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REVIEW ARTICLE
Year : 2017  |  Volume : 10  |  Issue : 5  |  Page : 1128-1136

HIV and sexually transmitted co-infections among sex workers in the Southern African economic region


1 Implementation Science Unit, Wits Reproductive Health and HIV Institute, Faculty of Health Sciences, University of the Witwatersrand; Department of Biochemistry and Microbiology, Nelson Mandela University, Port Elizabeth, South Africa
2 Africa Disease Intelligence and Surveillance, Communication and Response Institute, Yaoundé; Higher Institute of Health Sciences, Faculty of Health Sciences, Université des Montagnes, Bangangté, Cameroon
3 Implementation Science Unit, Wits Reproductive Health and HIV Institute, Faculty of Health Sciences, University of the Witwatersrand; Department of Sociology, University of Johannesburg, South Africa
4 Implementation Science Unit, Wits Reproductive Health and HIV Institute, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

Correspondence Address:
Clarence S Yah
Implementation Science Unit, Wits Reproductive Health and HIV Institute, Faculty of Health Sciences, University of the Witwatersrand
South Africa
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ATMPH.ATMPH_31_17

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Background: The Southern African Development Community (SADC) economic block is the most affected region by HIV epidemic in Sub-Saharan Africa (SSA). Despite programmatic interventions, HIV infections remain unprecedentedly high among female sex workers (FSW) in the region. This review assesses the HIV burden and the drivers associated with FSW in the SADC region. Methods: We systematically extracted and analyzed HIV burden and other sexually transmitted infections (STIs) research data on FSW indexed in various journal platform and reports from governmental and nongovernmental organizations between 2003 and 2015. Meta-analysis technique was used to estimate the pooled prevalence of the HIV burden among FSW in the region. Results: Of the 192 peer-reviewed articles and reports addressing HIV burden, only 21 articles met eligibility criteria totaling 14998 FSW. The combined overall pool HIV prevalence was estimated at 42.0% (95% CI 0.41–0.43). The estimated pooled HIV prevalence ranged from 16% (95% CI 0.13–18) in Democratic Republic of Congo, 59% (95% CI 0.57–0.62) in South Africa and 71% (95% CI 0.65–0.76) in Malawi. The most common STIs reported were syphilis, Chlamydia, and gonorrhea with little emphasis on viruses. Structural factors such as stigma and discrimination, access to healthcare services and various socioeconomic and political barriers impeded treatment and prevention. Conclusion: The HIV prevalence among FSW was 5–30 times higher when compared to the overall female reproductive age population in the SADC region. This signifies and necessitates increase evidence based HIV/STIs research and programs among FSW in the SADC region.


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