Remaining Gap in HIV Testing Uptake Among Female Sex Workers in Iran

Shokoohi, Mostafa; Noori, Atefeh; Karamouzian, Mohammad; Sharifi, Hamid; Khajehkazemi, Razieh; Fahimfar, Noushin; Hosseini‐Hooshyar, Samira; Kazerooni, Parvin Afsar; Mirzazadeh, Ali

doi:10.1007/s10461-017-1844-0

Cited by 38 publications

(46 citation statements)

References 23 publications

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“…Shokoohi et al [35]IranN = 1005 FSWsQN, CSPast year 27.5%n/aOlder age at first SWHIV knowledgeKnowledge where to testInjecting drugs ever in lifeReceiving free condoms during 12 monthsHigher perceived risk26. Shokoohi et al [39]IranN = 1337FSWsQN, CSEver tested:80.6%Past year 70.4%n/aHigher educational levelHigher HIV knowledgeKnowledge of where to testMore than 5 paying SPMore than one none-paying SPConsistent condom useReceiving HR servicesHealth service utilizationHigher perceived risk27. Simonovikj et al [53]MacedoniaN = 106 SWsCase reportn/an/an/a28.…”

Section: Resultsmentioning

confidence: 99%

“…Shokoohi et al [35]n/an/an/aRapid testing26. Shokoohi et al [39]n/an/an/an/aReferral’sCommunity-based outreach testingSelf-testing27. Simonovikj et al [53]n/an/aCases of forced testing during police arrestn/an/a28.…”

Section: Resultsmentioning

confidence: 99%

“…We found no consistent associations [18, 27, 31, 32, 44–46] of education and age [23, 31, 45] with HIV testing uptake. Highly educated women in the Philippines and Iran were more likely to test [39, 45], but studies in China reported higher HIV testing uptake amongst women with both high [23] and low education level [31]. In two studies conducted in China and one in the Philippines, older age facilitated HIV testing [31, 44, 45], but in Russia, Ethiopia and Kenya older-aged FSWs [46, 47] and those aged + 30 [27] were less likely to test compared to younger FSWs.…”

Section: Resultsmentioning

confidence: 99%

“…In Kenya, Zambia, Benin, Ethiopia, Russia and India, having children or being pregnant facilitated HIV testing [27, 28, 34, 47–49]. In Iran, incarceration was associated with recent testing [39]. …”

Section: Resultsmentioning

confidence: 99%

“…In China, a quantitative study identified that condom use was associated with HIV testing [20], although in a previous qualitative study the same author found that FSWs who used condoms consistently felt to be sufficiently protected from HIV and not in need of testing [41]. In Iran, consistent condom use during each sexual intercourse was associated with recent testing [39]. …”

Section: Resultsmentioning

confidence: 99%

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HIV Testing and Counseling Among Female Sex Workers: A Systematic Literature Review

et al. 2018

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HIV testing uptake continues to be low among Female Sex Workers (FSWs). We synthesizes evidence on barriers and facilitators to HIV testing among FSW as well as frequencies of testing, willingness to test, and return rates to collect results. We systematically searched the MEDLINE/PubMed, EMBASE, SCOPUS databases for articles published in English between January 2000 and November 2017. Out of 5036 references screened, we retained 36 papers. The two barriers to HIV testing most commonly reported were financial and time costs—including low income, transportation costs, time constraints, and formal/informal payments—as well as the stigma and discrimination ascribed to HIV positive people and sex workers. Social support facilitated testing with consistently higher uptake amongst married FSWs and women who were encouraged to test by peers and managers. The consistent finding that social support facilitated HIV testing calls for its inclusion into current HIV testing strategies addressed at FSW.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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HIV Testing and Counseling Among Female Sex Workers: A Systematic Literature Review

et al. 2018

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Symptom-Based Versus Laboratory-Based Diagnosis of Five Sexually Transmitted Infections in Female Sex Workers in Iran

et al. 2018

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Among 1337 Iranian adult female sex workers in 2015, we assessed the diagnostic value of 4 self-reported sexually transmitted infection (STIs) symptoms for detecting laboratory-confirmed gonorrhea, chlamydia, trichomoniasis, human papillomavirus (HPV), and syphilis. While 37.7% reported vaginal discharge (VD), 25.9% reported pain or burning (P/B), 3.0% reported genital ulcers (GU), and 1.4% reported genital warts (GW), the prevalence of laboratory-confirmed syphilis, gonorrhea, chlamydia, trichomoniasis, and HPV was 0.4, 1.3, 6.0, 11.9, and 41.9%, respectively. The sensitivity of VD was 40.3% for detecting tricomoniasis, 37.5% for chlamydia, and 37.5% for gonorrhea. The sensitivity of P/B ranged from 12.5% for gonorrhea to 25.2% for trichomoniasis. The sensitivity of GU and GW was very low for 5 STIs. The sensitivity of all symptoms combined was also lower than 50%. Among asymptomatic participants, 41.2% tested positive for HPV, 11.8% for trichomoniasis, and less than 6.6% for other STIs. Symptom-based case management and surveillance of STIs can lead to misclassification of a large proportion of cases.

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HIV prevalence and associated factors among female sex workers in Iran: a bio-behavioral survey in 2020

et al. 2022

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Despite the overall decline in human immunodeficiency virus (HIV) prevalence, it remains unacceptably high in key populations. This study aimed to estimate prevalence of HIV infection and high-risk behaviors among female sex workers (FSWs). This study was a cross-sectional survey of FSWs conducted between December 2019 and August 2020 in eight geographically diverse cities in Iran. After providing informed consent, participants completed a bio-behavioral questionnaire and after completion of the interview, rapid diagnostic tests (RDT) and dried blood spots (DBS) were collected to determine HIV and syphilis status as per national guidelines, if the women consented. All analyzes were based on RDS adjustment. Weighting was done according to Giles’SS estimator. Among the 1515 FSWs, the overall prevalence of HIV and syphilis were 1.6% (95% CI: 0.8–2.3) and zero, respectively. The highest HIV prevalence was observed in Shiraz (5.1%) and Khorramabad city (1.6%). In addition, HIV-positive FSWs had a higher mean age at first sexual contact than HIV-negative FSWs (21.4 ± 5.6 vs. 17.2 ± 4.2 years). Injection drug use and a history of arrest or incarceration were associated with an increased odds of HIV infection (OR = 6.25; 95% CI: 1.90-20.55 and OR = 4.57; 95% CI: 1.64–12.72, respectively). Based on the results, strategies to improve early HIV diagnosis, harm reduction, and use of testing and treatment strategies are needed to reduce and control HIV infections.

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Remaining Gap in HIV Testing Uptake Among Female Sex Workers in Iran

Cited by 38 publications

References 23 publications

HIV Testing and Counseling Among Female Sex Workers: A Systematic Literature Review

HIV Testing and Counseling Among Female Sex Workers: A Systematic Literature Review

Symptom-Based Versus Laboratory-Based Diagnosis of Five Sexually Transmitted Infections in Female Sex Workers in Iran

HIV prevalence and associated factors among female sex workers in Iran: a bio-behavioral survey in 2020

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