Division of Global Public Health, Department of Medicine, University of California San Diego, School of Medicine, 9500 Gilman Drive, MC 0507, La Jolla, CA 92093-0507, USA.
Curr HIV/AIDS Rep. 2013 Mar;10(1):65-78. doi: 10.1007/s11904-012-0142-8.
Female sex workers (FSWs) continue to represent a high-risk population in need of targeted HIV prevention interventions. Targeting environmental risk factors should result in more sustainable behavior change than individual-level interventions alone. There are many types of FSWs who operate in and through a variety of micro- (eg, brothels) and macro-level (eg, being sex-trafficked) contexts. Efforts to characterize FSWs and inform HIV prevention programs have often relied on sex work typologies or categorizations of FSWs by venue or type. We conducted a systematic search and qualitatively reviewed 37 published studies on venue-based FSWs to examine the appropriateness of sex work typologies, and the extent to which this research has systematically examined characteristics of different risk environments. We extracted information on study characteristics like venue comparisons, HIV/STI prevalence, and sampling strategies. We found mixed results with regards to the reliability of typologies in predicting HIV/STI infection; relying solely on categorization of FSWs by venue or type did not predict seroprevalence in a consistent manner. Only 65 % of the studies that allowed for venue comparisons on HIV/STI prevalence provided data on venue characteristics. The factors that were assessed were largely individual-level FSW factors (eg, demographics, number of clients per day), rather than social and structural characteristics of the risk environment. We outline a strategy for future research on venue-based FSWs that ultimately aims to inform structural-level HIV interventions for FSWs.
性工作者（FSWs）仍然是一个需要有针对性艾滋病毒预防干预措施的高风险人群。针对环境风险因素应该会导致更可持续的行为改变，而不仅仅是个体层面的干预。有许多类型的性工作者在各种微观（例如，妓院）和宏观（例如，被性交易）环境中运作。为了描述性工作者并为艾滋病毒预防计划提供信息，人们经常依赖性工作分类或按场所或类型对性工作者进行分类。我们进行了系统搜索，并对 37 项已发表的基于场所的性工作者研究进行了定性审查，以检验性工作分类的适当性，以及这项研究在多大程度上系统地检查了不同风险环境的特征。我们提取了有关研究特征的信息，例如场所比较、艾滋病毒/性传播感染的流行率和抽样策略。我们发现，性工作分类在预测艾滋病毒/性传播感染方面的可靠性存在混合结果；仅仅依靠场所或类型对性工作者进行分类并不能以一致的方式预测血清流行率。只有 65%的允许对艾滋病毒/性传播感染的流行率进行场所比较的研究提供了关于场所特征的数据。评估的因素主要是个体层面的性工作者因素（例如，人口统计学、每天的客户数量），而不是风险环境的社会和结构特征。我们概述了基于场所的性工作者未来研究的策略，最终旨在为性工作者的结构性艾滋病毒干预措施提供信息。
