Grant: Travel Awards - Institute Community Support

Objective: Sex workers continue to face a disproportionate burden of HIV and other sexually transmitted and blood borne infections (STBBIs). This review aims to provide a comprehensive synthesis of global research on determinants of STBBIs and promising intervention practices for sex workers of all genders in high-income countries. Methods: We searched for publications over the last decade (January 2005-March 2016) among women, men, and trans sex workers. Data obtained from quantitative peer-reviewed studies were triangulated with publicly available reports and qualitative/ethnographic research where quantitative evidence was limited. Results: Research consistently demonstrates the direct and indirect impacts of structural factors (e.g., violence, stigma, criminalization) on increasing STBBI risk for sex workers, further compounded by individual and interpersonal factors (e.g., substance use, unprotected sex). Sub-optimal access to health and prevention services remains concerning. Full decriminalization of sex work has been shown to have the largest potential to avert new infections in sex work, through reducing workplace violence and increasing access to safer workspaces. Conclusions: The high burden of STBBIs among sex workers across high-income settings is of major concern. Multi-pronged structural and community-led approaches are paramount to addressing STBBI risk and are necessary to realizing health and human rights for sex workers.