Mandatory testing of sex workers for HIV and other sexually transmitted infections

Key take-home messages

• There is limited research evidence available describing the implications of mandatory HIV/STI testing for sex workers and whether it is effective at reducing the incidence of HIV/STIs.
• Commercial sex is currently licensed in Victoria, Australia and sex workers are required to have regular HIV/STI tests (monthly for gonorrhoea, chlamydia and trichomonas and every three months for HIV and syphilis). Two recent studies of the mandatory testing policy suggest that it is not an effective use of healthcare resources.
  • i. A cost-effectiveness analysis of the policy concluded that it is not cost-effective and that “[t]he current testing rate required of sex workers in Victoria is excessive. Screening intervals for sex workers should be based on local STI epidemiology and not locked by legislation”;
  • ii. Another assessment of the policy suggests that “[t]he current legislation requiring monthly STI testing is compromising the access for higher-risk individuals to sexual health”.

• Population(s)
  • Sex workers
• Testing
  • Testing
• Health Systems
  • Governance arrangements