Screening for sexually transmitted disease in London-based male prostitutes

To provide a screening service for sexually transmissible infections to male prostitutes working in the London area.

An open access service recruiting by a diverse range of methods to avoid over-representation of the more visible elements of this group.

Department of genitourinary medicine in a London teaching hospital and a community-based clinic at a safe address.

During the 10 months following the establishment of the service in June 1990, 57 male prostitutes (38 street based and 19 "escorts") were seen. Of these, 27 men (47%) were found to have evidence of such an infection. Twenty five per cent of the street-based men had serological evidence of previous infection with hepatitis B virus (HBV), 6% had positive syphilis serology, 9% had non-gonococcal urethritis (NGU), 18% had urethral and 13% rectal gonorrhoea. None had gonorrhoea at more than one site. Twenty-seven per cent of these men were HIV 1-antibody positive. Thirty-seven per cent of the escorts had serological evidence of previous infection with HBV, none had positive syphilis serology, 11% had NGU, 5% had urethral and 8% rectal gonorrhoea. None had gonorrhoea at more than one site. Twenty-five per cent of these men were HIV 1-antibody positive.

Specific targeting of resources at this group of individuals is necessary to promote better health education and use of health care provisions.