The Worldwide Epidemiology of Hepatitis B, Hepatitis C, and Herpes Simplex Virus Type 2 in Female Sex Workers: A Systematic Review and Meta-Analysis

Background and Aims: Female sex workers are vulnerable and at high risk to acquire sexually transmitted infections, and act as a bridge in the transmission of sexually transmitted infections (STIs) to the general population. This study was conducted to determine the prevalence of the main viral pathogens responsible for STIs, including Hepatitis B virus (HBV), Hepatitis C virus (HCV), and Herpes simplex virus type 2 (HSV-2) in female sex workers in the world. Materials and Methods: A systematic search was carried out for relevant literature in international databases from database inception to September 25, 2019. The pooled prevalence for each STI of interest was estimated by a DerSimonian-Laird random-effects model using the inverse variance method. Results: The lowest pooled prevalence of HBV, HCV, and HSV-2 infections was seen in the Republic of Mauritius (0.17%; 95% CI: 0.01%-2.64%), Panama (0.20%; 95% CI: 0.05%-0.80%), and Iran (14.12%; 95% CI: 6.66%-27.48%), respectively. The highest pooled prevalence of HBV infection was found in Slovakia (22.22%; 95% CI: 8.60%-46.47%), while for HCV and HSV-2 infections was observed in Scotland (64.29%; 95% CI: 54.35%-73.13%) and Indonesia (90.30%; 95% CI: 84.76%-93.97%), respectively. Conclusion: A decreasing trend was observed in the prevalence of STIs of interest among female sex workers during recent years. However, the prevalence has remained high in some regions, and therefore it is important to improve prevention programs and conduct surveillance regularly in all parts of the world to decrease the risk of transmission of infections to the general population.