Systematic Review of Interventions to Reduce HIV Risk Among Men Who Purchase Sex in Low- and Middle-Income Countries: Outcomes, Lessons Learned, and Opportunities for Future Interventions


Along with other partners of key population groups, men who purchase sex (MWPS) contributed to around 18% of new reported HIV cases in 2018 among people aged 15–49 years worldwide. A systematic review was performed to evaluate interventions conducted to reduce HIV risk among MWPS in low- and middle-income countries (LMICs). A comprehensive search of studies published in Embase, Medline, Global Health, Scopus, and Cinahl was performed. Among 32,115 studies found, 21 studies met the review’s inclusion criteria. Only four studies recruited MWPS, while the rest recruited groups often used as proxy populations for MWPS. The interventions were made primarily to increase HIV-related knowledge or perceptions through education and to improve condom usage rates through promotion and distribution. Few studies evaluated the impact of interventions on HIV testing rates and none looked at HIV treatment. Given the important role of testing as a prevention gate, together with UNAIDS’ 90-90-90 testing and treatment coverage goals for people infected with HIV, more studies which evaluate the impact of HIV testing and treatment provision among this group are needed.

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Correspondence to Luh Putu Lila Wulandari.

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Wulandari, L.P.L., Guy, R. & Kaldor, J. Systematic Review of Interventions to Reduce HIV Risk Among Men Who Purchase Sex in Low- and Middle-Income Countries: Outcomes, Lessons Learned, and Opportunities for Future Interventions. AIDS Behav 24, 3414–3435 (2020).

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  • Systematic review
  • Interventions
  • Human immunodeficiency virus—HIV
  • Men who purchase sex
  • Clients of sex workers