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Lancet. 2015 Jan 17;385(9964):287-301. doi: 10.1016/S0140-6736(14)60933-8. Epub 2014 Jul 22.

An action agenda for HIV and sex workers.

Author information

1
Center for Public Health and Human Rights, Johns Hopkins University, Baltimore, MD, USA. Electronic address: cbeyrer@jhu.edu.
2
University of Toronto, Toronto, ON, Canada.
3
Desmond Tutu HIV Research Centre, University of Cape Town, Cape Town, South Africa.
4
United Nations Population Fund, New York, NY, USA.
5
BC Center for Excellence in HIV/AIDS, University of British Columbia, Vancouver, BC, Canada.
6
Center for Public Health and Human Rights, Johns Hopkins University, Baltimore, MD, USA; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
7
Center for Public Health and Human Rights, Johns Hopkins University, Baltimore, MD, USA.
8
Center for Public Health and Human Rights, Johns Hopkins University, Baltimore, MD, USA; Department of Emergency Medicine, Johns Hopkins University, Baltimore, MD, USA.
9
Institut Pasteur, Paris, France.
10
UN Special Envoy for HIV in eastern Europe and central Asia, Geneva, Switzerland.
11
UNAIDS, Geneva, Switzerland.
12
Imperial College, London, UK.
13
University of California San Diego, San Diego, CA, USA.

Abstract

The women, men, and transgender people who sell sex globally have disproportionate risks and burdens of HIV in countries of low, middle, and high income, and in concentrated and generalised epidemic contexts. The greatest HIV burdens continue to be in African female sex workers. Worldwide, sex workers still face reduced access to needed HIV prevention, treatment, and care services. Legal environments, policies, police practices, absence of funding for research and HIV programmes, human rights violations, and stigma and discrimination continue to challenge sex workers' abilities to protect themselves, their families, and their sexual partners from HIV. These realities must change to realise the benefits of advances in HIV prevention and treatment and to achieve global control of the HIV pandemic. Effective combination prevention and treatment approaches are feasible, can be tailored for cultural competence, can be cost-saving, and can help to address the unmet needs of sex workers and their communities in ways that uphold their human rights. To address HIV in sex workers will need sustained community engagement and empowerment, continued research, political will, structural and policy reform, and innovative programmes. But such actions can and must be achieved for sex worker communities everywhere.

PMID:
25059950
PMCID:
PMC4302059
DOI:
10.1016/S0140-6736(14)60933-8
[Indexed for MEDLINE]
Free PMC Article

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