Systematic review examining differences in HIV, sexually transmitted infections and health-related harms between migrant and non-migrant female sex workers

Abstract

The lack of consistent differences in risk between migrants and non-migrants highlights the importance of the local context in mediating risk among migrant FSWs. The higher prevalence of HIV among some FSWs originating from African countries is likely to be due to infection at home where HIV prevalence is high. There is a need for ongoing monitoring and research to understand the nature of risk among migrants, how it differs from that of local FSWs and changes over time to inform the delivery of services.

HIV Epidemics in the European Region: Vulnerability and Response

“…While the main focus of the review is HIV vulnerability, PWID in Europe are also vulnerable to hepatitis C virus (HCV) [51]. Reviewed studies show HCV prevalence estimates between 52% and 94% among PWID in the West, 37% and 74% in Central Europe, and between 54% and 96% in the East.…”

“…Data from Europe show that levels of sexual and physical violence among SWs were universally high, particularly among minority groups such as Roma populations and transvestites [47,50]. Qualitative data from Western Europe suggest that violence among SWs is ubiquitous and compounded by drug use and the stigma associated with sex work [25,26,51]. Violence was the most frequently reported risk associated with work by respondents of the TAMPEP study who reported violence from clients, robberies, and verbal abuse from the police.…”

“…Receipt of ART reduces the infectivity of HIV-positive PWID by 80%. This number is based on results of recent trials [47,48] adjusted downward for the lower adherence levels characteristic of PWID [49][50][51], which has been shown to increase viral load [52][53][54][55]. For simplicity, it is assumed that all HIVpositive PWID (except those in the initial acute phase) can be recruited for ART at a fixed rate.…”

“…This may result from mandatory testing of migrants and the practice of "opt-out" rather than "opt in" testing policies at various clinic and health service settings; it may also result from occupational requirements [50,51]. Evidence reviewed tends to show the protective effect of HIV testing in reducing HIV risk among PWID and SWs and UAI among MSM; however, the cost of this widespread testing of general population groups in the East should be evaluated [52].…”

“…This information is used to assess homophily, or the extent to which recruiters are likely to recruit individuals similar to themselves, and to weight the sample to compensate or control for differences in network size, homophily, and recruitment success. RDS has been increasingly used in Europe and internationally to recruit samples of SWs [44,45], MSM [46] and PWID [47][48][49][50], and it has been championed for its ability to provide more representative estimates of risk behavior and HIV prevalence [46,[50][51][52][53]. There have been recent ethical concerns that the use of incentives may negatively affect participants' social and economic relationships in populations of PWID.…”