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Estimating the Impact of Reducing Violence Against Female Sex Workers on HIV Epidemics in Kenya and Ukraine: A Policy Modeling Exercise
Author(s) -
Decker Michele R.,
Wirtz Andrea L.,
Pretorius Carel,
Sherman Susan G.,
Sweat Michael D.,
Baral Stefan D.,
Beyrer Chris,
Kerrigan Deanna L.
Publication year - 2013
Publication title -
american journal of reproductive immunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.071
H-Index - 97
eISSN - 1600-0897
pISSN - 1046-7408
DOI - 10.1111/aji.12063
Subject(s) - human immunodeficiency virus (hiv) , population , psychological intervention , demography , medicine , environmental health , immunology , psychiatry , sociology
Problem Female sex workers ( FSW s) worldwide suffer disproportionate burdens of HIV and gender‐based violence. Despite evidence linking these threats, little is known about the potential HIV epidemic impact of reducing abuse. Method of study The G oals model approximated the impact of reducing violence against FSW s on HIV epidemics in U kraine and K enya, measured by reductions in new infections among FSW s and adults. Cumulative infections averted over a 5‐year period, in which violence declined was calculated, relative to a status quo with no reduction. Projections held HIV interventions constant at baseline levels; subsequently, scenarios adjusted for planned expansion of antiretroviral therapy ( ART ) coverage. Results An approximate 25% reduction in incident HIV infections among FSW s was observed when physical or sexual violence was reduced; cumulative infections averted were 21,200 and 4700 in K enya and U kraine, respectively. Similar percent reductions were observed assuming ART coverage expansion, with approximately 18,200 and 4400 infections averted among FSW s in K enya and U kraine. New infections were also averted in the general population. Conclusion Reducing violence against FSW s appears to impart significant reductions in new infections among FSW s and in the general adult population in both generalized and concentrated epidemics. Limitations provide direction to improve the precision of future estimates.