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

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Abstract

Although female sex workers are known to be vulnerable to HIV infection, little is known about the epidemiology of HIV infection among this high-risk population in the United States. We systematically identified and critically assessed published studies reporting HIV prevalence among female sex workers in the United States. We searched for and included original English-language articles reporting data on the prevalence of HIV as determined by testing at least 50 females who exchanged sexual practices for money or drugs. We did not apply any restrictions on date of publication. We included 14 studies from 1987 to 2013 that reported HIV prevalence for a total of 3975 adult female sex workers. Only two of the 14 studies were conducted in the last 10 years. The pooled estimate of HIV prevalence was 17.3 % (95 % CI 13.5–21.9 %); however, the prevalence of HIV across individual studies varied considerably (ranging from 0.3 to 32 %) and statistical heterogeneity was substantial (I2 = 0.89, Q = 123; p < 0.001). Although the variance across the 14 studies was high, prevalence was generally high (10 % or greater in 11 of the 14 included studies). Very few studies have documented the prevalence of HIV among female sex workers in the United States; however, the available evidence does suggest that HIV prevalence among this vulnerable population is high.

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Notes

  1. These included databases from the following organizations: World Health Organization; Population Council; Family Health International; John Snow International; Engender Health; Robert Wood Johnson Foundation; Kaiser Family Foundation; Alan Guttmacher Institute; AIDS Action Committee.

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Acknowledgments

We would like to thank Melissa Cribbin, MPH, for contributions to protocol and search strategy development. We want to express our gratitude to Amy Lansky and Nicole Crepaz for their review of the manuscript.

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Funding was provided by the Centers for Disease Control and Prevention.

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Correspondence to Gabriela Paz-Bailey.

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Paz-Bailey, G., Noble, M., Salo, K. et al. Prevalence of HIV Among U.S. Female Sex Workers: Systematic Review and Meta-analysis. AIDS Behav 20, 2318–2331 (2016). https://doi.org/10.1007/s10461-016-1332-y

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