Free sex texting in Switzerland

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Metrics details. Clients of street sex workers may be at higher risk for HIV infection than the general population. Furthermore, there is a lack of knowledge regarding HIV testing of clients of sex workers in developed countries. This pilot study assessed the feasibility and acceptance of rapid HIV testing by the clients of street-based sex workers in Lausanne, Switzerland.

For 5 evenings, clients in cars were stopped by trained field staff for face-to-face interviews focusing on sex-related HIV risk behaviors and HIV testing history. The clients were then offered a free anonymous rapid HIV test in a bus parked nearby.

Rapid HIV testing and counselling were performed by experienced nurse practitioners. Clients with reactive tests were offered confirmatory testing, medical evaluation, and care in our HIV clinic. We intercepted men, Among them, 50 A total of 31 None were reactive. Initially, 19 This pilot study showed that rapid HIV testing in the red Free sex texting in Switzerland district of Lausanne was feasible, and that the clients of sex workers accepted testing at an unexpectedly high rate.

Peer Review reports. Sincea yearly 3- to 5-evening preventive action called "Don Juan" has taken place on the streets of the red light districts in major Swiss cities. The prevalence of HIV in sex workers in Switzerland is unknown; however, the prevalence is pd to be higher than in the general population due to multiple risk factors. First, sex workers are a very heterogeneous group that includes forced migrants, injecting drug users, transsexuals, and individuals from other vulnerable and at-risk populations [ 1 ]. Furthermore, the sex workers often have unstable living and working situations.

As a consequence, their access to healthcare and disease prevention information is generally not optimal compared to the general population [ 2 — 4 ]. The prevalence of HIV in the clients of sex workers in Switzerland is also unknown.

This lack of knowledge stems from the difficulty of contacting clients in western countries; in addition, there is little epidemiological information about men who pay for sex [ 45 ]. However, sex workers report that clients frequently requested unprotected sex mainly oral intercourse [ 113 ]. The refusal of clients to use condoms and their willingness to pay more for unprotected sex is the greatest barrier to safer commercial sex [ 1516 ].

The "Don Juan" preventive action described here was deed to address these issues. Specifically, we wished to determine whether it was feasible in the red light district of Lausanne, Switzerland to test the clients of sex workers for HIV using rapid testing on finger-stick blood samples. We assessed whether clients would be willing to undergo such testing and determined HIV prevalence in this sample of clients. The study took place over 5 nights in September from 10 pm to 1 am in the red light district of Lausanne, Switzerland.

This well defined area consists of 4 parallel streets each less than meters long restricted by law area and time period. Clients of sex workers were stopped in their cars. A free condom was offered by trained field staff members through the car-window as a means of introduction to an interview.

A face to face questionnaire was administered by the trained field worker that focused on age, country of origin, profession, HIV testing history, whether the client had a stable partner or partners, and use of condoms with sex workers. Rapid HIV testing and counselling were performed by experienced nurse practitioners in accordance with the Swiss Federal Office of Public Health recommendations for anonymous voluntary counselling and testing VCT [ 17 ]. When the test were available, i.

The client was offered confirmatory testing, medical evaluation, and care in our HIV clinic if the test result was positive. The study protocol was approved by the Medical Ethics Committee of the University of Lausanne, and the study was performed in compliance with the Helsinki Declaration. The clients we stopped were all men who ranged from 19 to 63 years old. Clients' characteristics are summarized in Table 1. Between 20 and 60 clients visit the area every night.

The general flow of clients intercepted, interviewed and tested for HIV is summarised in figure 1. Of individuals intercepted on the street, The remaining 32 clients, just took the condom that was handed through the car-window and left without accepting the interview. In the interviewed clients sample, 50 Of the 31 rapid HIV tests performed Of note, 7 of the tested clients Nineteen additional clients Characteristics of the 31 clients who were tested for HIV compared to the clients who were not tested are summarized in Table 1.

This pilot study showed the feasibility of rapid HIV testing in the red light district of Lausanne. It also revealed an unexpectedly high rate of HIV testing acceptance i. To Free sex texting in Switzerland knowledge, this is the first study to assess the feasibility and acceptance of rapid HIV testing of sex workers' clients in a western country. By placing the bus on a dead end street, the survey and HIV testing took advantage of the well restricted area where cars engaging in the street know that it le "only" to sex workers.

The setting of the bus parked in the red light district with professional nurses face to face with the client inside the bus to perform HIV rapid testing was satisfactory from the technical, medical and patient point of view. Although sample sizes are small in this pilot study table 1we did not find any sociodemographic factors that ificantly differ between the clients that accepted or refused the HIV test.

