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保健参与情况和 STI/HIV 负担:回顾性队列研究

IF 3.9 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Journal of Migration and Health Pub Date : 2024-01-01 DOI:10.1016/j.jmh.2024.100281
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
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引用次数: 0

摘要

导言鲜有的欧洲研究表明,与非移民女性性工作者相比,移民女性性工作者(FSW)感染性传播疾病(STI)的几率更高,但感染 HIV 的几率较低。这项研究评估了第一代(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/艾滋病毒负担以及性保健参与情况。方法这项大型回顾性队列研究纳入了 2016 年至 2021 年间 11,363 名女性性工作者在荷兰性传播感染诊所就诊的 27,532 例病例。采用卡方检验比较了首次就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)。调整年龄、城市化程度和性行为的逻辑回归评估了移民身份与性传播疾病诊断之间的关联。在对年龄和性传播感染诊所城市化程度进行调整后,采用 Cox 比例危险度回归法比较了不同移民群体之间的复诊率。在女性外阴残割、女性生殖器残割和西方出生的女性外阴残割者中,分别有 11.4%、15.2% 和 13.3% (p < 0.001)被诊断出患有任何性传播疾病。女性外阴残割的女性外阴残割者被诊断为衣原体或淋病的几率较低 (aOR 0.78, 95 %:CI 0.65-0.94,p < 0.01),但在首次就诊时被诊断为艾滋病毒、梅毒或乙型肝炎的几率较高 (aOR 6.38,95 %CI:2.63-15.49,p < 0.001)。与西方出生的女性外阴残割者相比,女性外阴残割者在任何时候复诊的可能性都较低(aHR:0.73,95 %CI:0.69-0.77,p <0.001)。当务之急是提高移民女性同性恋者获得性医疗保健服务的机会并加强外联工作。
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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

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.
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来源期刊
Journal of Migration and Health
Journal of Migration and Health Social Sciences-Sociology and Political Science
CiteScore
5.70
自引率
8.70%
发文量
65
审稿时长
153 days
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