Impact of a Nurse Cyber-Outreach Program for Sex Workers and Patrons and Appeal of Internet-Based Testing in This Population

Background: The internet offers the opportunity to reach persons at risk for HIV/STDs who may not otherwise seek sexual health services. In British Columbia (BC), an established nurse outreach program delivers information/referrals to thousands of clients per year through one-on-one messaging and public “bulletin boards” on sexual/social networking/dating websites, including one local site used by sex workers and patrons.

Objectives: To evaluate satisfaction, knowledge/behaviour change, and sexual health-related needs of clients of this cyber-outreach service, through an anonymous web-based survey.

Methods: Participants were recruited through periodic invitations posted to a bulletin board on the website.

Results: The 99 respondents were predominantly male (82%). 70% had given and 17% had received money/drugs/goods/services in exchange for sex in the previous six months. 98% of clients found the service important and useful. 91% agreed that their knowledge of sexual health increased after using the service. Those who privately chatted with a nurse were more likely to report STD/HIV testing (61%) than those who only visited the bulletin board (42%). 67% had not looked for sexual health information on any other websites in the previous six months. 74% had a health care provider whom they routinely see; however, only 49% felt comfortable talking with this provider about sexual health. 76% would use internet-based STD/HIV testing if available. Detailed comments further suggested that cyber-outreach clients rely heavily upon this service for up-to-date and relevant sexual health information.

Conclusions: Sex workers and patrons accessing an online sexual health nursing outreach service in BC appreciate the service and may not otherwise receive sexual health information.

Implications for Programs, Policy, and Research: Expansion of internet-based sexual health services, including online access to nurses and STD/HIV testing, can facilitate improvements in sexual health knowledge and testing, particularly among marginalized populations that face difficulties accessing appropriate sexual health care.