Condomless sex with partners and clients among female sex workers in Iran: A systematic review and meta-analysis

Condomless sex is the most proximal risk for HIV acquisition among female sex workers (FSWs). We performed a systematic review and meta-analysis to summarize the evidence for the prevalence of condomless sex among FSWs in Iran. A random-effect meta-analysis model was used to pool the prevalence estimates and their 95% confidence intervals (CIs). The pooled prevalence of condomless sex at last sex with a paying client and a nonpaying partner was 34.23% (95% CI: 27.83–40.93) and 48.34 (95% CI: 38.43–58.32), respectively. Last-month inconsistent condom use was 49.01% (95% CI: 21.64–76.71) with paying clients and 60.21% (95% CI: 31.27–85.73) with nonpaying partners. The pooled prevalence of lifetime condom nonuse with any partners/clients was 15.26% (95% CI: 10.68–20.49). These findings indicate that a substantial proportion of FSWs engage in high-risk sexual practices. Community-led programs should be stimulated to improve consistent condom use among FSWs.

• Epidemiology and Determinants of Health
  • Epidemiology
• Population(s)
  • Women
  • Sex workers
  • General HIV- population