Evidence map›Paper›PMID 35687493›Full record

ArticleTropical medicine & international health : TM & IH2022

No increased HIV risk in general population near sex work sites: A nationally representative cross-sectional study in Zimbabwe.

Mariёlle Kloek, Caroline A Bulstra, Sungai T Chabata, Elizabeth Fearon, Isaac Taramusi, Sake J de Vlas, Frances M Cowan, Jan A C Hontelez

Open access · bronzeAbstract read
In one paragraph

Article in Tropical medicine & international health : TM & IH, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
2.0field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 5 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 5 institutions in 4 countries.

Mariёlle KloekDepartment of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Caroline A BulstraDepartment of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Sungai T ChabataDepartment of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Elizabeth FearonInfectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.
Isaac TaramusiNational AIDS Council of Zimbabwe, Harare, Zimbabwe.
Sake J de VlasDepartment of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Frances M CowanCentre for Sexual Health and HIV/AIDS Research (CeSHHAR), Harare, Zimbabwe.
Jan A C HontelezDepartment of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Erasmus MC · NLCentre for Sexual Health and HIV AIDS Research · ZWHeidelberg University · DELondon School of Hygiene & Tropical Medicine · GBNational AIDS Council · ZW

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesSex work sites have been hypothesised to be at the root of the observed heterogeneity in HIV prevalence in sub-Saharan Africa. We determined if proximity to sex work sites is associated with HIV prevalence among the general population in Zimbabwe, a country with one of the highest HIV prevalence in the world.

methodsIn this cross-sectional study we use a unique combination of nationally representative geolocated individual-level data from 16,121 adults (age 15-49 years) from 400 sample locations and the locations of 55 sex work sites throughout Zimbabwe; covering an estimated 95% of all female sex workers (FSWs). We calculated the shortest distance by road from each survey sample location to the nearest sex work site, for all sites and by type of sex work site, and conducted univariate and multivariate multilevel logistic regressions to determine the association between distance to sex work sites and HIV seropositivity, controlling for age, sex, male circumcision status, number of lifetime sex partners, being a FSW client or being a stable partner of an FSW client.

resultsWe found no significant association between HIV seroprevalence and proximity to the nearest sex work site among the general population in Zimbabwe, regardless of which type of site is closest (city site adjusted odds ratio [aOR] 1.010 [95% confidence interval {CI} 0.992-1.028]; economic growth point site aOR 0.982 [95% CI 0.962-1.002]; international site aOR 0.995 [95% CI 0.979-1.012]; seasonal site aOR 0.987 [95% CI 0.968-1.006] and transport site aOR 1.007 [95% CI 0.987-1.028]). Individual-level indicators of sex work were significantly associated with HIV seropositivity: being an FSW client (aOR 1.445 [95% CI 1.188-1.745]); nine or more partners versus having one to three lifetime partners (aOR 2.072 [95% CI 1.654-2.596]).

conclusionsSex work sites do not seem to directly affect HIV prevalence among the general population in surrounding areas. Prevention and control interventions for HIV at these locations should primarily focus on sex workers and their clients, with special emphasis on including and retaining mobile sex workers and clients into services.

Indexed as

HIV InfectionsHIV SeropositivitySex WorkersAdolescentAdultCross-Sectional StudiesFemaleHumansMaleMiddle AgedPrevalenceSeroepidemiologic StudiesSex WorkWorkplaceYoung AdultZimbabwecommercial sex workHIV/AIDSHIV epidemicHIV transmissionsub-Saharan AfricaZimbabwe

Identifiers

PMID35687493
PMCPMC9545096
OpenAlexW4281707475

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.