Abstract
BackgroundFemale sex workers (FSWs) play an important role in transmitting HIV and syphilis from high-risk groups to the general population. However, the trends in HIV and syphilis epidemics in Chinese FSWs in the period after 2000 are unclear to date.MethodsThe Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement was followed. Seven databases were searched for published peer-reviewed articles. The incidence of HIV and syphilis in FSWs in different time periods, provinces and workplaces in China were separately pooled by meta-analysis. Correlation analysis was conducted between HIV and syphilis incidence and study time, respectively.ResultsAfter 1,662 articles were screened, 190 published papers were included in the final analysis. Estimated HIV prevalence was 0.284% (95% CI: 0.080–0.488%) in the period 2000–2002, 0.211% (95% CI: 0.149–0.273%) in 2003–2005, 0.242% (95% CI: 0.190–0.294%) in 2006–2008 and 0.041% (95% CI: 0.024–0.058%) in 2009–2011. The corresponding syphilis prevalence was 9.669% (95% CI: 7.810–11.529%), 4.970% (95% CI: 4.384–5.556%), 4.404% (95% CI: 4.032–4.775%) and 3.169% (95% CI: 2.738–3.600%), respectively. Spearman rank correlation coefficients were −0.165 (p = 0.002) between HIV prevalence and study time, and −0.209 (p = 0.000) between syphilis prevalence and study time. The combined HIV prevalence was 0.318% (95% CI: 0.156–0.479%) in medium and high-tier workplaces and 0.393% (95% CI: 0.176–0.610%) in low-tier workplaces. The corresponding syphilis prevalence was 3.216% (95% CI: 2.192–4.240%) and 13.817% (95% CI: 10.589–17.044%), respectively.ConclusionsOur data suggested a decline in HIV and syphilis epidemics in FSWs in China on a national level during the study period (2000–2011). FSWs in low-tier workplaces should be given more attention in the future to ensure they are included in prevention programs for HIV and sexually transmitted diseases.
Highlights
The Joint United Nations Programme on HIV/AIDS (UNAIDS) estimated that in 33 countries HIV incidence had declined by more than 25% in the past decade, and epidemiological surveillance showed a decline in the rate of spread of HIV between 2002 and 2010 [1,2]
Our data suggested a decline in HIV and syphilis epidemics in Female sex workers (FSWs) in China on a national level during the study period (2000–2011)
FSWs in low-tier workplaces should be given more attention in the future to ensure they are included in prevention programs for HIV and sexually transmitted diseases
Summary
The Joint United Nations Programme on HIV/AIDS (UNAIDS) estimated that in 33 countries HIV incidence had declined by more than 25% in the past decade, and epidemiological surveillance showed a decline in the rate of spread of HIV between 2002 and 2010 [1,2]. At the end of 2011, the estimated number of people living with HIV/AIDS in China (PLHIV) was 0.78 million. They remained concentrated in several high-risk populations: commercial sex workers, injecting drug users (IDUs), former plasma donors (FPDs) and men who have sex with men [4]. Another important sexually transmitted disease (STD) in China – syphilis, can greatly increase the efficiency of HIV transmission [5]. Female sex workers (FSWs) play an important role in transmitting HIV and syphilis from high-risk groups to the general population. The trends in HIV and syphilis epidemics in Chinese FSWs in the period after 2000 are unclear to date
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