Differentiated prevention and care to support virtual elimination of infectious HIV among sex workers in southern Africa 


  • Prof Frances Cowan

    Liverpool School of Tropical Medicine

  • Dr Maryam Shahmanesh

    University College London

  • Dr Nicola Desmond

    Liverpool School of Tropical Medicine

  • Paul Revill

    University of York

  • Joanna Busza

    London School of Hygiene and Tropical Medicine

  • Tendayi Mharadze

    Centre for Sexual Health and HIV/AIDS Research Zimbabwe

  • Prof Andrew Phillips

    University College London

  • Prof James Hargreaves

    London School of Hygiene and Tropical Medicine

Project summary

Empowering female sex workers (FSWs) to collectively reduce their vulnerability to HIV and increase engagement in HIV prevention and treatment is a successful HIV control strategy when the infection is concentrated among high-risk populations, particularly in Asia. In sub-Saharan Africa, HIV programmes have focused on the general population, even though mathematical modelling suggests a high fraction of new infections can be attributed to sex work. Little is understood about how risk and health-seeking behaviour varies as women transition in and out of sex work. HIV prevalence and incidence are extremely high, suggesting inadequate uptake of effective HIV prevention measures and treatment. 

We will demonstrate that an intensified programme of prevention of HIV related to sex work which is tailored to the African context, improves FSWs’ engagement in care to levels that are likely to achieve virtual elimination of HIV transmission attributable to sex work which would be cost-effective and transferable throughout southern Africa.