LAUSR

Introduction Female sex workers (FSW) may experience barriers to accessing sexual health services. Appropriate treatment for STIs is paramount to prevent the spread of antibiotic resistant infections. We aimed to understand how healthcare access might impact self-treatment and antibiotic use for genitourinary symptoms among FSWs in Tijuana, Mexico. Methods 282 FSW participants were tested for STIs and underwent an interview. APTIMA COMBO 2 (Hologic, Inc.) was used to diagnose cervicovaginal Neisseria gonorrhoeae (NG) infection. We summarised data and used logistic regression to assess associations between self-medication (use of pills and/or injections that were not prescribed by a doctor or nurse) for genitourinary symptoms and prior HIV test (a proxy for accessing sexual health services), income and STI history. Genitourinary symptoms included dysuria, vaginal discharge, vaginal bleeding between periods, pelvic pain, or dyspareunia. Results 282 FSW participants were recruited in Tijuana. Of the 263 with test results, 41 (15.6%) tested positive for NG, of which 23 (56.1%) endorsed current genitourinary symptoms. Of the 282 total participants, 60 (21.3%) reported that they had ever self-medicated to treat genitourinary symptoms. Never having an HIV test (OR=2.3 (95% CI: 1.3, 4.3)) and reporting lower income (