Metrics details. For this qualitative study, semi-structured individual in-depth interviews were conducted with 20 MSW-MSM who worked home-based in the Dutch province of Limburg.
Participants were recruited from November to June by purposive sampling until saturation was reached via 1 five websites and smartphone applications commonly used by MSW-MSM, 2 STI clinic, 3 two gay saunas. A theory-informed interview guide was developed including themes such as sexuality, sex work, SHS and barriers and facilitators to SHS utilisation. Facebook , offering one-on-one online and informal communication with an SHS-provider e. SHS-providers could facilitate sex work disclosure by personally asking patients about sex in exchange for money or goods in a non-judgmental manner and explaining the medical relevance of disclosure.
Peer Review reports. Multiple studies have shown that a large part Soliciting clients independently of a third party from home as an in-call or out-call escort is often referred to as home-based sex work [ 12 ]. Internet sites and smartphone applications are widely being used by home-based MSW-MSM to arrange paid sexual encounters [ 1 ]. The shift towards an internet-based work method has also affected the scientific rigour of research by complicating the identification, sampling and assessment of MSW-MSM [ 1 , 13 ].
Furthermore, studies focused on MSW-MSM mainly include those who professionally sell sex and are thus often not representative of the MSW-MSM population who mostly sell sex with a dating and hustle motivation [ 14 , 15 ].
However, limited research has been conducted among MSW-MSM in a similar research context to identify these facilitators and barriers. A few barriers to SHS utilisation by MSW-MSM in the Netherlands have been identified, namely a perceived double stigma on sex work and homosexuality, a lack of trust in healthcare providers and a need to stay hidden from institutions like the police , tax authorities and the municipality [ 10 , 16 , 17 ].
