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Systematic review of sex work interventions in sub‐Saharan Africa: examining combination prevention approaches
Author(s) -
Awungafac George,
Delvaux Therese,
Vuylsteke Bea
Publication year - 2017
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.12890
Subject(s) - psychological intervention , medicine , binge drinking , systematic review , intervention (counseling) , harm reduction , sex work , reproductive health , family medicine , environmental health , medline , poison control , suicide prevention , population , human immunodeficiency virus (hiv) , psychiatry , political science , law
Objective The incidence of HIV and sexually transmitted infections is disproportionately high among sex workers ( SW ). We aimed to update the evidence on the effectiveness of SW interventions in sub‐Saharan Africa and to provide more insights into combination prevention. Methods The Systematic review followed PRISMA guidelines in a search of PUBMED and POPLINE for peer‐reviewed literature published between 1 January 2000 and 22 July 2016 (registration number on PROSPERO : CRD 42016042529). We considered cohort interventions, randomised controlled trials and cross‐sectional surveys of SW programmes. A framework was used in the description and mapping of intervention to desired outcomes. Results Twenty‐six papers(reporting on 25 studies) were included. A strategy that empowered peer educator leaders to steer community activities showed a twofold increase in coverage of behaviour change communication and utilisation of health facility among SW . Brief alcohol harm reduction effort demonstrated a significant effect on sexual violence and engagement in sex trading. A risk reduction counselling intervention among drug‐injecting SW showed an effect on alcohol, substance use and engagement in sex work. No study on a promising intervention like Pr EP among SW s was found. We observed that interventions that combined some structural components, biomedical and behavioural strategies tend to accumulate more desired outcomes. Conclusion The evidence base that can be considered in intervention designs to prevent HIV in SW in SSA is vast. The health sector should consider interventions to reduce binge alcohol intake and intravenous drug use among sex workers. Programmes should staunchly consider multicomponent approaches that explore community‐based structural approaches.