Free sex texting in Switzerland

Surprisingly, meeting the client while he was on his way to seek sex with a sex worker allowed a simple, direct, and authentic discussion. The clients' socio-demographic characteristics indicated that they had access to health care and enough money to get tested in anonymous VCT centers.

Free sex texting in Switzerland

Some clients acknowledged that our "fly-on-the-wall" approach was effective because this setting allowed them to take an HIV test without justification. The anonymity of the test was also Free sex texting in Switzerland important factor in clients' decisions to be tested [ 19 ]. Rapid HIV testing produces a result in about 30 minutes, and the rapidity is known to facilitate clients usage [ 1920 ].

We do not know whether the fact that the testing was provided for free compared to 30 euros in the VCT centers contributed to the high acceptance rate. Studies proposing HIV tests may be confounded by selection bias. The main pitfall is that people who accept the HIV test are the ones who do not need it because they are at a low risk. Although the sample size of our pilot study is small, we did not find a sociodemographic bias suggesting that the clients who accepted the HIV test were at a lower risk than the clients who refused the HIV test.

This pilot study identified some factors that decreased the test acceptance rate. More than one third of the clients who initially agreed to HIV testing were ultimately not tested owing to an unacceptable waiting time. Indeed, there were more clients willing to get tested for HIV than we anticipated; by having more nurse practitioners and thus decreasing the waiting time, 19 additional HIV rapid tests could have been administered, increasing the of tests performed to 50 The cold and rainy weather on the 5 autumn nights certainly contributed to clients' reluctance to wait on the street for an HIV test, which is something that should be considered in future studies or when devising a similar HIV testing strategy.

HIV testing in anonymous VCT centers or caregiver facilities fails to reach a high percentage of the clients of sex workers. HIV testing in red light districts should be considered, since this study shows that such testing is feasible. The cost effectiveness must be assessed, taking into that late diagnosis of HIV is costly and that early identification of HIV may decrease the spread of the disease to both sex workers and to the clients' regular partners. Sex Transm Infect. Aust Fam Physician. PubMed Google Scholar. Google Scholar. An analysis of the increasing prevalence of female commercial sex contacts among men in Britain.

Sex Transm Dis. Article PubMed Google Scholar. HIV Med. AIDS Care. Swiss Med Wkly. J Acquir Immune Defic Syndr. Download references. Point Fixe let us use their bus. Paul Vaucher assisted EAD in the data base setting and analysis. You can also search for this author in PubMed Google Scholar. Correspondence to Matthias Cavassini. EAD drafted the manuscript.

All authors read and approved the final manuscript. Reprints and Permissions. Diserens, EA. Clients of sex workers in Switzerland: it makes sense to counsel and propose Free sex texting in Switzerland test for HIV on the street, a preliminary report. BMC Infect Dis 10, 74 Download citation. Received : 22 July Accepted : 19 March Published : 19 March Anyone you share the following link with will be able to read this content:.

Free sex texting in Switzerland

Sorry, a shareable link is not currently available for this article. Free sex texting in Switzerland by the Springer Nature SharedIt content-sharing initiative. Search all BMC articles Search. Download PDF. Abstract Background Clients of street sex workers may be at higher risk for HIV infection than the general population. Method This pilot study assessed the feasibility and acceptance of rapid HIV testing by the clients of street-based sex workers in Lausanne, Switzerland. Result We intercepted men, Conclusion This pilot study showed that rapid HIV testing in the red light district of Lausanne was feasible, and that the clients of sex workers accepted testing at an unexpectedly high rate.

Background Sincea yearly 3- to 5-evening preventive action called "Don Juan" has taken place on the streets of the red light districts in major Swiss cities. Methods The study took place over 5 nights in September from 10 pm to 1 am in the red light district of Lausanne, Switzerland. Table 1 Clients' characteristics: sociodemographic, condom use with sex workers and past HIV tests Full size table. Figure 1. Flowchart of clients intercepted. Full size image. Discussion This pilot study showed the feasibility of rapid HIV testing in the red light district of Lausanne.

Conclusion HIV testing in anonymous VCT centers or caregiver facilities fails to reach a high percentage of the clients of sex workers. References 1. PubMed Google Scholar 3. Google Scholar 4. Google Scholar 5. Article PubMed Google Scholar 7. Article PubMed Google Scholar 9. Article PubMed Google Scholar Acknowledgements Point Fixe let us use their bus. View author publications. Additional information Competing interests The authors declare that they have no competing interests.

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