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Occupational barriers to HIV care in female sex workers living with HIV: structural or community solutions?
  1. Anna Tokar,
  2. Denise Naniche
  1. ISGlobal (Barcelona Institute for Global Health) Hospital Clinic, University of Barcelona, Barcelona, Spain
  1. Correspondence to Ms Anna Tokar, Barcelona Institute for Global Health, Barcelona 08036, Spain; annatokar{at}

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The UNAIDS 90-90-90 targets, defined as 90% of people living with HIV aware of their status, among which 90% are on antiretroviral treatment (ART) and among which 90% have HIV viral suppression, have galvanised efforts worldwide to reduce HIV transmission with the goal of ending the HIV epidemic by 2030. Sex workers, who are particularly vulnerable to HIV, and their sexual partners account for more than half (54%) of new HIV infections globally.1 Available data suggest that the relative risk of HIV acquisition among sex workers globally was 21 times higher than it was among all adults aged 15–49 years in 2018.1 Still, ART utilisation is poor among female sex workers (FSWs) globally—with an estimated 38% and 57% pooled prevalence for current ART use and viral suppression, respectively.2 With the goal of ending the AIDS epidemic by 2030, the critical question is how to increase the 90-90-90 targets, including awareness of HIV status, initiation and adherence to ART among sex workers.

Addressing the HIV epidemic among sex workers requires a profound understanding of context-specific barriers and facilitators of HIV outcomes: HIV testing, access to ART and adherence to treatment among different subpopulations of sex workers. Iterative …

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  • Contributors AT drafted the initial version of the text. AT and DN revised and finalised the commentary.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned; internally peer reviewed.

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