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![Page 1: Sex work among people who inject drugs in England, Wales & Northern Ireland: Findings from a National Survey of Health Harms and Behaviours Sara Croxford,](https://reader033.fdocuments.us/reader033/viewer/2022051517/56649d6f5503460f94a51aa5/html5/thumbnails/1.jpg)
Sex work among people who inject drugs in England, Wales & Northern
Ireland: Findings from a National Survey of Health Harms and
Behaviours
Sara Croxford, L Platt, V Hope, KJ Cullen, JV Parry, F NcubeHIV & STI Department, Centre for Infectious Disease Surveillance and Control (CIDSC)Public Health England
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2 Sex work among people who inject drugs in England, Wales and Northern Ireland
Background
44% people who inject drugs (PWID) have antibodies to HCV
15% of PWID infected with HBV
18% of new HIV infections among PWID
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3 Sex work among people who inject drugs in England, Wales and Northern Ireland
Unlinked Anonymous Monitoring Survey of
PWID• Each year, since 1990, a nationally reflective sample of PWID are recruited from >60 drug services across EW&NI.
• Clients who have ever injected psychoactive drugs are invited to: provide a dried blood spot (DBS)
self-complete a short questionnaire
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4 Sex work among people who inject drugs in England, Wales and Northern Ireland
• No national surveillance of sex workers in the UK.
• UAM Survey of PWID questionnaire was revised in 2011 to include the following question on sex work:
“Have you ever received money, goods or drugs in exchange for sex?”
• This study presents the first analyses of these data.
Background
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5 Sex work among people who inject drugs in England, Wales and Northern Ireland
Results
• Of the 2,400 eligible PWID recruited in 2011, 75% (1,810) were men.
• Overall 14% (330) of PWID reported a history of sex work.
• A higher proportion of women reported sex work (31%; 185/590) compared to men (8%; 145/1,810).
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6 Sex work among people who inject drugs in England, Wales and Northern Ireland
Factors found to be significant among men who inject drugs
Male non-sex workers Male sex workers
Median injecting duration (IQR) 12 (6-17) 14 (7-19)Median age of first use of an NSP 22 (19-28) 18 (20-26)Median age first in prison 18 (16-21) 17 (15-19)
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7 Sex work among people who inject drugs in England, Wales and Northern Ireland
Factors found to be significant among women who inject drugs
Female non-sex workers Female sex workers
Median injecting duration (IQR) 6 (2.5-10) 11 (6-17)Median age of first use of an NSP 23 (20-28) 21 (18-26)
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8 Sex work among people who inject drugs in England, Wales and Northern Ireland
Sex work and BBVs
After adjustment, sex work was found NOT to be associated with increased likelihood of
either anti-HIV/HBV or anti-HCV.
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9 Sex work among people who inject drugs in England, Wales and Northern Ireland
Conclusions• First national estimate of the prevalence of sex work
among PWID in EW&NI: 14%
Higher among women than men (1 in 3 vs.1 in 12).
• PWID engaging in sex work are a particularly vulnerable population with higher reported risk.
Longer history of drug taking and injecting
Higher rates of reported needle/syringe sharing
Higher prevalence of Injection site infections and BBVs
Significantly more experience of prison and homelessness
Riskier sexual behaviour (more partners, more same sex partners among men)
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10 Sex work among people who inject drugs in England, Wales and Northern Ireland
Recommendations
• Need for a comprehensive range of services for PWID
Onsite BBV testing
HBV vaccination
Harm reduction interventions
Targeting to sub-groups of PWID including MSM, migrants and sex workers
• Maintained provision of effective interventions, particularly needle/syringe programmes.
• Continued public health surveillance of BBVs and risk behaviours among PWID is essential.
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11 Sex work among people who inject drugs in England, Wales and Northern Ireland
Paper published as a short report via IJDP
DOI: 10.1016/j.drugpo.2014.09.014
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12 Epidemiology of HIV in the United Kingdom, 2012
THANK YOU!
We gratefully acknowledge the continuing collaboration of participating PWID, drug services,
public health practitioners, microbiologists and other colleagues who contribute to the
surveillance of BBVs among PWID in the UK.
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13 Epidemiology of HIV in the United Kingdom, 2012
References Hope, V. D., Eramova, I., Capurro, D., & Donoghoe, M. C. (2014). Prevalence and estimation of hepatitis B and C infections in the WHO European Region: a review of data focusing on the countries outside the European Union and the European Free Trade Association. Epidemiol.Infect., 142, 270-286.
Platt, L., Jolley, E., Hope, V., Latypov, A., Hickson, F., Reynolds, L. et al. (2013). The HIV Epidemics in Europe: Vulnerability and response Washington DC: The World Bank; World Helath Organisation Europe; London School of Hygiene and Tropical Medicine.