The Need to Focus on Sex Workers in Generalized HIV Epidemic Settings

摘要

In this issue, Vandepitte and coworkers report a high prevalence of HIV and sexually transmitted infections among sex workers in Kampala, Uganda. HIV prevalence was 37% among 1027 women recruited from red-light areas in Kampala in 2008 and 2009-80% of women were positive for herpes simplex virus-2, 13% were infected with gonorrhea, and 9% with chlamydia. This finding is noteworthy because it adds to a growing body of literature documenting worrisome trends that HIV prevalence and incidence may be increasing in Uganda, a country that has been hailed as one of the few poster children of HIV prevention success. Uganda's success in decreasing national HIV prevalence from a high of 18% in 1992 to 6% in 2005 has been widely heralded. This decline has been largely attributed to reductions in multiple partnerships (in particular casual sex), in addition to social and contextual factors such as community mobilization and communication about HIV.