HIV Risk 14 Times Higher Among Sex Workers In Poorer Nations

The risk of contracting HIV is 14 times higher for female sex workers in low- and middle-income countries (LMIC) than for women in the general population, according to a study published Online First in The Lancet Infectious Diseases.

Three decades have passed since the global HIV epidemic started, yet the knowledge about HIV amongst sex workers is still limited, despite these women's increased risk of infection because of higher exposure to biological, behavioral and structural risk factors.

Dr. Stefan Baral, from the Center for Public Health and Human Rights at the Johns Hopkins Bloomberg School of Public Health in Baltimore, MD, USA, and his team decided to perform a meta-analysis of 102 studies that included nearly 100,000 female sex workers in 50 countries.

They discovered an overall HIV occurrence in 12% of female sex workers in LMIC, and that sex workers were 14 times more likely to be infected with the virus as compared with the general female population in those countries. 31% of female sex workers in 26 countries categorized as medium or high background HIV prevalence tested positive to the virus, with the risk for infection in these female sex workers being 12 times higher compared with women from the general population.

The worst region in terms of infection risk for female sex workers was Asia, with an increased risk of 29 times, whilst the risk in Africa and Latin America was 12-fold as compared to the general female population.

The researchers concluded:

"We identified consistent evidence of substantially higher levels of HIV among female sex workers compared with all women of reproductive age in low-income and middle-income countries in all regions with data.

Although female sex workers have long been understood to be a key affected population, the scope and breadth of their disproportionate risk for HIV infection had to date not been systematically documented. These findings suggest an urgent need to scale up access to quality HIV-prevention programming and services among female sex workers because of their heightened burden of disease and likelihood of onward transmission through high numbers of sexual partners as clients.

In view of the high burden of HIV among female sex workers and recent biomedical advances related to treatment as prevention, improvement of linkages to antiretroviral treatment, and retention in care, ongoing prevention for sex workers already living with HIV is crucial...Considerations of the legal and policy environments in which sex workers operate, and the important role of stigma, discrimination, and violence targeting female sex workers globally will be required to reduce the disproportionate disease burden among these women."

Dr. Kate Shannon of the Gender and Sexual Health Initiative, and Dr Julio S G Montaner from the British Columbia Centre for Excellence in HIV/AIDS and the University of British Columbia in Vancouver, BC, Canada, write in a linked comment:

"As the epidemic matures in many settings, with some countries already reporting over 50% of sex workers living with HIV, comprehensive initiatives simultaneously targeting HIV prevention, ART access, and care are increasingly vital. As highlighted in a recent report by the UNAIDS advisory on sex work and HIV, removal of structural barriers (e.g., criminalized laws and policies, violence) remains a necessary precondition to an effective HIV response in sex work worldwide."

Written by Petra Rattue
Copyright: Medical News Today
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Obesity May Be A Price Paid By Developing Nations For Economic And Social Growth

Developing nations experiencing economic and social growth might also see growing waistlines among their poorest citizens, according to a new study from Rice University and the University of Colorado.

The researchers found that while growth of developing countries may improve conditions such as malnutrition and infectious disease, it may increase obesity among people with lower socio-economic status.

"It's a troubling finding," said Rice sociology professor Justin Denney, who co-authored the study with University of Colorado sociology professors Fred Pampel and Patrick Krueger. Their study will appear in the April issue of Social Science & Medicine. The researchers examined data from the World Health Survey, an initiative of the World Health Organization aimed at collecting high-quality health data for people across all regions of the world. The researchers looked at data from 67 of the 70 countries surveyed during 2002 and 2003.

"In many cases, developing nations are still dealing with issues such as hunger and infectious disease, especially among the most disadvantaged segments of their population," Denney said. "At the same time, they're dealing with a whole new set of health issues that emerge as they continue to develop."

The study also showed that people with higher socio-economic status in developing countries are more likely to be obese, whereas people with higher socio-economic status living in developed countries are less likely. Denney said that can be attributed to the different cultural values/norms at play in developing versus developed countries.

"In the developing world, being large comes with its own status and prestige, whereas in the developed world, being large is stigmatized," he said. "There's sort of a switching of cultural ideals, and these results are consistent with that."

Denney said the reasons for increased incidence of obesity among the socio-economically disadvantaged living in developed countries are twofold: There is a lack of education about health issues and a lack of access to high-quality, healthy (and in many cases, more expensive) food.

"Unfortunately, our research suggests that if a country develops to the state of the U.S., in all likelihood you'll see the same thing that's happening here in our country," Denney said. "Obesity is a major problem here in the U.S., but primarily for the most disadvantaged segments of the population."

Denney hopes the study will promote further research of the worldwide obesity epidemic.

"Social and economic development of a country helps many people, but it also brings these new issues that need consideration, particularly on a global scale," Denney said. "If we're going to start thinking about worldwide health policies, it might be beneficial for them to target specific groups of people."

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our obesity / weight loss / fitness section for the latest news on this subject. The study was funded by a grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development to the University of Colorado Population Center.
Study: Obesity, SES, and economic development: A test of the reversal hypothesis: http://www.sciencedirect.com/science/article/pii/S0277953612000561
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