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HIV prevalence high among female sex workers
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Increased access to HIV prevention programs in low- and middle-income countries is necessary because the burden of HIV among female sex workers is markedly increased in these areas, data from a meta-analysis indicate.
“There are two take-home messages from this study,” Stefan Baral, MD, MPH, of the department of epidemiology at the Johns Hopkins School of Public Health, told Infectious Disease News. “Female sex workers carry a disproportionate burden of HIV in nearly every place studied, as compared to other women, and there is a disappointingly low level of data characterizing HIV rates among female sex workers, especially in the highly widespread HIV epidemics found in southern and eastern Africa.”
Baral and colleagues conducted the systematic review and meta-analysis by gathering data from several databases for studies of female sex workers in low-income and middle-income countries published between Jan. 1, 2007, and June 25, 2011. The search yielded 434 articles and reports; 102 were included in the current analysis.
Stefan Baral
Among the 99,878 female sex workers across 50 countries, the overall HIV prevalence was 11.8%; the pooled OR for HIV infection was 13.5 (95% CI, 10-18.1).
Compared with the lowest prevalence for HIV observed in the Middle East and North Africa, the highest prevalence was in sub-Saharan Africa, followed by Eastern Europe, Latin America, the Caribbean and Asia. Sex workers with very low or low HIV prevalence had higher odds for infection vs. sex workers from countries of medium or high HIV prevalence.
“Although these data tell us that HIV prevalence among sex workers is extremely high, complementary studies tell us that criminalizing sex work doesn’t end or even decrease sex work, but does make it more difficult for sex workers to protect themselves during sex,” Baral said. “We need to continue to evaluate comprehensive HIV prevention programs that address biomedical risks for HIV acquisition and transmission, behavioral prevention programs to increase condom use during sex, and structural programs to increase the ability of sex workers to protect themselves.”
References:
Baral S. Lancet Infect Dis. 2012;doi:10.1016/S1473-3099(12)70066-X.
Disclosures:
Dr. Baral reports no financial disclosures.