HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
Arch Sex Behav. 2020 Aug;49(6):1923-1937. doi: 10.1007/s10508-019-01574-0. Epub 2019 Nov 7.
Given the high burden of HIV and other sexually transmitted infections (STIs) among female sex workers (FSW) and their potential role in bridging HIV/STIs into the general population, estimating the prevalence of HIV/STIs among FSW is essential for future research and policy developments. This systematic review and meta-analysis synthesize the available HIV/STIs data among FSW in Iran. We searched MEDLINE, PsycINFO, CINAHL, Embase, Web of Science, Google Scholar, and Iranian databases from inception through to January 2018. Inclusion criteria were original quantitative studies that measured HIV/STIs prevalence among FSW. Pooled prevalence estimates were calculated using random-effects meta-analyses. Out of a total of 299 screened studies, 12 were included with total study participants of 4328 FSW. Heterogeneity was present but meta-regression analyses revealed no significant association between HIV prevalence and year of publication, city, and age. Pooled HIV prevalence was 2.23% (95% confidence interval [CI] 0.82, 3.64). We estimated the prevalence of other STIs as 0.77% (95% CI 0.01, 1.53) for hepatitis B, 6.18% (95% CI 1.32, 11.04) for hepatitis C, 0.33% (95% CI 0.00, 0.66) for syphilis, 1.47% (95% CI 0.22, 2.71) for gonorrhea, 9.80% (95% CI 4.70, 14.91) for chlamydia, and 6.18% (95% CI 4.92, 7.43) for trichomonas vaginalis. Based on the existing evidence, HIV and STIs prevalence among FSW are relatively low in Iran. Strategies for timely diagnosis and treatment of HIV and other STIs among FSW and their sexual and injecting partners are needed to reduce the burden of HIV/STIs among these vulnerable populations in Iran.
鉴于性工作者（FSW）中艾滋病毒和其他性传播感染（STI）的负担沉重，以及他们在将艾滋病毒/性传播感染传播给普通人群方面的潜在作用，估计 FSW 中艾滋病毒/STI 的流行率对于未来的研究和政策发展至关重要。本系统评价和荟萃分析综合了伊朗 FSW 中现有的艾滋病毒/STI 数据。我们检索了 MEDLINE、PsycINFO、CINAHL、Embase、Web of Science、Google Scholar 和伊朗数据库，从开始到 2018 年 1 月。纳入标准是测量 FSW 中艾滋病毒/STI 流行率的原始定量研究。使用随机效应荟萃分析计算汇总流行率估计值。在总共 299 项筛选研究中，有 12 项研究符合纳入标准，共有 4328 名 FSW 参与研究。存在异质性，但荟萃回归分析显示，艾滋病毒流行率与发表年份、城市和年龄之间没有显著关联。估计 HIV 流行率为 2.23%（95%置信区间 [CI] 0.82, 3.64）。我们估计其他 STI 的流行率为乙型肝炎 0.77%（95%CI 0.01, 1.53）、丙型肝炎 6.18%（95%CI 1.32, 11.04）、梅毒 0.33%（95%CI 0.00, 0.66）、淋病 1.47%（95%CI 0.22, 2.71）、衣原体 9.80%（95%CI 4.70, 14.91）和滴虫 6.18%（95%CI 4.92, 7.43）。根据现有证据，伊朗 FSW 中的艾滋病毒和 STI 流行率相对较低。需要制定策略，及时诊断和治疗 FSW 及其性伴侣和注射药物使用者中的艾滋病毒和其他 STI，以减轻伊朗这些脆弱人群中艾滋病毒/STI 的负担。
