HSV-2 as a biomarker of HIV epidemic potential in female sex workers: meta-analysis, global epidemiology and implications

Abstract This study investigated herpes simplex virus type 2 (HSV-2) seroprevalence utility as a predictor of HIV epidemic potential among female sex workers (FSWs) globally. We updated and analyzed a systematically-assembled database for paired HSV-2 and HIV seroprevalence measures among FSWs. The study identified 231 paired HSV-2/HIV prevalence measures from 40 countries. The pooled mean HIV prevalence using meta-analysis increased from 3.7% (95% CI 0.3–9.9%) among populations of FSWs with HSV-2 prevalence < 25% to 18.7% (95% CI 14.1–23.8%) among those with HSV-2 prevalence 75–100%. HIV prevalence was negligible in FSWs with HSV-2 prevalence ≤ 20% suggesting a threshold effect. Multivariable meta-regressions explained > 65% of HIV prevalence variation, and identified a strong positive HSV-2/HIV association. Compared to populations of FSWs with HSV-2 prevalence < 25%, adjusted odds ratios (AORs) of HIV infection increased from 2.8 (95% CI 1.2–6.3) in those with HSV-2 prevalence 25–49%, to 13.4 (95% CI 6.1–29.9) in those with HSV-2 prevalence 75–100%. HSV-2 is a strong predictor of HIV epidemic potential among FSWs. HSV-2 prevalence of 25–49% indicates potential for intermediate-intensity HIV epidemics, with higher levels indicative of large epidemics. HSV-2 surveillance could inform HIV preparedness in countries where HIV prevalence among FSWs is still limited or at zero-level.

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Prevalence and incidence of HIV among female sex workers and their clients: modelling the potential effects of intervention in Rwanda

BMJ Global Health ◽

10.1136/bmjgh-2020-002300 ◽

2020 ◽

Vol 5 (8) ◽

pp. e002300

Author(s):

Sabin Nsanzimana ◽

Edward J Mills ◽

Ofir Harari ◽

Placidie Mugwaneza ◽

Etienne Karita ◽

...

Keyword(s):

General Population ◽

Condom Use ◽

Sex Workers ◽

Female Sex Workers ◽

Hiv Prevalence ◽

Consistent Condom ◽

People Living With Hiv ◽

Hiv Incidence ◽

Female Sex ◽

Hiv Epidemic

BackgroundRwanda has identified several targeted HIV prevention strategies, such as promotion of condom use and provision of antiretroviral therapy (ART) and pre-exposure prophylaxis (PrEP) for female sex workers (FSWs). Given this country’s limited resources, understanding how the HIV epidemic will be affected by these strategies is crucial.MethodsWe developed a Markov model to estimate the effects of targeted strategies to FSWs on the HIV prevalence/incidence in Rwanda from 2017 to 2027. Our model consists of the six states: HIV-; HIV+ undiagnosed/diagnosed pre-ART; HIV+ diagnosed with/without ART; and death. We considered three populations: FSWs, sex clients and the general population. For the period 2017–2027, the HIV epidemic among each of these population was estimated using Rwanda’s demographic, sexual risk behaviour and HIV-associated morbidity and mortality data.ResultsBetween 2017 and 2027, with no changes in the current condom and ART use, the overall number of people living with HIV is expected to increase from 344,971 to 402,451. HIV incidence will also decrease from 1.36 to 1.20 100 person-years. By 2027, a 30% improvement in consistent condom use among FSWs will result in absolute reduction of HIV prevalence among FSWs, sex clients and the general population by 7.86%, 5.97% and 0.17%, respectively. While recurring HIV testing and improving the ART coverage mildly reduced the prevalence/incidence among FSWs and sex clients, worsening the two (shown by our worst-case scenario) will result in an increase in the HIV prevalence/incidence among FSWs and sex clients. Introduction of PrEP to FSWs in 2019 will reduce the HIV incidence among FSWs by 1.28%.ConclusionsContinued efforts toward improving condom and ART use will be critical for Rwanda to continue their HIV epidemic control. Implementing a targeted intervention strategy in PrEP for FSWs will reduce the HIV epidemic in this high-risk population.

