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Lopez-Corbeto E, Sanclemente C, González V, Mansilla R, Casabona J, Folch C. HIV, Chlamydia and gonorrhoea vulnerability depending to sex work site. Enferm Infecc Microbiol Clin (Engl Ed) 2022; 40:166-171. [PMID: 35216949 DOI: 10.1016/j.eimce.2022.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 09/08/2020] [Accepted: 09/13/2020] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Women sex workers (WSW) are one of key population on the HIV and other sexually transmitted infections (STIs) monitoring and evaluation. Socioeconomic, structural factors and other factors associated with the workplace influence exposure to these infections. The objectives of this study were to describe and compare the social characteristics, risk behaviours and HIV, chlamydia and gonorrhoeae prevalence according to sex work site (street or highway, clubs and flats). METHODS Cross-sectional study on 400 WSW in Catalonia. Socio-demographic, sex work and behavioral characteristics were collected through personal interview. Oral fluid and urine samples were collected to determine STI prevalence. RESULTS WSW that exercised in the street or highway presented more precarious conditions and a greater vulnerability related to socioeconomic factors: older population, with a lower education level and with less economic remuneration for their service. Other factors associated with lifestyle or behaviour was also observed: greater injecting drug use, longer sex work or vulnerabilities associated with structural or social determinants: less access to health services, higher proportion of forced relations and stay in prison. The overall HIV, chlamydia and gonorrhoeae prevalence was 3.0%, 1.8% and 0.5%, respectively and higher in women who exercised on the street or highway, 5.6%, 1.9% and 1.2%, respectively. CONCLUSION The information generated in this study will be useful for the design specific preventive interventions aimed at this group.
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Affiliation(s)
- Evelin Lopez-Corbeto
- Centro de Estudios Epidemiológicos sobre las Infecciones de Transmisión Sexual y Sida de Cataluña (CEEISCAT), Departament de Salut, Generalitat de Catalunya, Badalona, Barcelona, Spain; CIBER Epidemiologia y Salud Pública (CIBERESP), Spain.
| | | | - Victoria González
- Centro de Estudios Epidemiológicos sobre las Infecciones de Transmisión Sexual y Sida de Cataluña (CEEISCAT), Departament de Salut, Generalitat de Catalunya, Badalona, Barcelona, Spain; CIBER Epidemiologia y Salud Pública (CIBERESP), Spain; Servicio de Microbiología, Laboratori Clínic Metropolitana Nord, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Rosa Mansilla
- Vigilància, Prevenció i Control de les Infeccions de Transmissió Sexual i el VIH, Subdirecció General de Vigilància i Resposta a Emergències de Salut Pública, Agència de Salut Pública de Catalunya, Departament de Salut, Generalitat de Catalunya, Barcelona, Spain
| | - Jordi Casabona
- Centro de Estudios Epidemiológicos sobre las Infecciones de Transmisión Sexual y Sida de Cataluña (CEEISCAT), Departament de Salut, Generalitat de Catalunya, Badalona, Barcelona, Spain; CIBER Epidemiologia y Salud Pública (CIBERESP), Spain; Departamento de Pediatría, Obstetricia y Ginecología y de Medicina Preventiva, Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain
| | - Cinta Folch
- Centro de Estudios Epidemiológicos sobre las Infecciones de Transmisión Sexual y Sida de Cataluña (CEEISCAT), Departament de Salut, Generalitat de Catalunya, Badalona, Barcelona, Spain; CIBER Epidemiologia y Salud Pública (CIBERESP), Spain
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Sentís A, Montoro-Fernandez M, Lopez-Corbeto E, Egea-Cortés L, Nomah DK, Díaz Y, Garcia de Olalla P, Mercuriali L, Borrell N, Reyes-Urueña J, Casabona J. STI epidemic re-emergence, socio-epidemiological clusters characterisation and HIV coinfection in Catalonia, Spain, during 2017-2019: a retrospective population-based cohort study. BMJ Open 2021; 11:e052817. [PMID: 34903544 PMCID: PMC8672020 DOI: 10.1136/bmjopen-2021-052817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES To describe the epidemiology of sexually transmitted infections (STIs), identify and characterise socio-epidemiological clusters and determine