a Department of Epidemiology , Harvard T.H. Chan School of Public Health , Boston , MA , USA.
b Department of Sociomedical Sciences , Columbia Mailman School of Public Health , New York , NY , USA.
Glob Public Health. 2018 Apr;13(4):414-425. doi: 10.1080/17441692.2016.1149598. Epub 2016 Mar 15.
Laws and policies can affect the HIV risk of key populations through a number of direct and indirect pathways. We investigated the association between HIV prevalence among men who engage in transactional sex and language in the penal code protecting sexual minorities, including men who have sex with men (MSM), and sex workers. HIV prevalence among men who engage in transactional sex was assessed through meta-analysis of published literature and country surveillance reports. Meta-regression was used to determine the association between HIV prevalence and protective laws for sexual minorities and sex workers. Sixty-six reports representing 28 countries and 31,924 individuals were included in the meta-analysis. Controlling for multiple study- and country-level variables, legal protection for sexual minorities was associated with a 10.9% (95% CI: 3.8-18.0%) and sex workers associated with a 7.0% (95% CI: 1.3-12.8%) decrease in country-level HIV prevalence among men who engage in transactional sex. Laws that seek to actively protect sex workers and MSM may be necessary to decrease HIV risk for this key population.
法律和政策可以通过多种直接和间接途径影响重点人群的艾滋病毒风险。我们调查了刑法中保护男男性行为者（MSM）和性工作者等性少数群体的条款与从事商业性性行为的男性中的艾滋病毒流行率之间的关系。通过对已发表文献和国家监测报告的荟萃分析评估了从事商业性性行为的男性中的艾滋病毒流行率。使用元回归来确定艾滋病毒流行率与保护性少数群体和性工作者的法律之间的关系。荟萃分析纳入了 66 份报告，代表 28 个国家和 31924 人。在控制了多项研究和国家层面的变量后，性少数群体的法律保护与从事商业性性行为的男性的国家层面艾滋病毒流行率降低 10.9%（95%置信区间：3.8-18.0%）有关，而性工作者与艾滋病毒流行率降低 7.0%（95%置信区间：1.3-12.8%）有关。寻求积极保护性工作者和 MSM 的法律可能对于降低这一重点人群的艾滋病毒风险是必要的。
