Project Shikamana: Baseline Findings From a Community Empowerment–Based Combination HIV Prevention Trial Among Female Sex Workers in Iringa, Tanzania
The heightened risk of HIV infection among female sex workers (FSWs) has been clearly established across settings. In sub-Saharan Africa (SSA), FSWs have an estimated HIV prevalence of 36.9% as compared to 7.4% in the general adult female population. In the Iringa region of Tanzania, a recently integrated biobehavioral surveillance survey found that 32.9% of FSWs were living with HIV. Previous formative research conducted in Iringa documented the negative impact of stigma, discrimination, and violence among FSWs. Such social and structural factors have been shown to inhibit engagement in HIV services among FSWs in SSA contributing to their disproportionate risk and onward transmission.
Comprehensive, community empowerment–based approaches that address the sociostructural vulnerabilities of FSWs to HIV infection, and ensure equitable access to prevention interventions, have been shown to be effective in South Asia and Latin America. We recently conducted a systematic review and meta-analysis of the impact of community empowerment on HIV outcomes among FSWs in Tanzania.