The role of sex work laws and stigmas in increasing HIV risks among sex workers.

Journal: Nature communications

Volume: 11

Issue: 1

Year of Publication: 2020

Affiliated Institutions:  Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins School of Public Health,  N Wolfe St, Baltimore, MD, , USA. clyons@jhu.edu. Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins School of Public Health,  N Wolfe St, Baltimore, MD, , USA. Department of Mental Health, Johns Hopkins School of Public Health, Hampton House  N. Broadway th Floor, Baltimore, MD, , USA. Centre for Gender & Sexual Health Equity, University of British Columbia, Burrard St, Vancouver, BC, Canada. Enda Santé, Senegal, Cité Comico VDN, B.P, , Dakar, Senegal. People's Matrix Association, Maseru, Lesotho. Institut de Recherche en Sciences de la Santé, Ouagadougou, Burkina Faso, Institut Africain de Santé Publique, BP , Ouagadougou, Burkina Faso. ONG Arc-en-Ciel, B.P., , Lomé, Togo. Ministère de la Sante et de l'Hygiène Publique, Abidjan, Côte d'Ivoire. Health Research Department, Strategic Information Division, Ministry of Health, Cooper Centre Office , Mbabane, Eswatini. Metabiota. Avenue Mvog-Fouda Ada, Av ., Carrefour Intendance BP, , Yaoundé, Cameroon. DVC Research and Innovation Office, North-West University, Potchefstroom Campus, Private Bag X Potchefstroom, , Potchefstroom, South Africa. Actionaid, Banjul The Gambia, MDI Road, Kanifing South PMB , Serrekunda PO Box , Banjul, The Gambia. Enda Santé, Guiné-Bissau. Bairro Santa Luzia, Rua s/n, CP , Bissau, Guinea-Bissau.

Abstract summary 

Globally HIV incidence is slowing, however HIV epidemics among sex workers are stable or increasing in many settings. While laws governing sex work are considered structural determinants of HIV, individual-level data assessing this relationship are limited. In this study, individual-level data are used to assess the relationships of sex work laws and stigmas in increasing HIV risk among female sex workers, and examine the mechanisms by which stigma affects HIV across diverse legal contexts in countries across sub-Saharan Africa. Interviewer-administered socio-behavioral questionnaires and biological testing were conducted with 7259 female sex workers between 2011-2018 across 10 sub-Saharan African countries. These data suggest that increasingly punitive and non-protective laws are associated with prevalent HIV infection and that stigmas and sex work laws may synergistically increase HIV risks. Taken together, these data highlight the fundamental role of evidence-based and human-rights affirming policies towards sex work as part of an effective HIV response.

Authors & Co-authors:  Lyons Schwartz Murray Shannon Diouf Mothopeng Kouanda Simplice Kouame Mnisi Tamoufe Phaswana-Mafuya Cham Drame Aliu Djaló Baral

Study Outcome 

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Statistics
Citations :  Baral S, et al. The disconnect between individual-level and population-level HIV prevention benefits of antiretroviral treatment. Lancet HIV. 2019;6:e632–e638. doi: 10.1016/S2352-3018(19)30226-7.
Authors :  16
Identifiers
Doi : 773
SSN : 2041-1723
Study Population
Female
Mesh Terms
Adolescent
Other Terms
Study Design
Study Approach
Country of Study
Publication Country
England