BMJ  2007;334:863 (28 April), doi:10.1136/bmj.39191.716458.3A

Letters

Stigmatising sex workers

BMA public health doctor's claims lack evidence

There is no epidemiological evidence to support the recent statement by Spencer Jones that 70% of all sexually transmitted infections (STIs) in Birmingham are circulating in a pool of prostitutes and their clients.¹ Surveillance data routinely collected by clinics for genitourinary medicine (GUM) and analysed by the Health Protection Agency do not include the proportion of STIs diagnosed in sex workers or their clients. Furthermore, data from the "Safe Project," a dedicated sexual health promotion service for Birmingham's sex workers, indicates that over the past year, the prevalence of STIs among the 208 sex workers attending this targeted service was low (chlamydia (1.9%), HIV (0), gonorrhoea (2.9%), and syphilis (1%).)

More recently a local enhanced surveillance programme introduced for syphilis indicated that, although commercial sex work or reported use of sex workers were identified among those found to be infected with syphilis, just 5% of the total number of syphilis diagnoses were attributable to this group.

Trends in HIV infections in Birmingham are similar to those seen nationally, and there is no evidence that contact with commercial sex workers is a significant risk factor in those newly diagnosed with HIV infection.^{2 3}

Overall the claims made by the chairman of the BMA public health committee seem to be without substance. As a public health doctor he has a duty not only to ensure that important public health issues are discussed but also to check out the facts before going public.

¹ Heart of Birmingham Primary Care Trust, Bartholomew House, Birmingham B16 9PA, ² Department of Genitourinary Medicine, Whittall Street Clinic, Birmingham B4 6DH

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Competing interests: None declared.

References

1. Day M. BMA public health doctor is accused of stigmatising sex workers. BMJ 2007;334:767. (14 April.) doi: 10.1136/bmj.39181.578229.BE[Free Full Text]
2. Health Protection Agency. Sexually transmitted infections in residents of Birmingham and Solihull Jan-Dec 2005. West Midlands: HPA, 2006.
3. The UK Collaborative Group for HIV and STI Surveillance. A complex picture. HIV and other sexually transmitted infections in the United Kingdom: 2006. London: Health Protection Agency Centre for Infections, 2006. www.hpa.org.uk/publications/2006/hiv_sti_2006/pdf/a_complex_Picture

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BMA public health doctor is accused of stigmatising sex workers

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