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Please take this quick survey to tell us about what happens after you publish a paper. AIDS and Behavior. We synthesizes evidence on barriers and facilitators to HIV testing among FSW as well as frequencies of testing, willingness to test, and return rates to collect results. Out of references screened, we retained 36 papers. Social support facilitated testing with consistently higher uptake amongst married FSWs and women who were encouraged to test by peers and managers.
Worldwide, early HIV testing is a public health priority especially among key populations such as female sex workers FSWs [ 1 , 2 , 3 ]: out of the estimated 33 million people living with HIV in the world, 19 million do not know their status [ 1 ]. Historically, HIV prevention efforts focused on key populations, including sex workers, as an effective approach to reduce HIV transmission, particularly in the early phase of the epidemic [ 5 ]. Several systematic reviews have examined HIV prevalence [ 6 , 7 , 8 ] and effectiveness of different HIV prevention interventions for SWs [ 9 , 10 , 11 , 12 ].
Shahmanesh et al. A Cochrane review of behavioral interventions concluded that, compared with standard care or no intervention, behavioral interventions are effective in reducing HIV and the incidence of STIs amongst FSWs [ 10 ].
A systematic review of community empowerment interventions in low- and middle-income countries demonstrated significant protective combined effect for HIV infection prevalence , STIs such as gonorrhea and chlamydia, and increase of consistent condom use with all clients [ 12 ]. A systematic review of community empowerment interventions in generalized and concentrated epidemics has shown their positive impact on HIV prevalence, estimated number of averted infections among SWs and adult population, and expanded coverage of ART [ 11 ].
These previous studies did not systematically assess HIV testing approaches, but rather examined the combined effect of a variety of prevention activities. Thus, they failed to address unique determinants of different HIV testing approaches. HIV testing activities among sex workers were assessed in only two papers including a meta-analysis of community-based approaches [ 13 ], and a study of barriers to HIV testing in Europe [ 14 ]. Still, neither of those studies focused on FSWs nor systematically reviewed unique facilitators and barriers to HIV testing faced by this group.