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HIV-surveys among high risk populations in Rotterdam 2002-2003

HIV-surveys bij hoog-risicogroepen in Rotterdam 2002-2003


There is a potential risk for further spread of HIV and STI from high risk groups into the general population in the Netherlands. These are the main conclusions of the first HIV survey among high risk groups in Rotterdam. Among commercial sex workers (CSW) the HIV prevalence is 7%, 10% among injecting drug users (IDU), 1% among Cape Verde migrants and among Surinamese and Antillian migrants 0%. Sexual risk behaviour is high in these groups. The objectives were to assess the HIV prevalence, related risk behaviours among CSW , IDU and migrants from HIV endemic countries, and the potential of HIV transmission into the general population. This survey is part of the national HIV-surveillance.HIV prevalence among CSW in Rotterdam is higher in street-based prostitution (12%) than in establishment-based prostitution (2%). HIV prevalence among transgender sex workers is 20%. Condom use with customers is high (88%), although condom failure is reported regularly (49%). Condom use with steady and casual partners is low (15% and 25%, respectively). Therefore there is a potential for further spread of HIV in the general population. Number of years in prostitution, transgenders and injecting of drugs were associated with HIV. Substantial sexual risk behaviour is reported in the migrant groups, more in males than females: many sexual partners, concurrent partnerships and less frequent condom use with steady and casual partners (10% and 44%, respectively). Sexual contacts during visits to their countries of origin were reported by 19-32% of the respondents. Due to unsafe sex practices, concurrent partnerships, multiple partners and mixing between ethnic groups, further transmission of HIV and STI in the general population is a potential risk. HIV prevalence among IDU did not change significantly in comparison with prior studies in 1997. IDU shared less needles and syringes over time; however inconsistent condom use remained high: 85% with steady partners, 43% with casual partners. The potential for further spread is considerable due to the high HIV prevalence, the reported unsafe sex behaviour and the sexual mixing between IDU and non-IDU. Results of this survey will be used to target future prevention activities of the Municipal Health Service in Rotterdam. Repeated HIV-surveys are needed to monitor trends in sexual behaviour in high risk groups.

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