The role of sex work laws and stigmas in increasing HIV risks among sex workers.
Carrie E LyonsSheree R SchwartzSarah McIvor MurrayKate ShannonDaouda DioufTampose MothopengSeni KouandaAnato SimpliceAbo KouameZandile MnisiUbald TamoufeNancy Phaswana-MafuyaBai ChamFatou M DrameMamadú Aliu DjalóStefan BaralPublished in: Nature communications (2020)
Globally HIV incidence is slowing, however HIV epidemics among sex workers are stable or increasing in many settings. While laws governing sex work are considered structural determinants of HIV, individual-level data assessing this relationship are limited. In this study, individual-level data are used to assess the relationships of sex work laws and stigmas in increasing HIV risk among female sex workers, and examine the mechanisms by which stigma affects HIV across diverse legal contexts in countries across sub-Saharan Africa. Interviewer-administered socio-behavioral questionnaires and biological testing were conducted with 7259 female sex workers between 2011-2018 across 10 sub-Saharan African countries. These data suggest that increasingly punitive and non-protective laws are associated with prevalent HIV infection and that stigmas and sex work laws may synergistically increase HIV risks. Taken together, these data highlight the fundamental role of evidence-based and human-rights affirming policies towards sex work as part of an effective HIV response.
Keyphrases
- antiretroviral therapy
- hiv positive
- hiv infected
- hiv testing
- human immunodeficiency virus
- hiv aids
- hepatitis c virus
- men who have sex with men
- electronic health record
- big data
- depressive symptoms
- mental health
- risk assessment
- artificial intelligence
- social support
- machine learning
- human health
- risk factors
- mental illness