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HIV/AIDS Among Female Sex Workers in China: Epidemiology and Recent Prevention Strategies

  • The Global Epidemic (S Vermund, Section Editor)
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Abstract

Purpose of Review

This review aims to describe the epidemiology of HIV among female sex workers (FSWs) in China over the past decade, to summarize current gaps in knowledge regarding risk factors, and to identify new directions for HIV prevention strategies.

Recent Findings

We summarized national and regional levels of HIV prevalence among FSWs based on reported rates in the literature from 2008 to 2018. Studies identified cases of HIV infection among FSWs in all but one province during this time period, and demonstrated a sporadic pattern in most provinces, with a low overall national HIV prevalence below 1%. However, in Yunnan and Guanxi Zhuang Autonomous Regions, the median-reported prevalence rates were close to or slightly above 1%. National prevention programs have widely promoted male condoms as a primary and practical measure for HIV prevention, but studies evaluating condom use practices among FSWs demonstrated wide variability. A rise in illicit use of synthetic drugs and changing sexual practices in the setting of sex work (e.g., anal sex) may represent newer risk factors for HIV transmission among FSWs; however, more data are needed to better characterize these trends. Limited studies have examined the feasibility and efficacy of innovative prevention tools (e.g., female condoms) or strategies (e.g., pre-exposure prophylaxis, PrEP) to prevent HIV among FSWs.

Summary

We call for a more comprehensive understanding of current trends in HIV risk among FSWs, as well as more research focuses on innovative strategies to reduce the spread of HIV in this vulnerable population.

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Funding

Dr. Hsieh is supported by NIH/Fogarty International Center K01TW009995, and the Rheumatology Research Foundation K Supplement Award.

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Authors and Affiliations

  1. National Center for AIDS/STD Control and Prevention, China Center for Disease Control and Prevention, No.155 Changbai Road, Changping District, Beijing, China

    Hanxi Zhang & Lu Wang

  2. Section of Rheumatology, Allergy and Immunology, Yale School of Medicine, New Haven, CT, 06520, USA

    Evelyn Hsieh

  3. Institute of Basic Medical Science, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 5 Dongdan SanTiao, Dongcheng District, Beijing, China

    Susu Liao

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  1. Hanxi Zhang
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  2. Evelyn Hsieh
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  3. Lu Wang
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Correspondence to Lu Wang or Susu Liao.

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Zhang Hanxi, Wang Lu, and Liao Susu declare that they have no conflict of interest.

Dr. Hsieh has previously received honoraria from Gilead, unrelated to this manuscript.

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Zhang, H., Hsieh, E., Wang, L. et al. HIV/AIDS Among Female Sex Workers in China: Epidemiology and Recent Prevention Strategies. Curr HIV/AIDS Rep 17, 151–160 (2020). https://doi.org/10.1007/s11904-019-00477-y

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