factors associated with HIV coinfection. DESIGN Retrospective population-based cohort. SETTING Catalonia, Spain. PARTICIPANTS 42 283 confirmed syphilis, gonorrhoea, chlamydia and lymphogranuloma venereum cases, among 34 600 individuals, reported to the Catalan HIV/STI Registry in 2017-2019. PRIMARY AND SECONDARY OUTCOMES Descriptive analysis of confirmed STI cases and incidence rates. Factors associated with HIV coinfection were determined using logistic regression. We identified and characterized socio-epidemiological STI clusters by Basic Health Area (BHA) using K-means clustering. RESULTS The incidence rate of STIs increased by 91.3% from 128.2 to 248.9 cases per 100 000 population between 2017 and 2019 (p<0.001), primarily driven by increase among women (132%) and individuals below 30 years old (125%). During 2017-2019, 50.1% of STIs were chlamydia and 31.6% gonorrhoea. Reinfections accounted for 10.8% of all cases and 6% of cases affected HIV-positive individuals. Factors associated with the greatest likelihood of HIV coinfection were male sex (adjusted OR (aOR) 23.69; 95% CI 16.67 to 35.13), age 30-39 years (versus <20 years, aOR 18.58; 95% CI 8.56 to 52.13), having 5-7 STI episodes (vs 1 episode, aOR 5.96; 95% CI 4.26 to 8.24) and living in urban areas (aOR 1.32; 95% CI 1.04 to 1.69). Living in the most deprived BHAs (aOR 0.60; 95% CI 0.50 to 0.72) was associated with the least likelihood of HIV coinfection. K-means clustering identified three distinct clusters, showing that young women in rural and more deprived areas were more affected by chlamydia, while men who have sex with men in urban and less deprived areas showed higher rates of STI incidence, multiple STI episodes and HIV coinfection. CONCLUSIONS We recommend socio-epidemiological identification and characterisation of STI clusters and factors associated with HIV coinfection to identify at-risk populations at a small health area level to design effective interventions.
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Affiliation(s)
- Alexis Sentís
- Centre of Epidemiological Studies of Sexually Transmitted Disease and AIDS in Catalonia (CEEISCAT), Department of Health, Generalitat of Catalonia, Badalona, Spain
- Pompeu Fabra University (UPF), Barcelona, Spain
- Epidemiology Department, Epiconcept, Paris, France
| | - Marcos Montoro-Fernandez
- Centre of Epidemiological Studies of Sexually Transmitted Disease and AIDS in Catalonia (CEEISCAT), Department of Health, Generalitat of Catalonia, Badalona, Spain
- Fundació Institut d'Investigació Germans Trias i Pujol (IGTP), Badalona, Spain
| | - Evelin Lopez-Corbeto
- Centre of Epidemiological Studies of Sexually Transmitted Disease and AIDS in Catalonia (CEEISCAT), Department of Health, Generalitat of Catalonia, Badalona, Spain
- Fundació Institut d'Investigació Germans Trias i Pujol (IGTP), Badalona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Laia Egea-Cortés
- Centre of Epidemiological Studies of Sexually Transmitted Disease and AIDS in Catalonia (CEEISCAT), Department of Health, Generalitat of Catalonia, Badalona, Spain
- Fundació Institut d'Investigació Germans Trias i Pujol (IGTP), Badalona, Spain
| | - Daniel K Nomah
- Centre of Epidemiological Studies of Sexually Transmitted Disease and AIDS in Catalonia (CEEISCAT), Department of Health, Generalitat of Catalonia, Badalona, Spain
- Department of Paediatrics, Obstetrics and Gynecology and Preventive Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Yesika Díaz
- Centre of Epidemiological Studies of Sexually Transmitted Disease and AIDS in Catalonia (CEEISCAT), Department of Health, Generalitat of Catalonia, Badalona, Spain
- Fundació Institut d'Investigació Germans Trias i Pujol (IGTP), Badalona, Spain
| | - Patricia Garcia de Olalla
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Epidemiology Service, Public Health Agency of Barcelona, Barcelona, Spain
| | - Lilas Mercuriali
- Epidemiology Service, Public Health Agency of Barcelona, Barcelona, Spain
| | - Núria Borrell
- Epidemiological Surveillance and Response to Public Health Emergencies Service in Tarragona, Agency of Public Health of Catalonia, Generalitat of Catalonia, Tarragona, Spain
| | - Juliana Reyes-Urueña
- Centre of Epidemiological Studies of Sexually Transmitted Disease and AIDS in Catalonia (CEEISCAT), Department of Health, Generalitat of Catalonia, Badalona, Spain
