2C 2 Evaluation of the Change in Screening Regulation of Sex Workers for Sexually Transmitted Infections in Victoria, Australia

Tuesday, June 10, 2014: 3:10 PM
Eric PF Chow, PhD, Glenda Fehler, BSc, Marcus Chen, PhD, Catriona Bradshaw, PhD and Christopher Fairley, PhD, Melbourne Sexual Health Centre, The Alfred Hospital, Melbourne, Australia

Background: In Victoria, Australia, the legislation for sex workers to undergo mandatory testing for sexually transmitted infections (STIs) was changed from monthly to quarterly in 07-Oct-2012. The aim of this study was to determine the impact of this legislatory change on STI diagnoses, clinical consultations and clients seen at the Melbourne Sexual Health Centre (MHSC). 

Methods: Computerised medical records of all clients attending at MHSC from 07-Oct-2011 to 07-Oct-2013 were analysed. Parameters in the year prior to the legislatory change were compared to the year following the change. 

Results: Comparing the post- to pre-legislation period, there was a small decrease in the total number of consultations at MSHC [4.1% (36260 to 34775)] but a minimal reduction in consultation hours [0.58% (from 10020 h to 9962 h)]. However, the number of consultations with FSW halved from 6146 to 3453 (p<0.001) and the consultation time spent on FSW reduced by 40.6% (1942 h to 1153 h). More heterosexual men (p<0.001), and women (p<0.001) were seen in the post-legislation period. Overall, 2158 (6.0 cases/100 consultations) and 2441 (7.0 cases/100 consultations) cases of chlamydia, gonorrhoea, syphilis or HIV (STIs) were detected at MSHC in the pre- and post-legislation period [13.1% increase (p<0.001)]. STIs cases attributed to FSW decreased from 135 (2.2 cases/100 consultations) to 95 cases (2.8 cases/100 consultations) during the period but remained substantially below the rate in heterosexual women (5.0 to 5.5), men (5.9 to 6.0) and MSM (8.0 to 10.8).

Conclusions: The change of STIs screening legislation of sex worker from monthly to quarterly resulted in more complex higher risk clients being seen and a 13% increase in STI diagnoses in the clinic although there was a small increase in STIs cases/100 FSW consultations. Overall the change in legislation is likely to have had a beneficial effect on STI control in Victoria.