Prevalence and Factors Associated With Human Immunodeficiency Virus Infection Among Sex Workers in Samarkand, Uzbekistan

Todd, Catherine S.; Khakimov, Mumtaz M.; Giyasova, G M; Saad, Magdi D.; Botros, Boulos A.; Sánchez, José L.; Carr, Jean K.; Earhart, Kenneth C.

doi:10.1097/olq.0b013e31818adb54

Cited by 10 publications

(6 citation statements)

References 14 publications

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“…Studies conducted in Ukraine and Uzbekistan examining risk factors for HIV among FSWs show more evidence of increased risk associated with injecting drug use 53 82 83. Among FSWs currently injecting drugs, the risk of HIV is higher among those who reported selling sex for drugs and injecting daily,83 and among those injecting home-made drugs in the Russian Federation 76.…”

Section: Resultsmentioning

confidence: 99%

Factors mediating HIV risk among female sex workers in Europe: a systematic review and ecological analysis

et al. 2013

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ObjectivesWe reviewed the epidemiology of HIV and selected sexually transmitted infections (STIs) among female sex workers (FSWs) in WHO-defined Europe. There were three objectives: (1) to assess the prevalence of HIV and STIs (chlamydia, syphilis and gonorrhoea); (2) to describe structural and individual-level risk factors associated with prevalence and (3) to examine the relationship between structural-level factors and national estimates of HIV prevalence among FSWs.DesignA systematic search of published and unpublished literature measuring HIV/STIs and risk factors among FSWs, identified through electronic databases published since 2005. ‘Best’ estimates of HIV prevalence were calculated from the systematic review to provide national level estimates of HIV. Associations between HIV prevalence and selected structural-level indicators were assessed using linear regression models.Studies reviewedOf the 1993 papers identified in the search, 73 peer-reviewed and grey literature documents were identified as meeting our criteria of which 63 papers provided unique estimates of HIV and STI prevalence and nine reported multivariate risk factors for HIV/STI among FSWs.ResultsHIV in Europe remains low among FSWs who do not inject drugs (<1%), but STIs are high, particularly syphilis in the East and gonorrhoea. FSWs experience high levels of violence and structural risk factors associated with HIV, including lack of access to services and working on the street. Linear regression models showed HIV among FSWs to link with injecting drug use and imprisonment.ConclusionsFindings show that HIV prevention interventions should be nested inside strategies that address the social welfare of sex workers, highlighting in turn the need to target the social determinants of health and inequality, including regarding access to services, experience of violence and migration. Future epidemiological and intervention studies of HIV among vulnerable populations need to better systematically delineate how microenvironmental and macroenvironmental factors combine to increase or reduce HIV/STI risk.

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Section: Resultsmentioning

confidence: 99%

Factors mediating HIV risk among female sex workers in Europe: a systematic review and ecological analysis

et al. 2013

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“…7 Studies in other settings have also documented higher HIV prevalence and risk factors among non-venue-based FSW than venue-based FSW. [8][9][10][11][12] As such there is a need for new surveillance approaches to monitor behavioural risks and HIV/STI infections among this hidden segment of FSW. 13 -15 Respondent-driven sampling (RDS) has been developed to sample hidden and high-risk populations.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2013

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The pattern of sex work in Thailand has shifted substantially over the last two decades from direct commercial establishments to indirect venues and non-venue-based settings. This respondent-driven sampling survey was conducted in Bangkok in 2007 among female sex workers (FSW) in non-venue-based settings to pilot a new approach to surveillance among this hidden population. Fifteen initial participants recruited 707 consenting participants who completed a behavioural questionnaire, and provided oral fluid for HIV testing, and urine for sexually transmitted infection (STI) testing. Overall HIV prevalence was 20.2% (95% confidence interval [CI] 16.3-24.7). Three-quarters of women were street-based (75.8%, 95% CI 69.9-81.1) who had an especially high HIV prevalence (22.7%, 95% CI 18.2-28.4); about 10 times higher than that found in routine sentinel surveillance among venue-based FSW (2.5%). STI prevalence (Chlamydia trachomatis and Neisseria gonorrhoeae) was 8.7% (95% CI 6.4-10.8) and 1.0% (95% CI 0.2-1.9), respectively. Lower price per sex act and a current STI infection were independently associated with HIV infection (P < 0.05). High HIV prevalence found among FSW participating in the survey, particularly non-venue-based FSW, identifies need for further prevention efforts. In addition, it identifies a higher-risk segment of FSW not reached through routine sentinel surveillance but accessible through this survey method.

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“…Increased economic hardships due to the recent global financial crisis as well as tightening of legal measures against migrant workers have made it even more difficult for migrant women to find employment (Mezentseva, 2011). Unemployed, struggling financially, and needing to support their families, many female migrants in Moscow turn to sex work, a pattern also demonstrated in other countries (Dworkin & Ehrhardt, 2006; Huang et al, 2004; Todd et al, 2009). Moscow has an estimated 30,000 to 150,000 female sex workers, with a substantial proportion being migrants, although definitive statistics are lacking.…”

Section: Introductionmentioning

confidence: 75%

Female Migrant Sex Workers in Moscow: Gender and Power Factors and HIV Risk

et al. 2013

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This study aimed to build formative knowledge regarding HIV risks in female migrant sex workers in Moscow, focusing on gender and power. This was a collaborative ethnographic study, informed by the theory of gender and power, in which we conducted minimally structured interviews with 24 female sex workers who were migrants to Moscow and who provided sexual services to male migrant laborers. Overall, the female migrant sex workers engaged in HIV risk behaviors and practiced inadequate HIV protection with their clients. These behaviors were shaped by gender and power factors in the realms of labor, behavior, and cathexis. In the labor realm, because some female migrants were unable to earn enough money to support their families, they were pushed or pulled into sex work providing service to male migrants. In the behavior realm, many female migrant sex workers were intimidated by their male clients, feared violence, and lacked access to women’s health care and prevention. In the cathexis realm, many had a sense of shame, social isolation, emotional distress, and lacked basic HIV knowledge and prevention skills. To prevent HIV transmission requires addressing the gender and power factors that shape HIV/AIDS risks among female migrant sex workers through multilevel intervention strategies.

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Prevalence and Factors Associated With Human Immunodeficiency Virus Infection Among Sex Workers in Samarkand, Uzbekistan

Cited by 10 publications

References 14 publications

Factors mediating HIV risk among female sex workers in Europe: a systematic review and ecological analysis

Factors mediating HIV risk among female sex workers in Europe: a systematic review and ecological analysis

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

Female Migrant Sex Workers in Moscow: Gender and Power Factors and HIV Risk

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