- Fundació Institut d'Investigació Germans Trias i Pujol (IGTP), Badalona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Jordi Casabona
- Centre of Epidemiological Studies of Sexually Transmitted Disease and AIDS in Catalonia (CEEISCAT), Department of Health, Generalitat of Catalonia, Badalona, Spain
- Fundació Institut d'Investigació Germans Trias i Pujol (IGTP), Badalona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Department of Paediatrics, Obstetrics and Gynecology and Preventive Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
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Lopez-Corbeto E, Sanclemente C, González V, Mansilla R, Casabona J, Folch C. HIV, Chlamydia and gonorrhoea vulnerability depending to sex work site. Enferm Infecc Microbiol Clin 2020; 40:S0213-005X(20)30312-8. [PMID: 33199062 DOI: 10.1016/j.eimc.2020.09.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 09/08/2020] [Accepted: 09/13/2020] [Indexed: 11/03/2022]
Abstract
INTRODUCTION Women sex workers (WSW) are one of key population on the HIV and other sexually transmitted infections (STIs) monitoring and evaluation. Socioeconomic, structural factors and other factors associated with the workplace influence exposure to these infections. The objectives of this study were to describe and compare the social characteristics, risk behaviours and HIV, Chlamydia and gonorrhoeae prevalence according to sex work site (street or highway, clubs and flats). METHODS Cross-sectional study on 400WSW in Catalonia. Socio-demographic, sex work and behavioral characteristics were collected through personal interview. Oral fluid and urine samples were collected to determine STI prevalence. RESULTS WSW that exercised in the street or highway presented more precarious conditions and a greater vulnerability related to socioeconomic factors: older population, with a lower education level and with less economic remuneration for their service. Other factors associated with lifestyle or behaviour was also observed: greater injecting drug use, longer sex work or vulnerabilities associated with structural or social determinants: less access to health services, higher proportion of forced relations and stay in prison. The overall HIV, Chlamydia and gonorrhoeae prevalence was 3.0%, 1.8% and 0.5%, respectively, and higher in women who exercised on the street or highway: 5.6%, 1.9% and 1.2%, respectively. CONCLUSION The information generated in this study will be useful for the design specific preventive interventions aimed at this group.
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Affiliation(s)
- Evelin Lopez-Corbeto
- Centro de Estudios Epidemiológicos sobre las Infecciones de Transmisión Sexual y Sida de Cataluña (CEEISCAT), Departament de Salut, Generalitat de Catalunya, Badalona, Barcelona, España; CIBER Epidemiología y Salud Pública (CIBERESP), Spain.
| | | | - Victoria González
- Centro de Estudios Epidemiológicos sobre las Infecciones de Transmisión Sexual y Sida de Cataluña (CEEISCAT), Departament de Salut, Generalitat de Catalunya, Badalona, Barcelona, España; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Servicio de Microbiología, Laboratori Clínic Metropolitana Nord, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España
| | - Rosa Mansilla
- Vigilància, Prevenció i Control de les Infeccions de Transmissió Sexual i el VIH, Subdirecció General de Vigilància i Resposta a Emergències de Salut Pública, Agència de Salut Pública de Catalunya, Departament de Salut, Generalitat de Catalunya, Barcelona, España
| | - Jordi Casabona
- Centro de Estudios Epidemiológicos sobre las Infecciones de Transmisión Sexual y Sida de Cataluña (CEEISCAT), Departament de Salut, Generalitat de Catalunya, Badalona, Barcelona, España; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Departamentos de Pediatría, Obstetricia y Ginecología y de Medicina Preventiva, Universitat Autònoma de Barcelona, Badalona, Barcelona, España
| | - Cinta Folch
- Centro de Estudios Epidemiológicos sobre las Infecciones de Transmisión Sexual y Sida de Cataluña (CEEISCAT), Departament de Salut, Generalitat de Catalunya, Badalona, Barcelona, España; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
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