Atuhaire Lydia, Adetokunboh Olatunji, Shumba Constance, Nyasulu Peter S
Division of Epidemiology & Biostatistics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
Division of Epidemiology & Biostatistics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
BMJ Open. 2020 Oct 27;10(10):e039495. doi: 10.1136/bmjopen-2020-039495.
Female sex workers (FSWs) are a known high-risk group that are at increased risk of HIV transmission due to exposure to multiple sexual partners and inability to negotiate safe sex attributed to challenging economic circumstances. Previous systematic reviews have examined the effectiveness of HIV interventions prioritising FSWs and have shown that targeted interventions improve access to HIV prevention and treatment services. Interventions that increase FSWs' uptake of services are well documented; however, evidence on specific interventions aimed at improving FSWs' continuity in HIV care along the treatment cascade is lacking. This systematic review aims to document the performance of community-based interventions along the HIV treatment cascade.
We will use a sensitive search strategy for electronic bibliographic databases, bibliographies of included articles and grey literature sources. In addition, the Joint United Nations Programme on HIV/AIDS and the WHO websites, peer-reviewed conference papers and grey literature sources will be searched for additional reports of sex work programmes. We will include randomised controlled trials, cross-sectional surveys and cohort interventions where community-based HIV services were provided to FSWs and measure the performance of the HIV intervention on one or more cascade stages. We will conduct a systematic review of studies published from 2004 to present within the sub-Saharan Africa region. We will report quantitative study outcomes of HIV testing and diagnosis, linkage to care, initiation on antiretroviral therapy and viral suppression. We will analyse the data using the random-effects meta-analysis method, and funnel plots will be used to assess the publication bias.
This systematic review will not require ethical approval; we will publish data from manuscripts. The results of this study will be disseminated in peer-reviewed journals and conference presentations.
CRD42020157623.
女性性工作者是一个已知的高危群体，由于接触多个性伴侣以及因经济困境而无法协商安全性行为，她们感染艾滋病毒的风险增加。以往的系统评价研究了优先针对女性性工作者的艾滋病毒干预措施的有效性，结果表明，有针对性的干预措施改善了艾滋病毒预防和治疗服务的可及性。关于提高女性性工作者服务利用率的干预措施已有充分记录；然而，缺乏针对改善女性性工作者在艾滋病毒治疗过程中治疗连续性的具体干预措施的证据。本系统评价旨在记录基于社区的干预措施在艾滋病毒治疗过程中的实施情况。
我们将对电子文献数据库、纳入文章的参考文献以及灰色文献来源采用敏感的检索策略。此外，还将检索联合国艾滋病毒/艾滋病联合规划署和世界卫生组织网站、同行评审的会议论文以及灰色文献来源，以获取性工作项目的其他报告。我们将纳入为女性性工作者提供基于社区的艾滋病毒服务的随机对照试验、横断面调查和队列干预措施，并衡量艾滋病毒干预措施在一个或多个治疗阶段的实施情况。我们将对2004年至目前在撒哈拉以南非洲地区发表的研究进行系统评价。我们将报告艾滋病毒检测与诊断、与护理的联系、开始抗逆转录病毒治疗以及病毒抑制的定量研究结果。我们将使用随机效应荟萃分析方法分析数据，并使用漏斗图评估发表偏倚。
本系统评价无需伦理批准；我们将发表稿件中的数据。本研究结果将在同行评审期刊和会议报告中传播。
PROSPERO注册号：CRD42020157623。
