Official websites use. Share sensitive information only on official, secure websites. All other authors declare no competing interests. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Key populations, including sex workers, are at high risk of HIV acquisition and transmission. Men who pay for sex can contribute to HIV transmission through sexual relationships with both sex workers and their other partners.
We performed random-effects meta-analyses of population-based surveys conducted in SSA from to with information on paid sex by men. We pooled by regions and time periods, and assessed time trends using meta-regressions.
Study limitations include a reliance on self-report of sensitive behaviors and the small number of surveys with information on ARV use and VLS. Further prevention efforts are needed for this vulnerable population, including improved access to HIV testing and condom use initiatives.
Men who pay for sex should be recognized as a priority population for HIV prevention. Clients of sex workers often have central roles in HIV transmission networks: they have sexual contacts with both sex workers and other partners. Despite their vulnerability to HIV acquisition and transmission, male clients of sex workers are not formally recognized as a key population.
