Skip to main content
PLoS ONEVolume 10, Issue 10, 21 October 2015, Article number e0121145

Feasible, efficient and necessary, without exception - Working with sex workers interrupts HIV/STI transmission and brings treatment to many in need(Article)(Open Access)

  • Steen, R.,
  • Wheeler, T.,
  • Gorgens, M.,
  • Mziray, E.,
  • Dallabetta, G.
  Save all to author list
  • aDepartment of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
  • bOffice of HIV/AIDS, United States Agency for International Development, Washington, DC, United States
  • cWorld Bank, Washington, DC, United States
  • dBill and Melinda Gates Foundation, Washington, DC, United States

Abstract

Background and Overview. High rates of partner change in sex work-whether in professional, 'transactional' or other context-disproportionately drive transmission of HIV and other sexually transmitted infections. Several countries in Asia have demonstrated that reducing transmission in sex work can reverse established epidemics among sex workers, their clients and the general population. Experience and emerging research from Africa reaffirms unprotected sex work to be a key driver of sexual transmission in different contexts and regardless of stage or classification of HIV epidemic. This validation of the epidemiology behind sexual transmission carries an urgent imperative to realign prevention resources and scale up effective targeted interventions in sex work settings, and, given declining HIV resources, to do so efficiently. Eighteen articles in this issue highlight the importance and feasibility of such interventions under four themes: 1) epidemiology, data needs and modelling of sex work in generalised epidemics; 2) implementation science addressing practical aspects of intervention scaleup; 3) community mobilisation and 4) the treatment cascade for sex workers living with HIV. Conclusion. Decades of empirical evidence, extended by analyses in this collection, argue that protecting sex work is, without exception, feasible and necessary for controlling HIV/STI epidemics. In addition, the disproportionate burden of HIV borne by sex workers calls for facilitated access to ART, care and support. The imperative for Africa is rapid scale-up of targeted prevention and treatment, facilitated by policies and action to improve conditions where sex work takes place. The opportunity is a wealth of accumulated experience working with sex workers in diverse settings, which can be tapped to make up for lost time. Elsewhere, even in countries with strong interventions and services for sex workers, an emerging challenge is to find ways to sustain them in the face of declining global resources. © 2015 Steen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Indexed keywords

EMTREE medical terms:AfricaArticlecommunitycondom usecost effectiveness analysisdisease transmissionepidemicevidence based practicehealth care policyhumanHuman immunodeficiency virus infectioninfection preventionmorbiditymortalityprostitutionsexual transmissionsexually transmitted diseasecommunicable disease controldisease transmissionhealthHIV Infectionsincidenceneeds assessmentprevention and controlproceduressex workertransmission
EMTREE drug terms:antiretrovirus agent
MeSH:Anti-Retroviral AgentsCommunicable Disease ControlDisease Transmission, InfectiousGlobal HealthHIV InfectionsHumansIncidenceNeeds AssessmentSex Workers

Chemicals and CAS Registry Numbers:

Anti-Retroviral Agents

  • ISSN: 19326203
  • CODEN: POLNC
  • Source Type: Journal
  • Original language: English
  • DOI: 10.1371/journal.pone.0121145
  • PubMed ID: 26488796
  • Document Type: Article
  • Publisher: Public Library of Science


© Copyright 2015 Elsevier B.V., All rights reserved.

Cited by 11 documents

Kislovskiy, Y. , Erpenbeck, S. , Martina, J.
HIV awareness, pre-exposure prophylaxis perceptions and experiences among people who exchange sex: qualitative and community based participatory study
(2022) BMC Public Health
Reza-Paul, S. , Steen, R. , Maiya, R.
Sex Worker Community-led Interventions Interrupt Sexually Transmitted Infection/Human Immunodeficiency Virus Transmission and Improve Human Immunodeficiency Virus Cascade Outcomes: A Program Review from South India
(2019) Sexually Transmitted Diseases
Bhattacharjee, P. , Musyoki, H.K. , Becker, M.
HIV prevention programme cascades: insights from HIV programme monitoring for female sex workers in Kenya
(2019) Journal of the International AIDS Society
View details of all 11 citations
{"topic":{"name":"Sex Workers; Human Immunodeficiency Virus 1; Prostitution","id":8222,"uri":"Topic/8222","prominencePercentile":94.13371,"prominencePercentileString":"94.134","overallScholarlyOutput":0},"dig":"a0ed7898aaa1cd57e7261fdb7cfca41548dc580419b8d56bb8c90855c6fd82ee"}

SciVal Topic Prominence

Topic:
Prominence percentile: