(P369) STI/HIV burden and sexual healthcare-seeking behaviour among first- and second-generation migrant and Western-born male sex workers who have sex with men in the Netherlands between 2016-2021

Background: Globally migrant sex workers have a higher STI/HIV burden. However, it is unclear to what extent migrant male sex workers who have sex with men (MSW-MSM) experience worse sexual health outcomes compared to Western-born MSW-MSM in Western Europe. This unique and large study aimed to assess demographics, STI/HIV burden and sexual healthcare-seeking behaviour of first-generation migrant (FGM) and second-generation migrant (SGM) MSW-MSM versus Western-born MSW-MSM.

Methods: A large number of coded STI clinic consultations (n=6970) from 3116 individual MSW-MSM attending any Dutch STI clinic between 2016-2021 were included. FGM is defined as born outside of central/western Europe/North America/Oceania and SGM as at least one parent born outside of central/western Europe/North America/Oceania. Logistic regression analysis was used to assess associations between STI in first consultation and MSW-MSM groups. Incidence in first repeat tests was compared between migration groups using Cox proportional hazard regression, stratified by STI in first consultation. All analyses were adjusted for age and urbanity of STI clinic region.

Results: FGM MSW-MSM (n=1085) were mostly born in Latin America (50%), while SGM MSW-MSM (n=368) mostly originated from North Africa (30.4%).

There was a significant difference in diagnosis of any STI (33.2%; 29.3%; 23.3%; p< 0.001) between the FGM, SGM and Western-born MSW-MSM. In Table 1 STI burden among the groups is specified.

FGM MSW-MSM had an aOR of 1.60 (95%CI:1.34-1.90, p< 0.001) of getting an STI diagnosis in the first consultation compared to Western-born MSW-MSM. Overall, incidence of first repeat tests per 100 person-years was 25.8 (95%CI:23.5-28.2) among FGM, 19.7 (95%CI:16.6-23.1) among SGM and 16.7 (95%CI:15.4-18.1) among Western-born MSW-MSM.

FGM MSW-MSM (compared to Western-born) have a hazard ratio of 1.51(95%CI 1.30-1.76, p< 0.001) of having a first repeat consultation at any time, when stratified for no STI in the first consultation. This association was absent when stratified for having an STI in the first consultation.

Conclusion: The STI/HIV burden is high among all three MSW-MSM groups and FGM have a higher odds of STI. Results suggest that FGM are not more lost to follow-up and highlight the importance of accessibility to STI testing and care for (migrant) MSW-MSM.