{"id":624,"date":"2012-04-22T21:49:08","date_gmt":"2012-04-22T21:49:08","guid":{"rendered":"https:\/\/blogs.bmj.com\/sti\/?p=624"},"modified":"2012-04-22T21:49:08","modified_gmt":"2012-04-22T21:49:08","slug":"female-sex-workers-bear-the-brunt-of-the-hiv-epidemic","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/sti\/2012\/04\/22\/female-sex-workers-bear-the-brunt-of-the-hiv-epidemic\/","title":{"rendered":"Female sex workers bear the brunt of the HIV epidemic"},"content":{"rendered":"<p>A meta-analysis in <em>The Lancet Infectious Diseases<\/em> offers a global picture of the heightened risks of HIV borne by female sex workers in low- and middle-income countries.\u00a0 The analysis includes 112\u00a0 papers and national reports, extracted from 19,180 relevant studies, and covers 50 low- and middle-income nations.\u00a0 A table gives, for each of the 50 countries, an estimate of <em>the relative burden of HIV disease in the female population that is borne by sex workers<\/em>, expressed as an odds ratio, and <em>the percentage of HIV infections that occur among female sex workers<\/em>.\u00a0 In addition, pooled figures are given for regions, where sufficient data is available: i.e. for Asia, Latin America and sub-Saharan Africa (though not for Eastern Europe or the Middle East, for which sufficient data was lacking).<\/p>\n<p>Globally, the odds ratio for a female sex worker being infected as against any female is 13.5, and the overall HIV prevalence for female sex workers is 11.8%. Discussion is devoted largely to the differences between regions (i.e. Asia etc.) and the possible impact of recent and ongoing programs.<\/p>\n<p>Asia is distinguished by a relatively large pooled odds ratio: 29.2 as opposed to 12 and 12.4 for Latin America and sub-Saharan Africa respectively, indicating a remarkably heavy burden of female HIV borne by sex-workers Asia.\u00a0 The cases of Latin America and sub-Saharan Africa differ from each other in respect to the general prevalence of HIV in the population, though female sex-workers appear to bear a similar proportion of it (OR 12 and OR 12.4 respectively).\u00a0 Thus, the prevalence of 5.2% for sex workers in Latin American has to be set against relatively low background prevalence in the female population as a whole, while the figure of 36.9% for sub-Saharan Africa reflects vastly higher levels of general prevalence.<\/p>\n<p>There is some rather piecemeal discussion of recent interventions affecting female sex-workers in these regions.\u00a0 The authors point out the effects of such interventions could take time to show up in the data.\u00a0 Nevertheless the overall impression is given of a problem that has in all the regions so far proved extremely refractory in the face of a number of serious and large-scale interventions.\u00a0 For example, following the scale-up of the Avahan and Sonagachi HIV prevention programs across India, female sex workers still carry more than a 50-times increased odds of HIV infection.<\/p>\n<p>Needless to say, the authors recommend a scale-up of access to quality HIV-prevention programming and services among female sex workers on account of their heightened burden of disease, and the likelihood of onward transmission through high numbers of sexual partners.