Sex Worker Health Surveillance: a Report to the New South Wales Ministry of Health

People who sell sex (sex workers) are considered a priority population in the NSW HIV Strategy 2016 – 2010 and the NSW Sexually Transmissible Infections Strategy 2016 – 2020. While previous Australian research has found generally high rates of condom use among men and women who sell sex, coupled with low rates of infection, monitoring the sexual health of sex workers is a key strategy in evaluating and maintaining these successes. Because sex work can involve a large and diverse number of sexual partners, sex workers have unique health needs and concerns. Further, the social stigma that many sex workers experience may affect their health-seeking behaviours, which has particular implications for sexual health testing and treatment.

From 2007 to 2015, this report collates data on testing and diagnoses of Chlamydia trachomatis (chlamydia), Neisseria gonorrhoeae (gonorrhoea), Treponema pallidum (syphilis), and human immunodeficiency virus (HIV) among sex workers attending publicly-funded sexual health clinics in NSW.

Key findings
  • Male and female sex workers attending sexual health clinics tended to be slightly older than non-sex workers and were more likely to live in an urban area. Female sex workers were less likely to be of Aboriginal or Torres Strait Islander background and more likely than non-sex workers to be born overseas.
  • Uptake and frequency of sexual health screening was high among both male and female sex workers, with frequency of full screen (i.e., test for chlamydia, gonorrhoea, infectious syphilis, and, among HIV negative patients, HIV) increasing over time.
  • Overall, incidence of infection among sex workers was similar to incidence among non-sex workers.
  • The incidence of HIV was similar among sex worker and non-sex worker gay and bisexual men and stable over time.
  • The incidence of anogenital chlamydia increased among female sex workers from 2007 to 2015. The incidence of anogenital chlamydia also increased among male sex workers but was similar to the general clinic population of gay and bisexual men not reporting sex work.