Transcript No Slide Title

A sexual health needs assessment of men and
women receiving payment for sex using the
internet
R
1
Ronghe ,
T
2
Groom ,
C
2
Mackillop ,
J
3
Heng
,A
3
Davidson
1. SRH NHS Lanarkshire 2. Sandyford Initiative 3. NHS Open Road Glasgow
Results
Introduction
Previous studies on sexual health needs of individuals exchanging sex for
payment have concentrated on street based individuals and those operating
in off-street settings such as saunas and massage parlours1.
Increasing numbers of men and women are exchanging sex for payment
using the internet. There is limited research about the sexual health needs of
these men and women2.
We conducted this study to assess the sexual health needs of men and
women using the internet to exchange sex for payment.
Awareness of sexual health risks –
20% of the respondents had received payment for not using condoms. Only
8% always used condoms for oral sex.
80% knew where to get tests for sexual transmitted infections and 83% had
been tested.
39% had used SHS for other reasons such as contraception and vaccination
against Hepatitis.
72% of eligible responders had up to date smears; 2 % had never had a
smear and 4% had a smear more that 10 years ago.
Awareness of services –
Aims and Objectives
To assess the sexual health needs of men and women using the internet to
exchange sex for payment and identify unmet sexual health needs of this
population.
Only 6 % of men and 33 % of women in the survey were aware of specialist
sexual health services (SHS) available for these clients.
19% knew about the sexual assault referral centre in Glasgow, Archway.
Forms of payment received
Drug use
Method
For this project we formed a multidisciplinary team with 2 representatives
from SRH department, 1 from Communication and Equality and 2 from NHS
Open Road which provides services for men who receive payment for sex.
The local ethics committee confirmed that ethical approval was not required
for this study.
We designed a health needs assessment questionnaire using survey monkey,
which was revised by the group.
A scoping exercise was carried out to identify websites advertising men and
women who exchange sex for payment in Greater Glasgow & Clyde. This also
afforded an opportunity to identify the best methods of contacting men and
women to provide them with a link to the questionnaire. A total of 35 websites
were utilised. We only included websites that gave personal email addresses
or mobile numbers.
We prepared a database of individual contacts and sent the questionnaire link
along with a short introductory message either via email or text.
The information about the survey and its link was also added to the Sandyford
website and all staff were informed about the survey.
The survey was open over a period of 9 months from May 2012 to February
2013.
Support received –
72% of the respondents were supported by their friends and 69% by peers,
34% received support from partners or family,
12% accessed counselling services and 6% accessed support groups,
6% utilised alcohol, drugs or prescribed medication respectively.
Only 25% of respondents had told their GP or other health staff that they
received payment for sex.
Exiting –
37% planned to continue their activity indefinitely, 28% wanted to exit in 12
months and 22% in 1 to 3 years. 28% knew how to get help to exit.
Dedicated sexual health services –
86% preferred to have dedicated SHS. The majority wanted to access online
support for sexual health issues.
Discussion
Results
The survey was sent to 492 individuals using the internet to exchange sex for
payment as follows: men (n=177), women (n=300), transgendered individuals
(n=9) and escort agencies (n=6). During the study period we had a total of 37
responses to the survey (with 1 spoiled response) as follows: men (n=12),
women (n=24) and transgendered (n=1). 80% of respondents were from the UK.
Gender of responders to the survey
Reason for exchanging sex
for payment
Our study shows that men and women exchanging sex for payment prefer a
dedicated SHS as they find it hard to disclose the nature of their activity to all
health professionals.
The majority of our study population were aware of their sexual health risks
and exhibited risk taking behaviours. As previous studies show, men and
women exchanging sex for payment are a risk group for forward transmission
of sexually transmitted infections2 so it is important to encourage access to
and engagement with SHS.
Although the majority of the respondents had plans to exit, only a few knew
how to get help to exit and would have liked to access more information
regarding this.
The common theme in free text was that ‘they did not want to be seen as
victims’ or ‘labelled as prostituted individuals’ or ‘judged based on their work’
as this would discourage them from attending services.
References
1. Jeal N, Salisburyc. A health needs assessment of street-based prostitutes:
cross sectional survey. Journal of Public Health. 2004, 26(2):147-151
2.Cunningham S, Kendall T. Risk behaviours among internet-facilitated sex
workers: evidence from two new datasets. Sex Transm Infect. 2010,86(3): 100105
Author’s contact: Dr Rashmi Ronghe, Consultant in SRH, NHS lanarkshire, Coathill Hospital, Coatbridge ML5 4DN