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Cited by 887

The DOI matches its Crossref record; 115 of the 115 references it cites were found in a registry or an index.

Global epidemiology of HIV among female sex workers: influence of structural determinants

Open access
Shannon, Kate, Strathdee, Steffanie A, Goldenberg, Shira M, Duff, Putu, Mwangi, Peninah, Rusakova, Maia, Reza-Paul, Sushena, Lau, Joseph, Deering, Kathleen, Pickles, Michael R, Boily, Marie-Claude·2015·The Lancet

Abstract

SUMMARY Female sex workers (FSWs) bear a disproportionately large burden of HIV infection worldwide. Despite decades of research and programme activity, the epidemiology of HIV and the role that structural determinants have in mitigating or potentiating HIV epidemics and access to care for FSWs is poorly understood. We reviewed available published data for HIV prevalence and incidence, condom use, and structural determinants among this group. Only 87 (43%) of 204 unique studies reviewed explicitly examined structural determinants of HIV. Most studies were from Asia, with few from areas with a heavy burden of HIV such as sub-Saharan Africa, Russia, and eastern Europe. To further explore the potential effect of structural determinants on the course of epidemics, we used a deterministic transmission model to simulate potential HIV infections averted through structural changes in regions with concentrated and generalised epidemics, and high HIV prevalence among FSWs. This modelling suggested that elimination of sexual violence alone could avert 17% of HIV infections in Kenya (95% uncertainty interval [UI] 1–31) and 20% in Canada (95% UI 3–39) through its immediate and sustained effect on non-condom use) among FSWs and their clients in the next decade. In Kenya, scaling up of access to antiretroviral therapy among FSWs and their clients to meet WHO eligibility of a CD4 cell count of less than 500 cells per μL could avert 34% (95% UI 25–42) of infections and even modest coverage of sex worker-led outreach could avert 20% (95% UI 8–36) of infections in the next decade. Decriminalisation of sex work would have the greatest effect on the course of HIV epidemics across all settings, averting 33–46% of HIV infections in the next decade. Multipronged structural and community-led interventions are crucial to increase access to prevention and treatment and to promote human rights for FSWs worldwide.

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Metadata

Authors
Shannon, K., Strathdee, S. A., Goldenberg, S. M., Duff, P., Mwangi, P., Rusakova, M., Reza-Paul, S., Lau, J., Deering, K., Pickles, M. R., & Boily, M.-C.
Venue
The Lancet
Publisher
Elsevier BV
Published
2015-01
Volume
385
Issue
9962
Pages
55-71
ISSN
  • 0099-5355 (ISSN-L)
  • 0140-6736
OpenAlex
W2113245562
Cited by
887
References
115
FWCI
245.37
Type
journal article
Language
en
Open access
bronze

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CoChat. (2026). Citation check: Global epidemiology of HIV among female sex workers: influence of structural determinants. https://app.cochat.ai/papers/10.1016/s0140-6736(14)60931-4
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Shannon, K., Strathdee, S. A., Goldenberg, S. M., Duff, P., Mwangi, P., Rusakova, M., Reza-Paul, S., Lau, J., Deering, K., Pickles, M. R., & Boily, M.-C. (2015). Global epidemiology of HIV among female sex workers: influence of structural determinants. The Lancet. https://doi.org/10.1016/s0140-6736(14)60931-4

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

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