Data and materials from this study can be obtained from the corresponding author on reasonable request. In Germany, local public health departments LPHD are required to offer low-threshold access to confidential counselling and testing for sexually transmitted infections STI for sex workers. We tested whether baseline characteristics of LPHD were associated with the proportion of positive test results. Overall, a median of In total, 22, STI tests were performed. The proportion of positive tests was 3.
The proportion of positive tests varied between 0 and This variation likely reflects different testing strategies. The online version of this article doi According to the Prostitution Act, sex workers have the right to access health insurance and obtain social benefits such as unemployment benefits and pension. In contrast, sex workers who are self-employed without a previous health insurance in Germany or in their home country if they are EU citizens have difficulties to obtain health insurance and access regular health care in Germany.
Sex workers without a residence permit have no access to health care insurance or to health care, unless they cover the costs themselves. Apart from the regular insurance-based health system, local public health authorities LPHD are required by law to run STI clinics offering confidential counselling and testing for sexually transmitted infections STI for persons with a higher risk for STI. Hence, this offer also addresses female sex workers FSW.
STI tests are usually free of charge. FSW may prefer LPHD since they can guarantee anonymity and provide additional services, such as counselling on sex work, general medical care or free condoms. Although FSW are often considered to be at a higher risk for STI [ 1 — 3 ], this may not always be the case in practise. A cross-sectional study among migrant FSW in Catalonia showed that the prevalence of Chlamydia trachomatis CT and Neisseria gonorrhoeae NG were similar to sexually active young people [ 4 ].
A higher prevalence of STI was observed in other studies among FSW with migration background and working on the street [ 5 — 8 ]. In Germany, only few data are available on STI. After the introduction of the Infection Protection Act in , only syphilis and HIV infections remained notifiable [ 9 , 10 ]. Indeed, a national increase in the number of reported syphilis infections has been observed between and and again from , but this has mostly been attributed to increased transmission among men who have sex with men [ 11 , 12 ].
