HIV prevalence among female sex workers in Iran: A systematic review and meta-analysis.

Abstract

Background: Despite all the global interventions and attempts, HIV/AIDS remains a global health challenge infecting and claiming lives of new victims every year. It is essential to understand the prevalence of HIV among vulnerable populations, such as female sex workers (FSWs), to plan public health, design intervention, and allocate resources. In countries like Iran in particular, where data may be scarce or scattered, a comprehensive review could offer critical insights to design efficient interventions. This systematic review and meta-analysis were designed to collect, synthesize, and critically assess the existing literature on the HIV prevalence among FSWs in Iran.

Methods: A careful literature search was performed across major databases including MEDLINE, Google Scholar, CINAHL Plus with full text and Scopus and Persian database, strictly following PRISMA guidelines. A meta-analysis and narrative synthesis were performed on studies that met the inclusion criteria to combine and interpret findings. Critical appraisal and potential biases of selected studies were assessed using the JBI's critical appraisal tool for prevalence studies. Quantitative synthesis was conducted by metaprop command of STATA to estimate the pooled prevalence of HIV.

Results: Eight studies, which spanned different regions and diverse FSW populations within Iran, were included in the study. The pooled HIV prevalence among them was calculated 1.52%. When compared with global estimates for HIV prevalence among FSWs, which is around 10-15%, a considerably lower prevalence in Iran is notable. Factors potentially underpinning this decreased prevalence encompass various methodological approaches, different sampling methods, and maybe, the efficacy of interventions implemented in Iran that target FSWs. However, significant heterogeneity among selected studies was observed (I2 = 78%), which may suggest different conditions that FSWs face in different Iranian regions or may be due to different methods used.

Conclusion: This systematic review offers a comprehensive picture of HIV prevalence among FSWs in Iran. Although HIV prevalence among FSWs in Iran is lower than the international estimations, they are still at higher risk of acquiring the virus. This highlights the need for suitable interventions, regular health monitoring and deep research to understand and address the health needs of FSWs in Iran.