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HIV infection among female sex workers in concentrated and high prevalence epidemics: Why a structural determinants framework is needed

机译：集中和高流行中女性性工作者中的艾滋病毒感染：为什么需要结构性决定因素框架

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摘要

PURPOSE OF REVIEW: This article reviews the current state of the epidemiological literature on female sex work and HIV from the past 18 months. We offer a conceptual framework for structural HIV determinants and sex work that unpacks intersecting structural, interpersonal, and individual biological and behavioural factors. RECENT FINDINGS: Our review suggests that despite the heavy HIV burden among female sex workers (FSWs) globally, data on the structural determinants shaping HIV transmission dynamics have only begun to emerge. Emerging research suggests that factors operating at macrostructural (e.g., migration, stigma, criminalized laws), community organization (e.g., empowerment) and work environment levels (e.g., violence, policing, access to condoms HIV testing, HAART) act dynamically with interpersonal (e.g., dyad factors, sexual networks) and individual biological and behavioural factors to confer risks or protections for HIV transmission in female sex work. SUMMARY: Future research should be guided by a Structural HIV Determinants Framework to better elucidate the complex and iterative effects of structural determinants with interpersonal and individual biological and behavioural factors on HIV transmission pathways among FSWs, and meet critical gaps in optimal access to HIV prevention, treatment, and care for FSWs globally.
机译：审查目的：本文回顾了过去18个月中有关女性性工作和艾滋病毒的流行病学文献的现状。我们为结构性HIV决定因素和性工作提供了一个概念框架，该结构揭示了相交的结构性，人际关系以及个体生物学和行为因素。最近的调查结果：我们的审查表明，尽管全球女性性工作者中艾滋病毒负担沉重，但影响艾滋病毒传播动态的结构性决定因素数据才刚刚开始出现。新兴研究表明，在宏观结构（例如移民，污名，刑事定罪的法律），社区组织（例如赋权）和工作环境水平（例如暴力，警务，使用安全套艾滋病毒检测，HAART）中起作用的因素与人际关系（例如dyad因素，性网络）和个体生物学和行为因素，以赋予女性性工作中HIV传播的风险或保护。摘要：未来的研究应以结构性HIV决定因素框架为指导，以更好地阐明具有人际关系和个体生物学及行为因素的结构性决定因素对FSW之间HIV传播途径的复杂和反复影响，并弥补在最佳途径获得HIV预防方面的重大差距，在全球范围内对FSW进行治疗和护理。

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