Higgins and Thompson [ 32 ] proposed a tentative classification of I2 values with the purpose of helping to interpret its magnitude. A final screening excluded four other reviews. The I2 index was calculated as a measure of the overall variation in prevalence that was attributable to between-study heterogeneity [ 32 , 33 ]. To reduce the likelihood that a low-level or concentrated epidemic may become a generalized epidemic, prevention programs should focus on potential epidemiological bridges, such as the sex partners of injecting drug users IDU , female sex workers FSW or truck drivers [ 6 , 7 ]. Activities include Support and technical assistance to help community-based organizations implement interventions directed toward persons who exchange sex e.
Comprehensive HIV Prevention Programs for Health Departments, a 5-year HIV prevention initiative for health departments in states, territories, and select cities, including those serving clients at risk for HIV infection because of exchanging sex. Citations that intersect all four domains were downloaded into the study database. Analyses were conducted using Stata version ShareCompartir Fast Facts The risk of HIV and other sexually transmitted diseases is high among persons who exchange sex for money or nonmonetary items. We chose a random-effects model for aggregating individual effect sizes because it provides a more conservative estimate than a fixed-effects model of variance. The following covariates were included in the meta-regression multivariable model: Unless we take urgent steps to intensify HIV prevention we will fail to sustain the gains of the past few years, and universal access will simply be a noble aspiration. Agreement on the two final screenings was also perfect. According to Hacker et al. This information is vital to inform health planning, resources allocation and might also be an important tool for advocacy and the elaboration of future scenarios [ 1 ]. For those factors multivariable analyses were carried out. All studies identified through these procedures that met our eligible criteria were entered into the study database. Act Against AIDS , a national initiative that focuses on raising awareness, fighting stigma, and reducing the risk of HIV infection among at-risk populations. For studies addressing drug users we also conducted a mixed-effects meta-regression model to assess the underlying reasons for between-study heterogeneity. Agreement between reviewers was also perfect on the second screening. Brazil was the first middle-income country to provide free and universal access to highly active antiretroviral therapy HAART , laboratory monitoring and clinical care at no cost at the point of health care delivery to any eligible patient, since [ 13 , 14 ]. The same strategy was used by our group in previous reviews [ 24 , 25 ]. Drug and Alcohol Use There is a strong link between exchange sex and drug and alcohol use. People who trade sex for drugs tend to have more clients, use condoms less often, and are more likely to share needles and other drug works. Other risk factors for this population include Multiple high-risk sex partners, e. The future course of the epidemic is determined by the nature and intensity of the interactions between subpopulations with high infection rates and the general population [ 3 - 5 ]. Persons who exchange sex may receive more money for sex without a condom. NIDU , region where the study was conducted Brazilian southern region vs. Third, we contacted authors of selected papers to obtain additional data on upcoming publications. This lack of data creates significant barriers to developing targeted HIV prevention efforts. According to a recent review [ 34 ], the I2 index assesses not only heterogeneity in a meta-analysis but also the extent of that heterogeneity. According to the UNAIDS, "for every two people who start taking antiretroviral drugs, another five become newly infected.
Video about hiv prevalence among female sex workers:
HIV and sex workers
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