P2-S4.07 Unsafe casual travel sex with discordant and concordant partners is common among visitors of a large STI outpatient clinic in Amsterdam; risk for international spread of STI
Authors: Urbanus A , Heijman T , Sonder G , van den Hoek A 
Published: July 2011

Background

Travelling has always been an important factor in the spread of STI. In the last decades international travelling has become very popular and therefore the risk for spreading STI internationally has become higher. Here we examine determinants of casual travel sex among visitors of a large STI clinic in the Netherlands. With these results specific advice about safe casual travel sex might be given.

Methods

During three waves of the bi-annual anonymous survey (mid 2008–mid 2009), 2971 attendees of the STI clinic Amsterdam, were interviewed about risk factors for blood-borne and sexually transmitted infections and about casual travel sex in the past 6 months. Determinants of casual travel sex were analysed using logistic regression. Analyses were done combined and separately for participants with Western, Surinam, and other ethnicity.

Results

In total 949/2971 (32%) participants had casual travel sex in the 6 months preceding the visit to our STI clinic. Of these participants 265 (28%) were women, 299 (32%) heterosexual men and 385 (41%) MSM. Participants who had casual travel sex were more often heterosexual men (OR 1.66, 95% CI 1.37 to 2.01) or MSM (OR 3.03, 95% CI 2.50 to 3.68), were older (median 31 vs 27; p<0.0001), had more often a history of STI (OR 1.66, 95% CI 1.42 to 1.94) and had a higher number of life time sexual partners (median 26 vs 13; p<0.0001). Participants who had unsafe travel sex were younger (mean 29 vs 33; p<0.001) and had less often a STI in the past (OR 1.41, 95% CI 1.08 to 1.82). In particular Western participants reported a high number of casual travel sex with discordant ethnic partners. In addition they reported more frequently unsafe sex with both discordant and concordant ethnic partners (see table). Around 60% of Western women, heterosexual men and MSM who had casual travel sex, had sex with a discordant ethnic partner. However, Western MSM were more likely to use a condom during casual travel sex (OR 2.39, 95% CI 1.45 to 3.92) than heterosexual men and women see Abstract P2-S4.07 Table 1.

Abstract P2-S4.07 Table 1

Number of participants who have casual travel sex per ethnicity group

Casual travel sexWith discordant ethnicity groupUnsafe sex with discordant ethnicity groupUnsafe sex with concordant ethnicity groupParticipant Western*647/1931 (33.5%)384/647 (59.0%)201/380 (52.9%)†160/263(60.8%) Suriname70/358 (19.6%)35/70 (50.0%)13/35 (37.1%)18/34 (52.9%)† Other232/682 (34.0%)93/232 (40.1%)48/93 (51.6%)73/136 (53.7%)†*

Dutch included.

†

Missings excluded.

Conclusion

Casual travel sex is very common among visitors of our STI clinic compared with the ca. 5% reported among visitors of a travel clinic, in particular among visitors who are older, with a high number of lifetime sex partners and with previous STI. These findings give insight in the risk of the international spread of STI and may be of help in providing specific pre-travel advice on safe sex abroad.