Introduction and objectives: Sex worker health needs are rarely evaluated and addressed beyond issues of sexually transmitted infections (STI) and HIV. St. James infirmary (SJI), founded in 1999, and located in San Francisco, California, is a first of its kind peer-based Occupational Health and Safety clinic for current and former sex workers and their families. Founded by local sex worker activists in partnership with the San Francisco Department of Public Health and the University of California, San Francisco, SJI, was created to evaluate sex worker health needs and create comprehensive peer-based medical and social services to address them. Methods: Observational study of sex worker health needs via structured intake questionnaire administered by peer counselors to sex workers who sought care at SJI between September 1999 and November 2004. Univariate, bivariate, and multivariable analyses assessed STI predictors. Results: A total of 783 current or former sex workers were interviewed with 53.6% identifying as female, 23.9% as male, 16.1% as male-to-female transgender and 6.5% as other. There was a wide range of ethnicities, educational levels, and type of sex work. Seventy percent never disclosed sex work to a medical provider. Roughly 40% reported current illicit substance use. Most common substance used was tobacco at 45.8%. Over half reported domestic violence and 36% reported work-related violence. Of those screened 5.07% were HIV positive, 12.4% were gonorrhea positive, 6.8% were chlamydia positive, 1.8% were syphilis positive and 34.3% were herpes simplex-2 positive. African-American race, male gender, and experince of violence were STI predictors. Conclusions: Health needs of sex workers extended beyond issues of STI\'s and HIV and include high prevalence of violence, illicit drug use, tobacco use. Sex workers were unlikley to disclose sex work to medical providers. Predictors of STI\'s exist.
Conflict of Interest: None disclosed
Financial Support/Funding: San Francisco Department Of Public Health, University Of California, San Francisco, Ford Foundation, St. James Infirmary
Sydney Australia, April 2007.
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