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Data and methods to characterize the role of sex work and to inform sex work programs in generalized HIV epidemics: evidence to challenge assumptions.

Publication ,  Journal Article
Mishra, S; Boily, M-C; Schwartz, S; Beyrer, C; Blanchard, JF; Moses, S; Castor, D; Phaswana-Mafuya, N; Vickerman, P; Drame, F; Alary, M; Baral, SD
Published in: Ann Epidemiol
August 2016

In the context of generalized human immunodeficiency virus (HIV) epidemics, there has been limited recent investment in HIV surveillance and prevention programming for key populations including female sex workers. Often implicit in the decision to limit investment in these epidemic settings are assumptions including that commercial sex is not significant to the sustained transmission of HIV, and HIV interventions designed to reach "all segments of society" will reach female sex workers and clients. Emerging empiric and model-based evidence is challenging these assumptions. This article highlights the frameworks and estimates used to characterize the role of sex work in HIV epidemics as well as the relevant empiric data landscape on sex work in generalized HIV epidemics and their strengths and limitations. Traditional approaches to estimate the contribution of sex work to HIV epidemics do not capture the potential for upstream and downstream sexual and vertical HIV transmission. Emerging approaches such as the transmission population attributable fraction from dynamic mathematical models can address this gap. To move forward, the HIV scientific community must begin by replacing assumptions about the epidemiology of generalized HIV epidemics with data and more appropriate methods of estimating the contribution of unprotected sex in the context of sex work.

Duke Scholars

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Published In

Ann Epidemiol

DOI

EISSN

1873-2585

Publication Date

August 2016

Volume

26

Issue

8

Start / End Page

557 / 569

Location

United States

Related Subject Headings

  • Unsafe Sex
  • Sexual Behavior
  • Sex Workers
  • Risk Assessment
  • Prevalence
  • Needs Assessment
  • Models, Theoretical
  • Humans
  • Health Promotion
  • HIV Infections
 

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Mishra, S., Boily, M.-C., Schwartz, S., Beyrer, C., Blanchard, J. F., Moses, S., … Baral, S. D. (2016). Data and methods to characterize the role of sex work and to inform sex work programs in generalized HIV epidemics: evidence to challenge assumptions. Ann Epidemiol, 26(8), 557–569. https://doi.org/10.1016/j.annepidem.2016.06.004
Mishra, Sharmistha, Marie-Claude Boily, Sheree Schwartz, Chris Beyrer, James F. Blanchard, Stephen Moses, Delivette Castor, et al. “Data and methods to characterize the role of sex work and to inform sex work programs in generalized HIV epidemics: evidence to challenge assumptions.Ann Epidemiol 26, no. 8 (August 2016): 557–69. https://doi.org/10.1016/j.annepidem.2016.06.004.
Mishra S, Boily M-C, Schwartz S, Beyrer C, Blanchard JF, Moses S, et al. Data and methods to characterize the role of sex work and to inform sex work programs in generalized HIV epidemics: evidence to challenge assumptions. Ann Epidemiol. 2016 Aug;26(8):557–69.
Mishra, Sharmistha, et al. “Data and methods to characterize the role of sex work and to inform sex work programs in generalized HIV epidemics: evidence to challenge assumptions.Ann Epidemiol, vol. 26, no. 8, Aug. 2016, pp. 557–69. Pubmed, doi:10.1016/j.annepidem.2016.06.004.
Mishra S, Boily M-C, Schwartz S, Beyrer C, Blanchard JF, Moses S, Castor D, Phaswana-Mafuya N, Vickerman P, Drame F, Alary M, Baral SD. Data and methods to characterize the role of sex work and to inform sex work programs in generalized HIV epidemics: evidence to challenge assumptions. Ann Epidemiol. 2016 Aug;26(8):557–569.
Journal cover image

Published In

Ann Epidemiol

DOI

EISSN

1873-2585

Publication Date

August 2016

Volume

26

Issue

8

Start / End Page

557 / 569

Location

United States

Related Subject Headings

  • Unsafe Sex
  • Sexual Behavior
  • Sex Workers
  • Risk Assessment
  • Prevalence
  • Needs Assessment
  • Models, Theoretical
  • Humans
  • Health Promotion
  • HIV Infections