Official websites use. Share sensitive information only on official, secure websites. Harriet S. Jones and Rebecca L. Anderson have contributed equally to the manuscript and share first authorship. RLA updated the review and identified additional unpublished data. HSJ led the quality assessment. RLA and OS led the quantitative analysis. All authors contributed to interpretation of results and edited the manuscript for intellectual content. All authors read and approved the final version of the manuscript for submission.
This work is licensed under a Creative Commons Attribution 4. The license allows for commercial use. We included studies reporting empirical estimates in any SSA country.
We calculated incidence rate ratios IRR compared to age-district-year matched total female population incidence estimates. Median HIV incidence was 4. Improved surveillance and standardisation of approaches to obtain empirical estimates of sex worker incidence would enable a clearer understanding of whether we are on track to meet global targets for this population and better support data-driven HIV prevention programming.
Identifying and following-up WESW is often difficult due to the heterogeneous, informal, and hidden nature of sex work, commonly driven by stigma and criminalisation. Sex work encompasses a broad spectrum of sexual transactions occurring in a range of settings, from on the streets, to in homes, brothels, or hotels. For surveillance, this presents challenges, as those not identifying as sex workers are unlikely to present at WESW-dedicated programmes.
Additionally, mobility among WESW is high, 9 and repeated initiation and cessation of sex work common, thus programmes and cohort studies encounter challenges with loss to follow-up. We conducted two searches of peer-reviewed literature available in English and published between January and December RLA additionally searched key population biobehavioural surveillance reports, collated during an earlier key population data collation exercise.
