Center on Health, Risk and Society, American University, 4400 Massachusetts Ave, NW, Washington, DC, 20016-8012, USA.
Instituto Dermatologico y Cirugia de la Piel, Calle Albert Thomas, 66, Santo Domingo, Dominican Republic.
Curr HIV/AIDS Rep. 2020 Apr;17(2):88-96. doi: 10.1007/s11904-020-00485-3.
This review describes social determinants of HIV in two geographic and epidemic settings, the Dominican Republic (DR) and Tanzania, among female sex workers (FSW), their influence on HIV outcomes including 90-90-90 goals, and the development and impact of tailored, context driven, community empowerment-based responses in each setting.
Our review documents the significance of social determinants of HIV including sex work-related stigma, discrimination, and violence and the impact of community empowerment-based approaches on HIV incidence in Tanzania and other HIV prevention, treatment, and care outcomes, including care engagement and adherence, in the DR and Tanzania. Community empowerment approaches where FSW drive the response to HIV and strategically engage partners to target socio-structural and environmental factors can have a demonstrable impact on HIV prevention, treatment, and care outcomes. Such approaches can also support further gains towards reaching the 90-90-90 across geographies and types of epidemics.
本综述描述了在多米尼加共和国（DR）和坦桑尼亚这两个地理和流行环境中，社会决定因素对女性性工作者（FSW）中 HIV 的影响，包括 90-90-90 目标，以及在每个环境中制定和实施的、基于具体情况和社区赋权的应对措施的发展和影响。
我们的综述记录了 HIV 的社会决定因素的重要性，包括与性工作相关的耻辱、歧视和暴力，以及社区赋权方法对坦桑尼亚和 DR 中 HIV 发病率以及其他 HIV 预防、治疗和护理结果（包括护理参与和坚持）的影响。FSW 推动对 HIV 的应对措施，并战略性地与合作伙伴合作，以针对社会结构和环境因素的社区赋权方法，对 HIV 的预防、治疗和护理结果可能产生显著影响。这种方法还可以支持在不同地理区域和流行类型中进一步实现 90-90-90 的目标。
