The global response and unmet actions for HIV and sex workers

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Title: The global response and unmet actions for HIV and sex workers
Authors: Shannon, K
Crago, A-L
Baral, S
Bekker, L-G
Kerrigan, D
Decker, M
Poteat, T
Wirtz, A
Weir, B
Boily, MC
Butler, J
Strathdee, S
Beyrer, C
Item Type: Journal Article
Abstract: Female, male, and transgender sex workers continue to have disproportionately high burdens of HIV infection in low-income, middle-income, and high-income countries in 2018. 4 years since our Lancet Series on HIV and sex work, our updated analysis of the global HIV burden among female sex workers shows that HIV prevalence is unacceptably high at 10·4% (95% CI 9·5–11·5) and is largely unchanged. Comprehensive epidemiological data on HIV and antiretroviral therapy (ART) coverage are scarce, particularly among transgender women. Sustained coverage of treatment is markedly uneven and challenged by lack of progress on stigma and criminalisation, and sustained human rights violations. Although important progress has been made in biomedical interventions with pre-exposure prophylaxis and early ART feasibility and demonstration projects, limited coverage and retention suggest that sustained investment in community and structural interventions is required for sex workers to benefit from the preventive interventions and treatments that other key populations have. Evidence-based progress on full decriminalisation grounded in health and human rights—a key recommendation in our Lancet Series—has stalled, with South Africa a notable exception. Additionally, several countries have rolled back rights to sex workers further. Removal of legal barriers through the decriminalisation of sex work, alongside political and funding investments to support community and structural interventions, is urgently needed to reverse the HIV trajectory and ensure health and human rights for all sex workers.
Issue Date: 25-Aug-2018
Date of Acceptance: 14-Jun-2018
URI: http://hdl.handle.net/10044/1/61493
DOI: https://doi.org/10.1016/S0140-6736(18)31439-9
ISSN: 0140-6736
Publisher: Elsevier
Start Page: 698
End Page: 710
Journal / Book Title: Lancet
Volume: 392
Issue: 10148
Copyright Statement: © 2018 Elsevier Ltd. All rights reserved. . This manuscript is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licence http://creativecommons.org/licenses/by-nc-nd/4.0/
Sponsor/Funder: Medical Research Council (MRC)
Funder's Grant Number: MR/R015600/1
Keywords: Science & Technology
Life Sciences & Biomedicine
Medicine, General & Internal
General & Internal Medicine
ORAL PREEXPOSURE PROPHYLAXIS
SUB-SAHARAN AFRICA
TRANSGENDER WOMEN
HIGH-PREVALENCE
COMMUNITY MOBILIZATION
CONDOM NEGOTIATION
RISK BEHAVIORS
FEMALE
PREVENTION
INFECTION
Adolescent
Adult
Anti-HIV Agents
Community Participation
Epidemics
Female
Global Burden of Disease
HIV
HIV Infections
Human Rights
Humans
Male
Minority Groups
Pre-Exposure Prophylaxis
Prevalence
Sex Work
Sex Workers
South Africa
Transgender Persons
Humans
HIV
HIV Infections
Anti-HIV Agents
Prevalence
Minority Groups
Human Rights
Adolescent
Adult
South Africa
Female
Male
Epidemics
Sex Workers
Pre-Exposure Prophylaxis
Transgender Persons
Sex Work
Community Participation
Global Burden of Disease
11 Medical and Health Sciences
General & Internal Medicine
Publication Status: Published
Online Publication Date: 2018-07-20
Appears in Collections:Faculty of Medicine
Epidemiology, Public Health and Primary Care



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