{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T11:38:27Z","timestamp":1772451507723,"version":"3.50.1"},"reference-count":41,"publisher":"BMJ","issue":"10","license":[{"start":{"date-parts":[[2024,10,23]],"date-time":"2024-10-23T00:00:00Z","timestamp":1729641600000},"content-version":"unspecified","delay-in-days":22,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Dutch National Institute for Public Health and Environment (RIVM); Grant","award":["4410003189"],"award-info":[{"award-number":["4410003189"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,10,8]]},"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To determine associations between the banning of sex work during the COVID-19 pandemic, and work, financial problems, mental well-being and HIV\/sexually transmittable infection (STI) testing among sex workers in the Netherlands.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Two cross-sectional online surveys. The first survey covered two time-periods: pre-COVID-19 (1 January 2019 to 31 December 2019) and period 1 (15 March 2020 to 1 July 2020). The second survey covered period 2 (1 January 2021 to 31 December 2021).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>The Netherlands<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>In total, 106 (first survey) and 196 (second survey) sex workers participated. Most of the participants in the first and second survey were cisgender women (respectively, 76.4% and 66.5%), followed by cisgender men (respectively, 12.3% and 15.7%) and the combination of transgender men, transgender women, non-binary or other (respectively, 11.3% and 17.6%). Most participants were born in the Netherlands (respectively, 61.4% and 69.7%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>We provide descriptive statistics of self-reported work during and prior to COVID-19 measures, financial problems due to COVID-19 measures and HIV\/STI testing and mental well-being during the COVID-19 pandemic. We also performed logistic and linear regression analyses to identify risk factors associated with reporting financial problems due to COVID-19 measures, not testing for HIV\/STIs and lower mental well-being during the COVID-19 pandemic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In periods 1 and 2, respectively, 69.6% and 62.0% reported financial problems due to the COVID-19 measures. Among those who reported to have had sex with clients, the percentage not HIV\/STI testing was: 4.5% (95% CI: 0.9; 12.5) pre-COVID-19, 28.2% (95% CI: 15.0; 44.9) in period 1, and 15.2% (95% CI: 9.7; 22.3) in period 2. In the multivariate analysis, reported financial problems due to the COVID-19 pandemic was associated with not HIV\/STI testing (OR: 12.1, p&lt;0.001) and lower mental well-being (B: \u22122.7, p&lt;0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The COVID-19 pandemic control measures in the Netherlands were associated with major financial problems, low mental well-being and reduced HIV\/STI testing among sex workers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-085202","type":"journal-article","created":{"date-parts":[[2024,10,24]],"date-time":"2024-10-24T02:00:28Z","timestamp":1729735228000},"page":"e085202","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Major financial problems, low mental well-being and reduced HIV\/STI testing among sex workers in the Netherlands during the COVID-19 pandemic: a repeated cross-sectional survey"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5574-3499","authenticated-orcid":false,"given":"Mari\u00eblle","family":"Kloek","sequence":"first","affiliation":[{"name":"Department of Public Health, Erasmus MC, Rotterdam, Zuid-Holland, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daphne","family":"van Wees","sequence":"additional","affiliation":[{"name":"RIVM, Bilthoven, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jane","family":"Bakker","sequence":"additional","affiliation":[{"name":"Independent Sex Worker, Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mischa","family":"Tyd","sequence":"additional","affiliation":[{"name":"Independent Sex Worker, Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julia Raxon","family":"Rosales","sequence":"additional","affiliation":[{"name":"Independent Sex Worker, Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomas","family":"Geling","sequence":"additional","affiliation":[{"name":"Soa Aids Netherlands, Amsterdam, Noord-Holland, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Evelien","family":"Spek","sequence":"additional","affiliation":[{"name":"Soa Aids Netherlands, Amsterdam, Noord-Holland, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9323-7861","authenticated-orcid":false,"given":"Jan A C","family":"Hontelez","sequence":"additional","affiliation":[{"name":"Department of Public Health, Erasmus MC, Rotterdam, Zuid-Holland, The Netherlands"},{"name":"Heidelberg Institute of Global Health, UniversitatsKlinikum Heidelberg, Heidelberg, Baden-W\u00fcrttemberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,10,23]]},"reference":[{"key":"2025120619115873000_14.10.e085202.1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMms2009984"},{"key":"2025120619115873000_14.10.e085202.2","unstructured":"Rijksoverheid . 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