Sexual Risk Behaviour And Sti Testing Behaviour Of Male Sex Workers Who Have Sex With Men (M$M) In The Netherlands

BackgroundMale sex workers who have sex with men (M$M) are a high-risk group for acquiring sexually transmitted infections (STI) including human immunodeficiency virus (HIV). An understanding of sexual risk behavior is necessary to successfully develop risk-reduction strategies. However, limited scientific knowledge is available on sexual risk behaviour of M$M in the Netherlands. The aim of this study was to assess M$M’s sexual risk behaviour in the Netherlands, e.g. STI testing behaviour, condom use, drug use before/during sex and hepatitis B (HBV) vaccination.MethodsFor this qualitative study semi-structured individual in-depth interviews were conducted with 20 M$M who worked home-based in the Dutch province of Limburg. Respondents were recruited by convenience sampling until saturation was reached via 1) five websites and smartphone applications commonly used by M$M 2) STI clinic 3) two gay sauna’s. An interview guide was developed including themes such as sexual health, condom use and STI testing behaviour. The interviews’ recordings were transcribed verbatim and inductively coded with Atlas.ti 8.ResultsThe majority of the interviewed M$M would regularly get tested for STI, however some had never or irregularly been tested. Their STI risk perception often determined testing behaviour. Condom use was reported to be high with anal sex, but low with oral sex. Condom use was mostly determined by STI risk perception, trust in clients and sexual pleasure. A third of the respondents was not vaccinated against HBV, mainly due to the lack of information and awareness of HBV vaccination and low risk perception of HBV. Furthermore, almost half of the M$M had used drugs before/during sex in the past six months.ConclusionIn this study we were able to assess sexual risk behaviour of 20 M$M in the Netherlands. The results can be taken into account for the tailoring of future risk-reduction strategies for M$M.