- There are at more risk of getting an STI and can pass an STI on to other people
- It is important for a sex worker to get the right STI tests. Vaginal, anal, oral and blood tests
- Recommend getting an STI test twice a year
- Also talk about other ways to protect against STIs
- Be away of the pitfalls of prejudices and stigmas surrounding sex work
Risk group
It is important to know if your client is a sex worker. That make it easier to determine what STI tests to do. Because of what they do for a living, sex workers are at more risk of getting an STI. And they can pass the STI on other other people. Follow these steps:
- Ask your client if it’s ok to ask them questions about sexual behavior
- Draw up questions to determine your client’s risk profile. What is your client’s situation? Who have they had sex with? Not all sex workers will talk about their work. Your approach during the chat can help. Read about how to talk about sex and STIs
- What did your client do during sex? Was the sex vaginal, anal or oral?
These questions can help you determine which STI tests are necessary. In the case of sex workers, you test for all STIs at all locations on the body.
You can read more about the steps you take during an STI consultation at soaaids.nl (Dutch only)
Which STI tests
Has the conversation revealed that your client is a sex worker? In that case, it is a good idea to test for these STIs:
- Gonorrhea
- Hepatitis B if the person has not been vaccinated
- HIV
- Syphilis
Test on all locations: vagina, penis, anus and throat.
You can read about how you can perform an STI test according to the guideline (Dutch only)
Treatment
Do the tests show that your client has an STI? Start the treatment as soon as possible. Does your client have a steady partner? In that case, the partner should also be tested quickly and given treatment if necessary.
Most STIs can be treated by a doctor or the municipal health service (GGD). For a number of STIs, you refer your client to a specialist center for treatment:
- HIV: HIV treatment center. Your client will be treated by the HIV specialist and monitored by the HIV consultant in the HIV treatment center
- Hepatitis B and Hepatitis C: MDL (stomach, intestinal and liver disease) doctor or infection specialist
You can read about how to treat STIs according to the guideline at soaaids.n (Dutch only)
Counseling
An important part of the STI consultation is discussing sexually risky behavior and offering support when making healthy choices. Talk about your client after the STI test. You talk about:
- Regular testing: in the case of sex workers, the advice is to get tested for all STIs at least twice a year. And test all over the body: vagina, penis and anus
- Tell your client that they should always get tested if they have symptoms. Or if a condom broke or slipped off or the sex worker did not use a condom
- Hepatitis B vaccination. If possible, offer the vaccination immediately
- and discuss whether PrEP is necessary for protection against HIV. This applies in particular to men and transgenders who have sex with men
- What can someone do if a condom broke or slipped off during sex
- Vaginal or penile hygiene: this can sometimes help to prevent an STI better
- Contraception: which one is best for your client?
Would you like to know what advice to give about this? Read more about STI counseling for sex workers
Lyle’s story: “My client was also scared”
Lyle (24) is studying political science, is a sex worker and is HIV positive. In this video, he talks about what he gets out of his work, how he is dealing with the diagnosis and why it is important to continue the dialogue about sex work.
Discussing test results
Do the tests show that your client has an STI? In that case, you send a message asking them to come to the municipal health service (GGD) for treatment. During the appointment, you discuss:
- The results of the STI test
- Who your client should warn. Offer them help and use the Partner Management guide (Dutch only)
- And whether your client can still work. Or when they can go back to work
Warning partners
Does your client have an STI? In that case, it is important to warn as many sex partners in the past few months as possible. It is often easier to warn your own partner. Warning clients is sometimes more difficult.
Tell your client that they never have to share the results with a landlord of the place of work or the proprietor
Tell them that they can also do this anonymously via partnerwaarschuwing.nl (in Dutch and English) and that you can help them do this.
How do you warn sex partners for your client (Dutch only)
Learn about sex work and health
Would you like to know how to set up an activity for sex workers about sexual health? Our e-learning, which includes practical tips, can get you started in two hours.