Lancaster Kathryn E, Cernigliaro Dana, Zulliger Rose, Fleming Paul F
a Division of Infectious Diseases, School of Medicine , University of North Carolina at Chapel Hill , Chapel Hill , North Carolina , USA.
b Department of Health, Behavior and Society , Johns Hopkins Bloomberg School of Public Health , Baltimore , Maryland, USA.
Afr J AIDS Res. 2016 Dec;15(4):377-386. doi: 10.2989/16085906.2016.1255652.
Female sex workers (FSW) living with HIV in sub-Saharan Africa have poor engagement to HIV care and treatment. Understanding the HIV care and treatment engagement experiences of FSW has important implications for interventions to enhance care and treatment outcomes. We conducted a systematic review to examine the HIV care experiences and determinants of linkage and retention in care, antiretroviral therapy (ART) initiation, and ART adherence and viral suppression among FSW living with HIV in sub-Saharan Africa. The databases PubMed, Embase, Web of Science, SCOPUS, CINAHL, Global Health, Psycinfo, Sociological Abstracts, and Popline were searched for variations of search terms related to sex work and HIV care and treatment among sub-Saharan African populations. Ten peer-reviewed articles published between January 2000 and August 2015 met inclusion criteria and were included in this review. Despite expanded ART access, FSW in sub-Saharan Africa have sub-optimal HIV care and treatment engagement outcomes. Stigma, discrimination, poor nutrition, food insecurity, and substance use were commonly reported and associated with poor linkage to care, retention in care, and ART initiation. Included studies suggest that interventions with FSW should focus on multilevel barriers to engagement in HIV care and treatment and explore the involvement of social support from intimate male partners. Our results emphasise several critical points of intervention for FSW living with HIV, which are urgently needed to enhance linkage to HIV care, retention in care, and treatment initiation, particularly where the HIV prevalence among FSW is greatest.
撒哈拉以南非洲地区感染艾滋病毒的女性性工作者对艾滋病毒护理和治疗的参与度较低。了解女性性工作者在艾滋病毒护理和治疗方面的参与经历，对于改善护理和治疗结果的干预措施具有重要意义。我们进行了一项系统综述，以研究撒哈拉以南非洲地区感染艾滋病毒的女性性工作者在艾滋病毒护理方面的经历、护理联系和留存的决定因素、抗逆转录病毒疗法（ART）的启动、ART依从性以及病毒抑制情况。在PubMed、Embase、科学网、SCOPUS、CINAHL、全球卫生、Psycinfo、社会学文摘和Popline等数据库中，搜索了与撒哈拉以南非洲人群中性工作和艾滋病毒护理及治疗相关的搜索词变体。2000年1月至2015年8月期间发表的10篇经同行评审的文章符合纳入标准，并被纳入本综述。尽管获得抗逆转录病毒疗法的机会有所增加，但撒哈拉以南非洲地区的女性性工作者在艾滋病毒护理和治疗方面的参与结果仍不理想。耻辱感、歧视、营养不良、粮食不安全和药物使用等情况屡见不鲜，且与护理联系不佳、护理留存率低以及抗逆转录病毒疗法启动率低有关。纳入研究表明，针对女性性工作者的干预措施应关注参与艾滋病毒护理和治疗的多层次障碍，并探索亲密男性伴侣提供社会支持的参与情况。我们的研究结果强调了感染艾滋病毒的女性性工作者几个关键的干预要点，这些要点对于加强与艾滋病毒护理的联系、护理留存率以及治疗启动至关重要，尤其是在女性性工作者中艾滋病毒流行率最高的地区。
