Institute of Global Health, University of Heidelberg, Heidelberg, Germany.
College of Health Sciences, University of Dodoma, Dodoma, Tanzania.
BMC Public Health. 2020 May 15;20(1):697. doi: 10.1186/s12889-020-08838-8.
Although sex workers are considered a key population in the HIV epidemic in sub-Saharan Africa (SSA), less consideration has been given to female bar workers (FBW), whose primary occupation is not sex work but who often engage in transactional sex. Understanding FBWs' risk profiles is central to designing targeted HIV prevention interventions for them. This systematic review describes the socio-demographic characteristics and risk factors for HIV transmission among FBWs in SSA.
We searched six databases: PubMed, Google Scholar, Web of Science, Popline, Embase and additionally the World Health Organization's WHOLIS database for grey literature between July and September 2017. Inclusion criteria were reporting (1) primary socio-demographic or behavioral data; on (2) women who sold or delivered drinks to clients; (3) in establishments serving alcohol; (4) in SSA. We excluded studies not presenting separate data on FBWs. We extracted quantitative and qualitative data from the selected studies and conducted a qualitative synthesis of findings.
We found 4565 potentially eligible articles, including duplicates. After applying inclusion and exclusion criteria, we retained 19 articles. FBWs often migrated from rural to urban areas due to economic need or social marginalization. They began bar-based transactional sex due to low wages, peer pressure and to increase financial independence. FBWs had high HIV risk awareness but low agency to negotiate condom use, particularly with regular partners or when offered higher prices for condomless sex. FBWs were also vulnerable to violence and stigmatization.
FBWs are a vulnerable population for HIV infection. Despite social stigmatization and elevated risk of contracting STIs, bar work remains attractive because it enables unskilled women to both, make a living and maintain some independence. FBWs face HIV-related risk factors at the individual, community and societal level and may benefit from biomedical, behavioral and structural interventions.
尽管性工作者被认为是撒哈拉以南非洲（SSA）艾滋病毒流行中的关键人群，但对女性酒吧工作者（FBW）的关注较少，她们的主要职业不是性工作，但经常从事交易性性行为。了解 FBW 的风险概况对于为他们设计有针对性的艾滋病毒预防干预措施至关重要。本系统评价描述了 SSA 中 FBW 的社会人口统计学特征和艾滋病毒传播风险因素。
我们在 2017 年 7 月至 9 月期间在六个数据库（PubMed、Google Scholar、Web of Science、Popline、Embase 和世界卫生组织的 WHOLIS 数据库）中搜索了灰色文献：PubMed、Google Scholar、Web of Science、Popline、Embase 和另外还包括世界卫生组织的 WHOLIS 数据库，以获取有关女性酒吧工作者的主要社会人口统计学或行为数据。纳入标准为：（1）报告了女性酒吧工作者的主要社会人口统计学或行为数据；（2）向客户销售或提供饮料的女性；（3）在提供酒精的场所；（4）在撒哈拉以南非洲。我们排除了未单独报告女性酒吧工作者数据的研究。我们从选定的研究中提取了定量和定性数据，并对研究结果进行了定性综合分析。
我们发现了 4565 篇潜在的合格文章，包括重复文章。在应用纳入和排除标准后，我们保留了 19 篇文章。女性酒吧工作者通常因经济需求或社会边缘化而从农村迁移到城市。由于工资低、同伴压力以及为了增加经济独立性，她们开始从事酒吧交易性性行为。女性酒吧工作者对艾滋病毒风险有较高的认识，但在谈判使用避孕套方面的机构能力较低，特别是与固定伴侣或提供更高价格的无保护性行为时。女性酒吧工作者也容易受到暴力和污名化。
女性酒吧工作者是艾滋病毒感染的脆弱人群。尽管受到社会污名化和性传播感染风险增加的影响，但酒吧工作仍然具有吸引力，因为它使非熟练女性能够谋生并保持一定的独立性。女性酒吧工作者面临个人、社区和社会层面的艾滋病毒相关风险因素，可能受益于生物医学、行为和结构干预措施。