<\/p>\n<p>&nbsp;<\/p>\n<p>Stefan Baral, Deanna Kerrigan et al., \u201cBurden of HIV among female sex workers in low-income and middle-income countries: a systematic review and meta-analysis\u201d, <em>The Lancet: Infectious Diseases<\/em>, published online 15<sup>th<\/sup> March, 2012<\/p>\n<p>&nbsp;<\/p>\n<p><a href=\"http:\/\/www.thelancet.com\/journals\/laninf\/article\/PIIS1473-3099(12)70066-X\/abstract\">http:\/\/www.thelancet.com\/journals\/laninf\/article\/PIIS1473-3099(12)70066-X\/abstract<\/a><\/p>\n<p>&nbsp;<\/p>\n<p><strong>Papers on related issues published in STI journal<\/strong>:<\/p>\n<p>&nbsp;<\/p>\n<p>Michele R. Decker, Stefan D. Baral, Chris Beyrer et al., \u201cInjection drug use, sexual risk, violence and STI\/HIV among Moscow female sex workers\u201d, published Online First: 27<sup>th<\/sup> January 2012<\/p>\n<p>[<a href=\"http:\/\/sti.bmj.com\/content\/early\/2012\/01\/27\/sextrans-2011-050171.abstract?sid=69760564-671f-4799-80af-77ef3c43a9e6\">Abstract<\/a>][<a href=\"http:\/\/sti.bmj.com\/content\/early\/2012\/01\/27\/sextrans-2011-050171.full?sid=69760564-671f-4799-80af-77ef3c43a9e6\">Full text<\/a>][<a href=\"http:\/\/sti.bmj.com\/content\/early\/2012\/01\/27\/sextrans-2011-050171.full.pdf+html?sid=69760564-671f-4799-80af-77ef3c43a9e6\">PDF<\/a>]<\/p>\n<p>C. T. Bautista, J. K. Carr et al., \u201cSeroprevalence of and risk factors for HIV-1 infection among female commercial sexworkers in South America\u201d, 2006:82:311-316<\/p>\n<p>[<a href=\"http:\/\/sti.bmj.com\/content\/82\/4\/311.abstract?sid=004f408a-86f8-465f-9268-972a2a477b4f\">Abstract<\/a>][<a href=\"http:\/\/sti.bmj.com\/content\/82\/4\/311.full?sid=004f408a-86f8-465f-9268-972a2a477b4f\">Full text<\/a>]<\/p>\n<p>N. Makyao, S. Kamazima et al., Oral Sessions epidemiology: oral session 8: STIs and HIV in female sex workers: 01-S08.01: High HIV prevalence within a generalised epidemic; condom use, violence, and sexually transmitted infections among female sex workers in Dar es Salaam, Tanzania, 2011:87:A40-A41<strong>\u00a0<\/strong><\/p>\n<p>[<a href=\"http:\/\/sti.bmj.com\/content\/87\/Suppl_1\/A40.3.abstract?sid=ff2c1641-9f76-44e0-b7fe-fd3ef373ef69\">Abstract<\/a>][<a href=\"http:\/\/sti.bmj.com\/content\/87\/Suppl_1\/A40.3.full.pdf+html?sid=ff2c1641-9f76-44e0-b7fe-fd3ef373ef69\">PDF<\/a>]<\/p>\n<p><strong>\u00a0<\/strong>Nurholis Majid, Robert Magnani et al., \u201cSyphilis\u00a0among\u00a0female\u00a0sex\u00a0workers\u00a0in\u00a0Indonesia: need\u00a0and\u00a0opportunity for\u00a0intervention\u201d, published online first: 3<sup>rd<\/sup> June 2012<\/p>\n<p>[<a href=\"http:\/\/sti.bmj.com\/content\/86\/5\/377.abstract?sid=ff2c1641-9f76-44e0-b7fe-fd3ef373ef69\">Abstract<\/a>][<a href=\"http:\/\/sti.bmj.com\/content\/86\/5\/377.full?sid=ff2c1641-9f76-44e0-b7fe-fd3ef373ef69\">Full text<\/a>][<a href=\"http:\/\/sti.bmj.com\/content\/86\/5\/377.full.pdf+html?sid=ff2c1641-9f76-44e0-b7fe-fd3ef373ef69\">PDF<\/a>]<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>A meta-analysis in The Lancet Infectious Diseases offers a global picture of the heightened risks of HIV borne by female sex workers in low- and middle-income countries.\u00a0 The analysis includes 112\u00a0 papers and national reports, extracted from 19,180 relevant studies, and covers 50 low- and middle-income nations.\u00a0 A table gives, for each of the 50 [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/sti\/2012\/04\/22\/female-sex-workers-bear-the-brunt-of-the-hiv-epidemic\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":152,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[151,2274],"tags":[],"class_list":["post-624","post","type-post","status-publish","format-standard","hentry","category-epidemiology","category-hiv-epidemiology"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.6 - 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