Sustained high prevalence of viral hepatitis and sexually transmissible infections among female sex workers in China: a systematic review and meta-analysis

Objectives To assess the proportion of female sex workers (FSWs) from low-prevalence (‘other’) and high-prevalence countries (HPCs) for sexually transmissible infections (STIs) in Melbourne. Methods: Retrospective data analysis from the Melbourne Sexual Health Centre database for February 2002–May 2011. Results: Some 1702 HPC FSWs, 2594 other FSWs and 13 644 nonFSW women were included, with 12 891 and 21 611 consultations, respectively, for HPC FSWs and other FSWs. Proportions of HPC FSWs with chlamydia (Chlamydia trachomatis) (4.2% v. 3.3%, P = 0.14), gonorrhoea (Neisseria gonorrhoeae) (0.24% v. 0.31%, P = 0.66) or trichomonas (0.65 v. 0.46, P = 0.42) at first visit were similar to those of other FSWs, but nonFSWs had a higher prevalence of chlamydia and gonorrhoea (P < 0.01). On return visits, chlamydia (1.2% v. 0.92%, P < 0.05) and gonorrhoea (0.29% v. 0.10%, P = <0.05) were more common in HPC FSWs than other FSWs. The presence of any of these STIs among FSWs was predicted by having private nonpaying partners in the last year (adjusted odds ratio (AOR): 1.99 (95% confidence interval (CI): 1.52–2.61)), having private partners from overseas (AOR: 1.69 (95% CI: 1.33–2.16)) and being a HPC FSW (AOR: 1.38 (95% CI: 1.12–1.72)). Injecting drug use was less common in HPC FSWs than in other FSWs (0.82% v. 16.54%, P < 0.0001). Conclusions: STI prevalence was low among FSWs from countries with high and low background STI. Among FSWs having private sex partners and private partners from overseas were the primary predictors for STIs.

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Prevalence and Genotype Distribution of Genital Human Papillomavirus Infection in Female Sex Workers in the World: A Systematic Review and Meta-Analysis

10.21203/rs.3.rs-18665/v2 ◽

2020 ◽

Author(s):

Mohammad Farahmand ◽

Mohsen Moghoofei ◽

Abolfazl Dorost ◽

Saeedeh Abbasi ◽

Seyed Hamidreza Monavari ◽

...

Keyword(s):

Systematic Review ◽

Human Papillomavirus ◽

Sex Workers ◽

Female Sex Workers ◽

Meta Analysis ◽

Hpv Infection ◽

Hpv Prevalence ◽

High Prevalence ◽

The World ◽

Hpv Types

Abstract Background: Female sex workers (FSWs) are amongst the most susceptible groups to acquire human papillomavirus (HPV) infection and consequently, to develop cervical intraepithelial neoplasia and cervical cancer. This is the first systematic review and meta-analysis to provide estimates of the pooled prevalence of HPV infection and the distribution of HPV types among FSWs across the world. Methods: Five computerized databases were searched for relevant studies published since the inception date of databases to September 2019. The pooled HPV prevalence was calculated by the random effect model described by DerSimonian-Laird. Subgroup analysis was performed to identify the probable sources of heterogeneity. The meta-analysis was performed using the “Metaprop” function in the R package Meta. Results: Sixty-two studies involving 21402 FSWs from 33 countries were included in this meta-analysis, and the pooled HPV prevalence was 42.60% (95% confidence interval (CI): 38.58%-46.71%). HPV-16 (10.16%, 95% CI: 8.20%–12.51%), HPV-52 (7.98%, 95% CI: 5.91%–10.70%), and HPV-53 (6.01%, 95% CI: 4.40%–8.15%) were the most common high-risk HPV types identified among FSWs. The pooled estimated prevalence of HPV infection among FSWs before and after 2010 were slightly different, 43.64% (95% CI: 36.12%-51.46%) and 41.97% (95% CI: 37.28%-46.81%), respectively. Conclusion: Due to the high prevalence of HPV infection, particularly with high-risk types, FSWs have a great susceptibility to the development of cervical and vaginal cancers. Furthermore, they can transmit their infection to their clients, which may result in a high prevalence of HPV and the incidence of HPV-associated malignancies among the general population.

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