名个体女性性工作者在荷兰性传播感染诊所的27532次会诊。首次会诊时的性传播感染诊断（衣原体/淋病/传染性梅毒/传染性乙型肝炎/艾滋病毒）使用卡方检验进行比较。对年龄、城市化程度和性行为进行逻辑回归调整，评估移民身份与性传播感染诊断之间的关联。使用Cox比例风险回归比较移民群体之间重复会诊的发生率，并对年龄和性传播感染诊所的城市化程度进行调整。
结果
第一代移民女性性工作者（n = 5085）大多来自东欧（50.5%），第二代移民女性性工作者（n = 1309）来自苏里南/荷属安的列斯群岛（36.3%）。在第一代移民、第二代移民和在西方出生的女性性工作者中，分别有11.4%、15.2%和13.3%（P<0.001）被诊断患有任何性传播感染。第一代移民女性性工作者被诊断患有衣原体或淋病的几率较低（调整后比值比[aOR]为0.78，95%置信区间[CI]：0.65 - 0.94，P<0.01），但在首次会诊时被诊断患有艾滋病毒、梅毒或乙型肝炎的调整后比值比更高（6.38，95%CI：2.63 - 15.49，P<0.001）。第一代移民女性性工作者在任何时候进行重复会诊的可能性都低于在西方出生的女性性工作者（调整后风险比[aHR]：0.73，�5%CI：0.69 - 0.77，P<0.001）。
结论
与在西方出生的女性性工作者相比，移民女性性工作者表现出不同的性传播感染负担，第一代移民女性性工作者感染传染性梅毒、乙型肝炎和艾滋病毒的比例和几率更高，重复会诊的可能性更低。必须加强性健康保健服务中针对移民女性性工作者的可及性和外展工作。
Zotero 插件