Cost effectiveness of HIV and sexual reproductive health interventions targeting sex workers: a systematic review
Open accessAbstract
BACKGROUND: Sex workers have high incidences of HIV and other sexually transmitted diseases. Although, interventions targeting sex workers have shown to be effective, evidence on which strategies are most cost-effective is limited. This study aims to systematically review evidence on the cost-effectiveness of sexual health interventions for sex workers on a global level. It also evaluates the quality of available evidence and summarizes the drivers of cost effectiveness. METHODS: A search of published articles until May 2018 was conducted. A search strategy consisted of key words, MeSH terms and other free text terms related to economic evaluation, sex workers and sexual and reproductive health (SRH) was developed to conduct literature search on Medline, Web of Science, Econlit and the NHS Economic Evaluation Database. The quality of reporting the evidence was evaluated using the CHEERS checklist and drivers of cost-effectiveness were reported. RESULTS: Overall, 19 studies met the inclusion criteria. The majority of the studies were based in middle-income countries and only three in low-income settings. Most of the studies were conducted in Asia and only a handful in Sub-Saharan Africa and Latin America. The reviewed studies mainly evaluated the integrated interventions, i.e. interventions consisted a combination of biomedical, structural or behavioural components. All interventions, except for one, were highly cost-effective. The reporting quality of the evidence was relatively good. The strongest drivers of cost-effectiveness, reported in the studies, were HIV prevalence, number of partners per sex worker and commodity costs. Furthermore, interventions integrated into existing health programs were shown to be most cost-effective. CONCLUSION: This review found that there is limited economic evidence on HIV and SRH interventions targeting sex workers. The available evidence indicates that the majority of the HIV and SRH interventions targeting sex workers are highly cost-effective, however, more effort should be devoted to improving the quality of conducting and reporting cost-effectiveness evidence for these interventions to make them usable in policy making. This review identified potential factors that affect the cost-effectiveness and can provide useful information for policy makers when designing and implementing such interventions.
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Poor methodological quality is known to be a major area of weakness for healthcare economic evaluations.
“Poor methodological quality is known to be a major area of weakness for healthcare economic evaluations [58,59].”
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Prevention, Intervention, and Rehabilitation
Swathisha, P., & Deb, S. (2026) · Springer eBooks · doi:10.1007/978-981-95-3365-7_6
- Authors
- Rinaldi, G., Kiadaliri, A. A., & Haghparast-Bidgoli, H.
- Affiliations
- St George's, University of London (GB)
- Venue
- Cost Effectiveness and Resource Allocation
- Published
- 2018-12
- Volume
- 16
- Issue
- 1
- Pages
- 63-63
- ISSN
- 1478-7547 (ISSN-L)
- PMC
- PMC6278021
- OpenAlex
- W2903077536
- Cited by
- 25
- References
- 61
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 5 · 2022: 2 · 2021: 5 · 2020: 4 · 2019: 3 · 2018: 1
- FWCI
- 1.16
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Cost Effectiveness and Resource Allocation (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Lund University Publications (Lund University) (submittedVersion)
- Topics
- Social Sciences › Sociology and Political Science › Sex work and related issues
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Keywords
- sex workers, HIV prevention, sexual and reproductive health, cost-effectiveness, economic evaluation, integrated intervention, HIV prevalence, number of sexual partners, reporting quality, CHEERS checklist, health policy
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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