Metrics details. Sex workers have high incidences of HIV and other sexually transmitted diseases. Although, interventions targeting sex workers have shown to be effective, evidence on which strategies are most cost-effective is limited. This study aims to systematically review evidence on the cost-effectiveness of sexual health interventions for sex workers on a global level.
It also evaluates the quality of available evidence and summarizes the drivers of cost effectiveness. A search of published articles until May was conducted. The quality of reporting the evidence was evaluated using the CHEERS checklist and drivers of cost-effectiveness were reported. Overall, 19 studies met the inclusion criteria. The majority of the studies were based in middle-income countries and only three in low-income settings. The reviewed studies mainly evaluated the integrated interventions, i.
All interventions, except for one, were highly cost-effective. The reporting quality of the evidence was relatively good. The strongest drivers of cost-effectiveness, reported in the studies, were HIV prevalence, number of partners per sex worker and commodity costs. Furthermore, interventions integrated into existing health programs were shown to be most cost-effective. The available evidence indicates that the majority of the HIV and SRH interventions targeting sex workers are highly cost-effective, however, more effort should be devoted to improving the quality of conducting and reporting cost-effectiveness evidence for these interventions to make them usable in policy making.
This review identified potential factors that affect the cost-effectiveness and can provide useful information for policy makers when designing and implementing such interventions. In past 2 decades, international agencies, in particular the United Nations and the Global Fund, have intensified their efforts on prevention of infectious diseases, especially HIV, through improving access to preventive and curative care [ 1 ].
The reasons for this are both humanitarian and financial, with sexually transmitted infections STIs known to hinder economic growth in low and middle income countries LMICs , particularly in Sub-Sharan Africa, due to increased morbidity and mortality, as a result reducing labor supply and productivity [ 2 ].
