HIV and Other Sexually Transmitted Infections Among Female Sex Workers in Iran: A Systematic Review and Meta-Analysis

Karamouzian, Mohammad; Nasirian, Maryam; Hoseini, Shervin Ghaffari; Mirzazadeh, Ali

doi:10.1007/s10508-019-01574-0

Cited by 28 publications

(26 citation statements)

References 45 publications

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“…In this study, the proportion of N. gonorroheae (1.2%) and C. trachomatis (4.9%) was lower than the reported in previous studies in Mexico (2.9% and 15.3%) [29] and Perú (1.6% and 16.4%) [30]. Regarding, the proportion of T. vaginalis (9.8%), it was higher than the rates reported in Peru (7.9%) [30], China (2.1%) [31] and Iran (6.1%) [32]. We observed a proportion of M. genitalium of 4.9%, somewhat lower than a 15.9% estimated among FSWs worldwide from a meta-analysis of studies between 1991 and 2016 [33].…”

Section: Plos Onecontrasting

confidence: 63%

Sexually transmitted infections and factors associated with risky sexual practices among female sex workers: A cross sectional study in a large Andean city

et al. 2021

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Background There are limited published data on factors related to risky sexual practices (RSP) affecting sexually transmitted infections (STIs) among female sex workers (FSWs) in Ecuador. Methods Cross-sectional study of FSWs presenting for a consultation in a primary health care centre during 2017. A questionnaire was administered to collect information on RSP and potential risk factors including age, membership of an FSW association, self-report of previous STI diagnosis, previous treatment for suspected STI and temporary migration for sex work. Associations between RSP and potential risk factors were estimated by logistic regression. The proportion of STI was estimated from vaginal swabs by real-time PCR for four sexually transmitted pathogens (Neisseria gonorrhoeae, Trichomonas vaginalis, Chlamydia trachomatis, and Mycoplasma genitalium). Results Of 249 FSWs recruited, 22.5% had reported RSPs at least once during sex work. Among FSWs reporting unprotected vaginal sex in the previous three months, 25.5% had at least one other RSP type. 17.6% (95%CI 13.3–22.8) had at least one active STI. Prevalence of co-infections was 2.4% (95%CI 1.1–5.2). In multivariable analysis, RSP was associated with age (adjusted OR 1.06; 95%CI 1.02–1.10), membership of an FSWs association (aOR 3.51; 95%CI 1.60–7.72) and self-reported previous STI (aOR 3.43; 95%CI 1.28–9.17). Conclusions Among a population of female sex workers with high proportion of STIs, increasing age and belonging to an FSWs association was associated with a higher likelihood of engaging in RSP with clients. Engaging with FSWs organisations may reduce the burden of STI among sex workers.

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Section: Plos Onecontrasting

confidence: 63%

Sexually transmitted infections and factors associated with risky sexual practices among female sex workers: A cross sectional study in a large Andean city

et al. 2021

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“…Methodological quality was independently assessed by two reviewers, and disagreements were resolved through discussion. The tool was modified to provide a numeric score [14,15]. Quality assessments were done with different tools based on different study designs.…”

Section: Quality Assessmentmentioning

confidence: 99%

COVID-19 Among People Living with HIV: A Systematic Review

et al. 2020

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This systematic review summarizes the evidence on the earliest patients with COVID-19-HIV co-infection. We searched PubMed, Scopus, Web of Science, Embase, preprint databases, and Google Scholar from December 01, 2019, to June 1, 2020. From an initial 547 publications and 75 reports, 25 studies provided specific information on COVID-19 patients living with HIV. Studies described 252 patients, 80.9% were male, the mean age was 52.7 years, and 98% were on antiretroviral treatment (ART). Co-morbidities in addition to HIV and COVID-19 (multimorbidity) included hypertension (39.3%), obesity or hyperlipidemia (19.3%), chronic obstructive pulmonary disease (18.0%), and diabetes (17.2%). Two-thirds (66.5%) had mild to moderate symptoms, the most common being fever (74.0%) and cough (58.3%). Among patients who died, the majority (90.5%) were over 50 years old, male (85.7%), and had multimorbidity (64.3%). Our findings highlight the importance of identifying co-infections, addressing co-morbidities, and ensuring a secure supply of ART for PLHIV during the COVID-19 pandemic.

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“…Previous studies among FSWs in Iran have identified chlamydia as one of the most prevalent STIs, with a pooled prevalence of approximately 10%. 14 Literature indicates that early sex work initiation increased the likelihood of HIV infection by 2.5 times 1 and 1.8 times, 11 suggesting the contributing role of sex work engagement at an early age to the HIV epidemic in this key affected population. Such an association was also shown in our sample (aOR ¼ 1.40) even though it was statistically nonsignificant.…”

Section: Discussionmentioning

confidence: 99%

“…In the Middle East and North Africa, a recent systematic review reported that HIV infection is on the rise among FSWs, with a wide range of 0-70% and the regional pooled HIV prevalence of 1.4%. 13 A recent meta-analysis in Iran reported the pooled prevalence of HIV among FSWs as 2.23%, 14 with primary analyses from the national surveillance surveys reporting an HIV prevalence of 4.5% in 2010 15 and 2.1% in 2015. 16 FSWs have been identified as the second most at-risk subpopulation for HIV infection in Iran, 17 with population size estimation studies showing that, on average, 228,700 women were engaged in sex work in urban settings in 2017.…”

Section: Introductionmentioning

confidence: 99%

Early sex work initiation and its association with condomless sex and sexually transmitted infections among female sex workers in Iran

et al. 2020

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Early sex work initiation among female sex workers (FSWs) increases their vulnerabilities to high-risk sexual practices and sexually transmitted infections (STIs). We examined the association of early sex work with condomless sex indicators, HIV, and other STIs, including human papillomavirus, chlamydia, trichomoniasis, syphilis, and gonorrhea, among FSWs in Iran. We recruited 1347 FSWs from 13 cities in 2015, with 1296 participants (94.2%) reporting information about their age of sex work initiation. Early sex work was defined as the initiation of selling sex before 18 years of age. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were reported using multivariable logistic regression. Overall, 10.1% of FSWs reported early sex work initiation. FSWs who initiated sex work earlier were more likely to report last-month inconsistent condom use (aOR = 3.31, 95% CI: 1.82, 6.02) and condomless sex with last client (aOR = 1.72, 95% CI: 1.15, 2.56). There was no statistically significant association between early sex work and HIV (aOR = 1.40, 95% CI: 0.43, 4.53) and any other STIs (aOR = 1.01, 95% CI: 0.69, 1.48), except for chlamydia (aOR = 2.09, 95% CI: 1.08, 4.04). These findings suggest that FSWs with early sexual debut would benefit from differentiated interventions including screening for STIs and enhanced counseling for condom use.

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HIV and Other Sexually Transmitted Infections Among Female Sex Workers in Iran: A Systematic Review and Meta-Analysis

Cited by 28 publications

References 45 publications

Sexually transmitted infections and factors associated with risky sexual practices among female sex workers: A cross sectional study in a large Andean city

Sexually transmitted infections and factors associated with risky sexual practices among female sex workers: A cross sectional study in a large Andean city

COVID-19 Among People Living with HIV: A Systematic Review

Early sex work initiation and its association with condomless sex and sexually transmitted infections among female sex workers in Iran

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