Female sex workers are at very high risk of acquiring and transmitting HIV infection. In Africa, female sex workers have 11 times higher odds of having HIV than women in the general population. Modelling suggests that across Africa, 40% of new infections within the population are likely attributable to unsafe sex work, suggesting that 40% of new infection could be prevented if sex workers could be supported to be full engaged with prevention and care services.
However, FSW are marginalised, sex work is illegal in many countries and female sex workers are often stigmatised by communities and health workers. Typically, female sex workers are also highly mobile. In Zimbabwe, where prevalence among sex workers is 58%, analysis of programme data from 2009-2014 suggests annual HIV incidence is over 10% (ten times that in the adult female population) and that only 67% are aware of their HIV status and that less than half of all FSW living with HIV have a viral load.