Screening for sexually transmitted disease in London-based male prostitutes

Abstract

Objective: To provide a screening service for sexually transmissible infections to male prostitutes working in the London area.

Design: An open access service recruiting by a diverse range of methods to avoid over-representation of the more visible elements of this group.

Setting: Department of genitourinary medicine in a London teaching hospital and a community-based clinic at a safe address.

Results: During the 10 months following the establishment of the service in June 1990, 57 male prostitutes (38 street based and 19 "escorts") were seen. Of these, 27 men (47%) were found to have evidence of such an infection. Twenty five per cent of the street-based men had serological evidence of previous infection with hepatitis B virus (HBV), 6% had positive syphilis serology, 9% had non-gonococcal urethritis (NGU), 18% had urethral and 13% rectal gonorrhoea. None had gonorrhoea at more than one site. Twenty-seven per cent of these men were HIV 1-antibody positive. Thirty-seven per cent of the escorts had serological evidence of previous infection with HBV, none had positive syphilis serology, 11% had NGU, 5% had urethral and 8% rectal gonorrhoea. None had gonorrhoea at more than one site. Twenty-five per cent of these men were HIV 1-antibody positive.

Conclusion: Specific targeting of resources at this group of individuals is necessary to promote better health education and use of health care provisions.