abstract: 'BackgroundAcross diverse regions globally, sex workers continue to face

  a disproportionate burden of HIV and other sexually transmitted and

  blood borne infections (STBBIs). Evidence suggests that behavioural and

  biomedical interventions are only moderately successful in reducing

  STBBIs at the population level, leading to calls for increased

  structural and community-led interventions. Given that structural

  approaches to mitigating STBBI risk beyond HIV among sex workers in

  high-income settings remain poorly understood, this critical review

  aimed to provide a comprehensive synthesis of the global research and

  literature on determinants of HIV and other STBBIs and promising

  intervention practices for sex workers of all genders in high-income

  countries.MethodsWe searched for publications over the last decade

  (January 2005-March 2016) among sex workers (cis women, cis men, and

  trans individuals). Data obtained from quantitative peer-reviewed

  studies were triangulated with publicly available reports and

  qualitative/ethnographic research where quantitative evidence was

  limited.ResultsResearch demonstrates consistent evidence of the direct

  and indirect impacts of structural factors (e.g., violence, stigma,

  criminalization, poor working conditions) on increasing risk for STBBIs

  among sex workers, further compounded by individual and interpersonal

  factors (e.g., mental health, substance use, unprotected sex).

  Sub-optimal access to health and STBBI prevention services remains

  concerning. Full decriminalization of sex work has been shown to have

  the largest potential to avert new infections in sex work, through

  reducing workplace violence and increasing access to safer workspaces.

  Promising practices and strategies that should be scaled-up and

  evaluated to prevent STBBIs are highlighted.ConclusionsThe high burden

  of STBBIs among sex workers across high-income settings is of major

  concern. This review uniquely contributes to our understanding of

  multilevel factors that potentiate and mitigate STBBI risk for sex

  workers of all genders. Research suggests that multipronged structural

  and community-led approaches are paramount to addressing STBBI burden,

  and are necessary to realizing health and human rights for sex workers.

  Given the heterogeneity of sex worker populations, and distinct

  vulnerabilities faced by cis men and trans sex workers, further research

  utilizing mixed-methods should be implemented to delineate the

  intersections of risk and ameliorate critical health inequalities.'
affiliation: 'Shannon, K (Corresponding Author), Univ British Columbia, Dept Med,
  Ctr Gender \& Sexual Hlth Equ, 1190 Hornby St, Vancouver, BC V6Z 2K5, Canada.

  Shannon, K (Corresponding Author), Univ British Columbia, Sch Populat \& Publ Hlth,
  Fac Med, 2206 East Mall, Vancouver, BC V6T 1Z9, Canada.

  Argento, Elena; Goldenberg, Shira; Shannon, Kate, Univ British Columbia, Dept Med,
  Ctr Gender \& Sexual Hlth Equ, 1190 Hornby St, Vancouver, BC V6Z 2K5, Canada.

  Argento, Elena, Univ British Columbia, Interdisciplinary Studies Grad Program, 2357
  Main Mall, Vancouver, BC V6T 1Z4, Canada.

  Goldenberg, Shira, Simon Fraser Univ, Fac Hlth Sci, 8888 Univ Dr, Burnaby, BC V5A
  1S6, Canada.

  Shannon, Kate, Univ British Columbia, Sch Populat \& Publ Hlth, Fac Med, 2206 East
  Mall, Vancouver, BC V6T 1Z9, Canada.'
article-number: '212'
author: Argento, Elena and Goldenberg, Shira and Shannon, Kate
author-email: Dr.Shannon@cgshe.ubc.ca
author_list:
- family: Argento
  given: Elena
- family: Goldenberg
  given: Shira
- family: Shannon
  given: Kate
da: '2023-09-28'
doi: 10.1186/s12879-019-3694-z
eissn: 1471-2334
files: []
journal: BMC INFECTIOUS DISEASES
keywords: 'Sex workers; HIV prevention; STBBI; Risk environment; High-income

  countries; Structural interventions'
keywords-plus: 'CROSS-SECTIONAL DATA; HIV-PREVENTION; TRANSGENDER WOMEN; CONDOM USE;

  STRUCTURAL DETERMINANTS; INTERNET ESCORTS; ENGLAND ANALYSIS; SOCIAL

  COHESION; RISK BEHAVIORS; HEALTH-CARE'
language: English
month: MAR 5
number-of-cited-references: '112'
orcid-numbers: Goldenberg, Shira/0000-0003-1633-9749
papis_id: 34eb224bab70176966d5a615155a94cb
ref: Argento2019preventingsexually
researcherid-numbers: Goldenberg, Shira/C-9627-2009
tags:
- review
times-cited: '22'
title: 'Preventing sexually transmitted and blood borne infections (STBBIs) among
  sex workers: a critical review of the evidence on determinants and interventions
  in high-income countries'
type: Review
unique-id: WOS:000460516800002
usage-count-last-180-days: '1'
usage-count-since-2013: '7'
volume: '19'
web-of-science-categories: Infectious Diseases
year: '2019'