title: Sexually transmissible infections among female sex workers: an international review with an emphasis on hard-to-access populations.
abstract: BACKGROUND
  Women who work commercially in sex work (female sex workers [FSW]) are considered a high-risk group for sexually transmissible infections (STI), yet the level of reported pathogens varies in studies around the world. This study reviewed STI rates reported in 42 studies of FSW around the world published between 1995 and 2006 and analysed the trends and types of populations surveyed, emphasising difficult to access FSW populations.
  
  
  METHODS
  Studies were retrieved by PUBMED and other search engines and were included if two or more pathogens were studied and valid laboratory methods were reported.
  
  
  RESULTS
  The five most commonly assessed pathogens were Neisseria gonorrhea (prevalence 0.5-41.3), Chlamydia trachomatis (0.61-46.2), Treponema pallidum (syphilis; 1.5-60.5), HIV (0-76.6), and Trichomonas vaginalis (trichomoniasis; 0.11-51.0). Neisseria gonorrhea and C. trachomatis were the most commonly tested pathogens and high prevalence levels were found in diverse areas of the world. HIV was highly prevalent mostly in African countries. Although human papillomavirus infection was surveyed in few studies, prevalence rates were very high and its aetiological role in cervical cancer warrant its inclusion in future FSW monitoring. Hard-to-access FSW groups tended to have higher rates of STI.
  
  
  CONCLUSIONS
  The five most commonly detected pathogens correspond to those that are highly prevalent in the general population, however there is an urgent need to develop rapid testing diagnostics for all five pathogens to increase prevention and treatment, especially in outreach programs to the most vulnerable groups among FSW.
authors: The Center for Women's Health Studies and Promotion, Ben-Gurion University of the Negev, Beer-Sheva 84105, Israel. jcwikel@bgu.ac.il
authors: Julie G
authors: JG
authors: Cwikel
authors: Tal
authors: T
authors: Lazer
authors: Fernanda
authors: F
authors: Press
authors: Simcha
authors: S
authors: Lazer
mesh_terms: D003906:Developing Countries / Q000706:statistics & numerical data*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D012307:Risk Factors; D011477:Sex Work / Q000706:statistics & numerical data*; D012749:Sexually Transmitted Diseases / Q000453:epidemiology* / Q000635:transmission; D012924:Social Conditions; D012959:Socioeconomic Factors; D016387:Women's Health; D014931:Women, Working / Q000706:statistics & numerical data*