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Trends in HIV prevalence among people injecting drugs, men having sex with men, and female sex workers in Ukraine

International Journal of STD & AIDS ◽

10.1177/0956462418784096 ◽

2018 ◽

Vol 29 (13) ◽

pp. 1337-1344 ◽

Cited By ~ 8

Author(s):

Kostyantyn Dumchev ◽

Yana Sazonova ◽

Tetiana Salyuk ◽

Olga Varetska

Keyword(s):

Sex Workers ◽

Female Sex Workers ◽

People Who Inject Drugs ◽

Hiv Prevalence ◽

New Wave ◽

Female Sex ◽

Hiv Epidemic ◽

Nationally Representative ◽

Sex With Men ◽

Generation Surveillance

Once recognized as the most severe in Europe, the HIV epidemic in Ukraine is concentrated among people who inject drugs, men who have sex with men, and female sex workers. Integrated biobehavioral surveys, as a part of the second generation surveillance, are used to monitor HIV infection trends in key populations since 2002. The present paper is focused on the analysis of HIV prevalence trends in four nationally representative rounds of integrated biobehavioral surveys from 2008/9, 2011, 2013, and 2015 in people who inject drugs, men who have sex with men, and female sex workers. Between 2008/9 and 2015, the HIV prevalence has decreased significantly in people who inject drugs (24.2 to 22.0%) and female sex workers (13.6 to 6.3%), while the change in men who have sex with men was not significant (8.5 to 7.8%). There was a significant increase in people who inject drugs and men who have sex with men between 2013 and 2015. In subgroups younger than 25 years, prevalence increased more than twofold in men who have sex with men (1.9 to 4.3%), with no changes in people who inject drugs and female sex workers. The observed decline in prevalence, especially in young subgroups, may result from the effect of extensive prevention efforts on drug injection-related transmission. Recent increase in young men who have sex with men may be a sign of a new wave of the epidemic in this group.

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HIV prevalence among female sex workers, drug users and men who have sex with men in Brazil: A Systematic Review and Meta-analysis

BMC Public Health ◽

10.1186/1471-2458-10-317 ◽

2010 ◽

Vol 10 (1) ◽

Cited By ~ 68

Author(s):

Monica Malta ◽

Monica MF Magnanini ◽

Maeve B Mello ◽

Ana Roberta P Pascom ◽

Yohana Linhares ◽

...

Keyword(s):

Systematic Review ◽

Sex Workers ◽

Drug Users ◽

Female Sex Workers ◽

Meta Analysis ◽

Hiv Prevalence ◽

Female Sex ◽

Sex With Men

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Unexpectedly high HIV prevalence among female sex workers in Bangkok, Thailand in a respondent-driven sampling survey

International Journal of STD & AIDS ◽

10.1177/0956462412472300 ◽

2013 ◽

Vol 24 (1) ◽

pp. 34-38 ◽

Cited By ~ 20

Author(s):

C Manopaiboon ◽

D Prybylski ◽

W Subhachaturas ◽

S Tanpradech ◽

O Suksripanich ◽

...

Keyword(s):

Sex Workers ◽

Female Sex Workers ◽

Hiv Prevalence ◽

Respondent Driven Sampling ◽

Female Sex ◽

Sampling Survey

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Prevalence of suicidality, depression, post-traumatic stress disorder, and anxiety among female sex workers: a systematic review and meta-analysis

Archives of Women s Mental Health ◽

10.1007/s00737-021-01144-1 ◽

2021 ◽

Author(s):

Juan Manuel Millan-Alanis ◽

Farid Carranza-Navarro ◽

Humberto de León-Gutiérrez ◽

Paloma C. Leyva-Camacho ◽

Andrea Fernanda Guerrero-Medrano ◽

...

Keyword(s):

Systematic Review ◽

Post Traumatic Stress Disorder ◽

Traumatic Stress ◽

Sex Workers ◽

Female Sex Workers ◽

Stress Disorder ◽

Meta Analysis ◽

Post Traumatic Stress ◽

Female Sex ◽

Post Traumatic

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Condomless Sex With Partners and Clients Among Female Sex Workers in Iran: A Systematic Review and Meta-Analysis

Journal of the Association of Nurses in AIDS Care ◽

10.1097/jnc.0000000000000305 ◽

2022 ◽

Vol 33 (1) ◽

pp. 63-77

Author(s):

Mehrdad Khezri ◽

Fatemeh Tavakoli ◽

Azam Bazrafshan ◽

Hamid Sharifi ◽

Mostafa Shokoohi

Keyword(s):

Systematic Review ◽

Sex Workers ◽

Female Sex Workers ◽

Meta Analysis ◽

Condomless Sex ◽

Female Sex

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Prevalence of HIV Among U.S. Female Sex Workers: Systematic Review and Meta-analysis

