A Systematic Review & Meta-Analysis of Prevalence, Trend & Geographical Distribution of HIV among Chinese Female Sex Workers (2000-2011): Implications tor Preventing Sexually Transmitted HIV

This meta-analysis investigates temporal and geographical trends of the HIV epidemic among female sex workers (FSWs) recruited from various venues in China.

The national HIV prevalence among FSWs has declined from 0.74% in 2000-2002 to 0.40% during 2009-2011. All Chinese regions demonstrate significant declines in HIV prevalence, apart from East and South Central China, in which the epidemics stabilised at low/moderate levels. Despite a significant decline from 1.92% (0.86-4.24%) to 0.87% (0.65-1.18%) during 2000-2011, Southwest China still bore the greatest HIV disease burden. Nationwide, FSWs recruited from detention centres have the highest HIV prevalence 0.92% (0.46-1.88%), followed by voluntary counselling and testing sites 0.80% (0.46-1.67%) and entertainment venues 0.61% (0.47-0.79%). Prevalence among FSWs in high-, middle- and low-tier entertainment venues were 0.59% (0.32-1.45%), 0.92% (0.50-1.77%) and 1.10% (0.71-2.16%) respectively. High- and middle-tier FSWs had a significantly lower risk of HIV infection than lower-tier FSWs (High/Low: OR=0.48 [0.40-0.59]; Middle/Low: OR=0.49 [0.37-0.66]).

The HIV epidemic has shown a gradual declining or stabilised trend among Chinese FSW. Intervention efforts should be diverted to high-risk subgroups of FSWs, such as drug-using and low-tier FSWs.

Read more at: http://ht.ly/SlTop 

By: Zhang L1, Chow EP2, Su S3, Yiu WL4, Zhang X5, Iu KI6, Tung K7, Zhao R8, Sun P9, Sun X10, Yuan L11, Muessig KE12, Tucker JD13, Jing J14.

• 1Research Center for Public Health, School of Medicine, Tsinghua University, Beijing, China; Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia; Melbourne Sexual Health Centre, Alfred Health, Melbourne, VIC, Australia; The Kirby Institute, University of New South Wales, Sydney, NSW, Australia. Electronic address: lzhang@kirby.unsw.edu.au.
• 2Research Center for Public Health, School of Medicine, Tsinghua University, Beijing, China; Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia; Melbourne Sexual Health Centre, Alfred Health, Melbourne, VIC, Australia; The Kirby Institute, University of New South Wales, Sydney, NSW, Australia.
• 3The Kirby Institute, University of New South Wales, Sydney, NSW, Australia.
• 4The Kirby Institute, University of New South Wales, Sydney, NSW, Australia.
• 5Research Center for Public Health, School of Medicine, Tsinghua University, Beijing, China.
• 6The Kirby Institute, University of New South Wales, Sydney, NSW, Australia. 
• 7The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
• 8Research Center for Public Health, School of Medicine, Tsinghua University, Beijing, China. 
• 9Research Center for Public Health, School of Medicine, Tsinghua University, Beijing, China. 
• 10Research Center for Public Health, School of Medicine, Tsinghua University, Beijing, China.
• 11The School of Sociology and Population Studies, Remin University of China, Beijing.
• 12The University of North Carolina Project-China, Guangzhou, China; Department of Health Behavior, Gillings School of Global Public Health at the University of North Carolina at Chapel Hill, USA. 
• 13The University of North Carolina Project-China, Guangzhou, China; London School of Hygiene and Tropical Medicine, London, United Kingdom. 
• 14The Kirby Institute, University of New South Wales, Sydney, NSW, Australia.
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