Health Services Use and HIV Prevalence Among Migrant and National Female Sex Workers in Portugal: Are We Providing the Services Needed?


This cross-sectional bio-behavioral survey conducted with 853 female sex workers (FSW) aimed to examine differences in use of HIV health services, testing and prevalence among migrant and national FSW. A quarter of undocumented FSW had never used National Health Service (NHS) and 15 % never tested for HIV, significantly more than nationals (p < 0.001 and p = 0.024, respectively). HIV infection was self-reported by 11.9 % of nationals, 1.8 % of documented and 0.8 % of undocumented migrants (p < 0.001). The HIV rapid test was reactive in 13.6 % of undocumented, 8.0 % of nationals and 2.3 % of documented. A higher proportion of migrants were unaware of their positive serostatus compared to nationals. Ever had HIV testing was less likely among undocumented, who never used the NHS and who didn’t know where to go if suspected being HIV-infected. Promoting early diagnosis with linkage to care among migrant FSW should be supported, while developing health services better tailored to their needs.


Una encuesta transversal biocomportamental fue realizada con una muestra de 853 trabajadoras sexuales (TS) con el objetivo de examinar diferencias en el uso de servicios de salud del VIH, test y prevalencia entre TS migrantes y nacionales. Un cuarto de las TS indocumentadas nunca utilizaron el Servicio Nacional de Salud (SNS) y el 15 % nunca fueron testadas respecto al VIH, porcentajes significativamente superiores a las observadas para las nacionales (p < 0.001 y p = 0.024, respectivamente). La infección por VIH fue auto reportada por 11.9 % de las nacionales, 1.8 % de las migrantes documentadas y 0.8 % de las indocumentadas (p < 0.001). El test rápido del VIH fue reactivo para un 13.6 % de las indocumentadas, 8.0 % de las nacionales y 2.3 % de las documentadas. Una proporción mayor de migrantes desconocía su serostatus positivo en comparación con las nacionales. El test del VIH fue menos frecuente entre las indocumentadas, quien nunca utilizó el SNS y quien no sabía dónde recurrir si sospechaba estar infectada por el VIH. Promover un diagnóstico precoz en conexión con los cuidados en TS migrantes debe ser respaldado mientras se desarrollan servicios de salud mejor adaptados a sus necesidades.

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The study was partially financed by the ADIS/SIDA Program from the National Program for the Prevention and Control of HIV/AIDS Infection. AG has a Ph.D. Grant from Fundação para a Ciência e a Tecnologia (SFRH/BD/84259/2012). The authors would like to thank Gabriela Cohen, Inês Rego, Ricardo Fernandes, Ricardo Fuertes, Ricardo Rosa and Sara Trindade for their collaboration in the project implementation. The authors are also very grateful to all the community partners of the project. Special thanks to all the participants of this study. Finally, the project team are thankful to GHTM – UID/Multi/04413/2013.


This study was funded by ADIS/SIDA Program from the National Program for the Prevention and Control of HIV/AIDS Infection (grant number not applicable).

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Correspondence to Sónia Dias.

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All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

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Informed consent was obtained from all individual participants included in the study.

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Dias, S., Gama, A., Pingarilho, M. et al. Health Services Use and HIV Prevalence Among Migrant and National Female Sex Workers in Portugal: Are We Providing the Services Needed?. AIDS Behav 21, 2316–2321 (2017).

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  • HIV infection
  • HIV testing
  • Health services use
  • Migrants
  • Sex workers