AIDS and Behavior ◽

10.1007/s10461-016-1332-y ◽

2016 ◽

Vol 20 (10) ◽

pp. 2318-2331 ◽

Cited By ~ 32

Author(s):

Gabriela Paz-Bailey ◽

Meredith Noble ◽

Kathryn Salo ◽

Stephen J. Tregear

Keyword(s):

Systematic Review ◽

Sex Workers ◽

Female Sex Workers ◽

Meta Analysis ◽

Female Sex

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Correlates of HIV prevalence among female sex workers in four north and east Indian states: findings of a national bio-behavioural survey

International Journal of STD & AIDS ◽

10.1177/0956462418799018 ◽

2018 ◽

Vol 30 (2) ◽

pp. 120-130 ◽

Cited By ~ 1

Author(s):

Gunjika Misra ◽

Damodar Sahu ◽

Umenthala S Reddy ◽

Saritha Nair

Keyword(s):

Sex Work ◽

Sex Workers ◽

Female Sex Workers ◽

Uttar Pradesh ◽

Hiv Prevalence ◽

Indian States ◽

Factors Affecting ◽

East Indian ◽

Female Sex ◽

Behavioural Surveillance

The socio-demographic, sex work characteristics and the factors affecting HIV prevalence among female sex workers (FSWs) are not well known in low prevalence states showing rising trends within the HIV epidemic. This paper studies these attributes among FSWs in three north (Punjab, Rajasthan and Uttar Pradesh) and one east Indian states (Jharkhand). Integrated Biological and Behavioural Surveillance (IBBS) data, collected from 4491 FSWs in the study states, were analysed, with HIV status as the dependent variable and several socio-demographic, sex work, knowledge and agency characteristics as independent variables. Multivariate analysis found a number of factors such as age above 25 years (adjusted odds ratio [AOR] 5.0, 95% confidence interval [CI] 1.4–18.1), client solicitation in rented rooms (AOR 2.8, 95% CI 1.2–6.4) and the use of mobile phones for client solicitation (AOR 5.1, 95% CI 1.6–16.0) to be significantly associated with HIV risk. The study found low levels of HIV programme services uptake and HIV/AIDS knowledge among FSWs in the study states. There is an urgent need to focus on these risk factors for improving the effectiveness of the ongoing HIV prevention efforts and attaining the ‘Sustainable Development Goals’ goal of ‘Ending the AIDS epidemic’ by 2030.

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Identifying Barriers to Condom Use Among Female Sex Workers: a Systematic Review and Meta-analysis

10.21203/rs.3.rs-48093/v1 ◽

2020 ◽

Author(s):

Tahereh Omidi ◽

Maryam Mohammadian-khoshnoud ◽

Younes Mohammadi

Keyword(s):

Sexual Abuse ◽

Condom Use ◽

Sex Workers ◽

Female Sex Workers ◽

Meta Analysis ◽

Sex Worker ◽

Female Sex ◽

History Of ◽

Hiv Risk Perception ◽

History Of Violence

Abstract Background: Many studies have shown a lot of factors which are as barriers to the condom use among female sex workers (FSWs). However, there is not a comprehensive study to report the number and magnitude of these barriers. This study aimed to resolve this gap by comprehensive systematic review and meta-analysis. Methods: We have searched the electronic databases include Web of Science, PubMed, and Scopus until September 2019. For each database we formulated a separate search strategy using keywords such as “condom use” and “sex worker” and the related synonyms. Epidemiological epidemiology addressed the factors associated with unprotected sex for the female sex worker. The heterogeneity across studies and probability of publication bias was investigated by I2 statistic and Begg's and Egger's tests respectively. The pooled effect size were expressed as odds ratio (OR) with 95% confidence intervals (CI) using a random-effects model.Results: Out of 5854 studies obtained in initial search, 35 studies with sample size 14218 participants had eligibility criteria which were included in the final analysis. Ten factors include marital status, alcohol use, history of violence, history of sexual abuse, history of STIs, STIs knowledge, HIV risk perception, drug use, knowledge about the condom use, condom use self-efficacy were identified in those studies. History of sexual abuse with OR=1.87 and the knowledge on AIDS with OR=1.07 had the strongest association and weakest association with condom use respectively. Conclusion: Many factors with different degrees of association influence on the condom use among female sex workers. However, history of sexual abuse, a history of violence, and HIV risk perception were considered as the major determinants of the condom use. The structural interventions, policy change and empowerment of female sex workers are recommended to increase consistent condom use in FSWs.

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