Systematic review of facility-based sexual and reproductive health services for female sex workers in Africa.
Systematic review of facility-based sexual and reproductive health services for female sex workers in Africa.
复制标题
对非洲女性性工作者的基于设施的性和生殖健康服务的系统审查。
DOI：
10.1186/1744-8603-10-46
复制
发表时间：
2014-06-10
影响因子：
10.8
通讯作者：
Chersich M
中科院分区：
文献类型：
--
作者：
Dhana A;Luchters S;Moore L;Lafort Y;Roy A;Scorgie F;Chersich M
一些生物、行为和结构风险因素使女性性工作者（FSWs）面临更高的艾滋病毒、性传播感染（sti）和其他不利的性健康和生殖健康（SRH）结果的风险。在许多情况下，妇女福利项目已经证明了改变这种风险、改善这些妇女的健康和福祉的有效方法。然而，在非洲，FSW项目的最佳交付模式尚不清楚。本系统综述描述了非洲的干预方案、服务提供模式以及政府参与这些服务的程度。2012年11月22日，我们在没有日期限制的情况下检索了Web of Science和MEDLINE，检索了描述非洲低收入和中等收入国家FSWs的临床和非临床设施性生殖健康预防和护理服务的研究。我们还在关键的非索引期刊和国际组织的网站上找到了文章。一名审稿人筛选标题和摘要，并使用标准化工具从文章中提取数据。我们找到了149篇文章，描述了54个项目。大多数是地方性和小规模的；侧重于研究活动（而不是大规模的服务提供）；在国家或区域几乎没有协调的情况下运作；而且几乎没有政府的支持（取而代之的是一系列国际捐助者普遍资助的服务）。几乎所有网站都只处理艾滋病毒预防和性传播感染问题。大多数服务提供男用避孕套，但只有10%提供女用避孕套。艾滋病毒服务主要包括艾滋病毒咨询和检测；很少有人提供艾滋病毒护理和治疗，如CD4检测或抗逆转录病毒治疗（ART）。虽然性传播感染服务更为全面，但仅在11例病例中提供了定期推定治疗。服务往往忽视了更广泛的性健康和生殖健康需求，如计划生育、宫颈癌筛查和基于性别的暴力服务。非洲的性工作规划覆盖面有限，服务范围狭窄，与更广泛的艾滋病毒和性与生殖健康服务协调不力。为了改善妇女的健康和减少艾滋病毒的进一步传播，需要紧急解决获得抗逆转录病毒治疗的问题。尽管如此，艾滋病毒预防仍应是各项服务的主要内容。迫切需要整合更广泛的性健康和生殖健康服务并解决结构性风险因素的服务提供模式。政府主导的高质量和规模的外来务工人员服务将显著减少非洲外来务工人员的性健康和生殖健康脆弱性。
Several biological, behavioural, and structural risk factors place female sex workers (FSWs) at heightened risk of HIV, sexually transmitted infections (STIs), and other adverse sexual and reproductive health (SRH) outcomes. FSW projects in many settings have demonstrated effective ways of altering this risk, improving the health and wellbeing of these women. Yet the optimum delivery model of FSW projects in Africa is unclear. This systematic review describes intervention packages, service-delivery models, and extent of government involvement in these services in Africa. On 22 November 2012, we searched Web of Science and MEDLINE, without date restrictions, for studies describing clinical and non-clinical facility-based SRH prevention and care services for FSWs in low- and middle-income countries in Africa. We also identified articles in key non-indexed journals and on websites of international organizations. A single reviewer screened titles and abstracts, and extracted data from articles using standardised tools. We located 149 articles, which described 54 projects. Most were localised and small-scale; focused on research activities (rather than on large-scale service delivery); operated with little coordination, either nationally or regionally; and had scanty government support (instead a range of international donors generally funded services). Almost all sites only addressed HIV prevention and STIs. Most services distributed male condoms, but only 10% provided female condoms. HIV services mainly encompassed HIV counselling and testing; few offered HIV care and treatment such as CD4 testing or antiretroviral therapy (ART). While STI services were more comprehensive, periodic presumptive treatment was only provided in 11 instances. Services often ignored broader SRH needs such as family planning, cervical cancer screening, and gender-based violence services. Sex work programmes in Africa have limited coverage and a narrow scope of services and are poorly coordinated with broader HIV and SRH services. To improve FSWs’ health and reduce onward HIV transmission, access to ART needs to be addressed urgently. Nevertheless, HIV prevention should remain the mainstay of services. Service delivery models that integrate broader SRH services and address structural risk factors are much needed. Government-led FSW services of high quality and scale would markedly reduce SRH vulnerabilities of FSWs in Africa.
登录
查看更多内容
影响因子：
4.5
作者：
Beattie TS;Bhattacharjee P;Ramesh BM;Gurnani V;Anthony J;Isac S;Mohan HL;Ramakrishnan A;Wheeler T;Bradley J;Blanchard JF;Moses S
通讯作者：
Moses S
影响因子：
56.3
作者：
Baral, Stefan;Beyrer, Chris;Kerrigan, Deanna
通讯作者：
Kerrigan, Deanna
影响因子：
4.5
作者：
Bandewar, Sunita V. S.;Kimani, Joshua;Lavery, James V.
通讯作者：
Lavery, James V.
影响因子：
3.8
作者：
ASAMOAHADU, A;WEIR, S;LAMPTEY, P
通讯作者：
LAMPTEY, P
影响因子：
3.8
作者：
Alary, M;Mukenge-Tshibaka, L;Joly, JR
通讯作者：
Joly, JR