Abstract：
:In the context of generalized human immunodeficiency virus (HIV) epidemics, there has been limited recent investment in HIV surveillance and prevention programming for key populations including female sex workers. Often implicit in the decision to limit investment in these epidemic settings are assumptions including that commercial sex is not significant to the sustained transmission of HIV, and HIV interventions designed to reach "all segments of society" will reach female sex workers and clients. Emerging empiric and model-based evidence is challenging these assumptions. This article highlights the frameworks and estimates used to characterize the role of sex work in HIV epidemics as well as the relevant empiric data landscape on sex work in generalized HIV epidemics and their strengths and limitations. Traditional approaches to estimate the contribution of sex work to HIV epidemics do not capture the potential for upstream and downstream sexual and vertical HIV transmission. Emerging approaches such as the transmission population attributable fraction from dynamic mathematical models can address this gap. To move forward, the HIV scientific community must begin by replacing assumptions about the epidemiology of generalized HIV epidemics with data and more appropriate methods of estimating the contribution of unprotected sex in the context of sex work.
journal_name
Ann Epidemioljournal_title
Annals of epidemiologyauthors
Mishra S,Boily MC,Schwartz S,Beyrer C,Blanchard JF,Moses S,Castor D,Phaswana-Mafuya N,Vickerman P,Drame F,Alary M,Baral SDdoi
10.1016/j.annepidem.2016.06.004subject
Has Abstractpub_date
2016-08-01 00:00:00pages
557-569issue
8eissn
1047-2797issn
1873-2585pii
S1047-2797(16)30163-6journal_volume
26pub_type
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journal_title：Annals of epidemiology
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