Community empowerment among female sex workers is an effective HIV prevention intervention: A systematic review of the peer-reviewed evidence from low- and middle-income countries

Deanna L. Kerrigan, Virginia A. Fonner, Susanne Stromdahl, Caitlin E. Kennedy

Research output: Contribution to journalReview articlepeer-review

Abstract

We conducted a systematic review and meta-analysis of community empowerment interventions for HIV prevention among sex workers in low- and middle-income countries from 1990-2010. Two coders abstracted data using standardized forms. Of 6,664 citations screened, ten studies met inclusion criteria. For HIV infection, two observational studies showed a significantly protective combined effect [odds ratio (OR): 0.84, 95 % confidence interval (CI): 0.709-0.988]. For STI infection, one longitudinal study showed reduced gonorrhoea/chlamydia (OR: 0.51, 95 % CI: 0.26-0.99). Observational studies showed reduced gonorrhoea (OR: 0.65, 95 % CI: 0.47-0.90), but non-significant effects on chlamydia and syphilis. For condom use, one randomized controlled trial showed improvements with clients (ß: 0.3447, p = 0.002). One longitudinal study showed improvements with regular clients (OR: 1.9, 95 % CI: 1.1-3.3), but no change with new clients. Observational studies showed improvements with new clients (OR: 3.04, 95 % CI: 1.29-7.17), regular clients (OR: 2.20, 95 % CI: 1.41-3.42), and all clients (OR: 5.87, 95 % CI: 2.88-11.94), but not regular non-paying partners. Overall, community empowerment-based HIV prevention was associated with significant improvements across HIV outcomes and settings.

Original languageEnglish (US)
Pages (from-to)1926-1940
Number of pages15
JournalAIDS and behavior
Volume17
Issue number6
DOIs
StatePublished - Jul 1 2013

Keywords

  • Community empowerment
  • HIV
  • Meta-analysis
  • Sex work
  • Systematic review

ASJC Scopus subject areas

  • Social Psychology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

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