Socio-demographic characteristics and risk factors for HIV transmission in female bar workers in Sub-saharan Africa: a systematic literature review

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dc.creatorDambach, Peter
dc.creatorMahenge, Bathsheba
dc.creatorMashasi, Irene
dc.creatorMuya, Aisa
dc.creatorBarnhart, Dale A.
dc.creatorBärnighausen, Till W.
dc.creatorSpiegelman, Donna
dc.creatorHarling, Guy
dc.date2021-05-19T06:12:24Z
dc.date2021-05-19T06:12:24Z
dc.date2020
dc.date.accessioned2022-10-20T14:01:43Z
dc.date.available2022-10-20T14:01:43Z
dc.descriptionFull text article. Also available at https://doi.org/10.1186/s12889-020-08838-8
dc.descriptionAlthough sex workers are considered a key population in the HIV epidemic in sub-Saharan Africa (SSA), less consideration has been given to female bar workers (FBW), whose primary occupation is not sex work but who often engage in transactional sex. Understanding FBWs risk profiles is central to designing targeted HIV prevention interventions for them. This systematic review describes the socio-demographic characteristics and risk factors for HIV transmission among FBWs in SSA. We searched six databases: PubMed, Google Scholar, Web of Science, Popline, Embase and additionally the World Health Organizations WHOLIS database for grey literature between July and September 2017. Inclusion criteria were reporting (1) primary socio-demographic or behavioral data; on (2) women who sold or delivered drinks to clients; (3) in establishments serving alcohol; (4) in SSA. We excluded studies not presenting separate data on FBWs. We extracted quantitative and qualitative data from the selected studies and conducted a qualitative synthesis of findings. We found 4565 potentially eligible articles, including duplicates. After applying inclusion and exclusion criteria, we retained 19 articles. FBWs often migrated from rural to urban areas due to economic need or social marginalization. They began bar-based transactional sex due to low wages, peer pressure and to increase financial independence. FBWs had high HIV risk awareness but low agency to negotiate condom use, particularly with regular partners or when offered higher prices for condomless sex. FBWs were also vulnerable to violence and stigmatization. FBWs are a vulnerable population for HIV infection. Despite social stigmatization and elevated risk of contracting STIs, bar work remains attractive because it enables unskilled women to both, make a living and maintain some independence. FBWs face HIV-related risk factors at the individual, community and societal level and may benefit from biomedical, behavioral and structural interventions. Keywords: Barmaids, Bar girls, Waitresses, Sex work, Behavioral risk factors, HIV, Sub-Saharan Africa
dc.identifierDambach, P., Mahenge, B., Mashasi, I., Muya, A., Barnhart, D. A., Bärnighausen, T. W., & Harling, G. (2020). Socio-demographic characteristics and risk factors for HIV transmission in female bar workers in Sub-Saharan Africa: a systematic literature review. BMC public health, 20, 1-14.
dc.identifierDOI: https://doi.org/10.1186/s12889-020-08838-8
dc.identifierhttp://hdl.handle.net/20.500.12661/3132
dc.identifier.urihttp://hdl.handle.net/20.500.12661/3132
dc.languageen
dc.publisherBMC
dc.subjectHIV
dc.subjectHuman immunodeficiency virus
dc.subjectHIV transmission
dc.subjectSub-Saharan Africa
dc.subjectHIV epidemic
dc.subjectBarmaids
dc.subjectBar girls
dc.subjectBehavioral risk factors
dc.subjectSex work
dc.titleSocio-demographic characteristics and risk factors for HIV transmission in female bar workers in Sub-saharan Africa: a systematic literature review
dc.typeArticle

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