Is migrant status a bacterial sexually transmitted infection risk factor? Prevalence of bacterial sexually transmitted infections in a free-clinic population in France: a monocentric cross-sectional retrospective study.

OBJECTIVES: Bacterial sexually transmitted infections (STIs) are a major public health concern, especially among vulnerable populations. This study aimed to assess the prevalence of bacterial STIs in a sexual health clinic population in France and determine whether migrant status is an independent risk factor.

METHODS: We retrospectively analyzed medical records from patients attending a Parisian-based STI free clinic between July 1, 2019 and December 31, 2023. The outcome for the primary analysis was the diagnosis of Chlamydia trachomatis, syphilis, or Neisseria gonorrhea infection. Multivariable logistic regression models were used to describe the association between migrant status and bacterial STIs, adjusting for age, number of sexual partners in the past year, sex work, gender, and sexual orientation. Adjusted odds ratios were estimated, and P-value was calculated using X2-test.

RESULTS: A total of 9949 adults were included, of whom 28% were migrants, including 9% who had recently arrived in France. Prevalence of bacterial STIs in migrant participants was 6.3% for C. trachomatis (95% confidence interval [CI] 5.4-7.2), 5.4% for N. gonorrhea (95% CI 4.5-6.3), and 6.3% for syphilis (95% CI 5.3-7.3). Multivariate analysis showed that migrant status was significantly associated with bacterial STI diagnosis (adjusted odds ratio = 1.48, 95% CI 1.25-1.74).

CONCLUSIONS: European recommendations for the care of migrants should include systematic screening for bacterial STIs. Screening must remain independent of immigration authorities. Ensuring access to sexual health services for vulnerable populations-while upholding informed consent and medical confidentiality-is essential to addressing the global rise in STIs.