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: Introduction: Developing effective targets, policies and services for key populations requires estimations of population sizes and HIV prevalence across countries and regions. We estimated the relative and absolute HIV prevalence among men who have sex with men (MSM), transgender women and men, and male and transgender sex workers (MSW and TGSW) in sub‐Saharan African countries using peer‐reviewed literature. Methods: We performed a systematic review of peer‐reviewed studies assessing HIV prevalence in MSM, transgender women and men, MSW and TGSW in sub‐Saharan Africa between 2010 and 2021, following PRISMA guidelines. We searched Embase, Medline Epub, Africa Index Medicus, Africa Journal Online, Web of Science and Google Scholar. We calculated HIV prevalence ratios (PRs) between the study prevalence, and the geospatial‐, sex, time and age‐matched general population prevalence. We extrapolated results for MSM and transgender women to estimate HIV prevalence and the number living with HIV for each country in sub‐Saharan Africa using pooled review results, and regression approximations for countries with no peer‐reviewed data. Results and discussion: We found 44 articles assessing HIV prevalence in MSM, 10 in transgender women, five in MSW and zero in transgender men and TGSW. Prevalence among MSM and transgender women was significantly higher compared to the general population: PRs of 11.3 [CI: 9.9–12.9] for MSM and 8.1 [CI: 6.9–9.6] for transgender women in Western and Central Africa, and, respectively, 1.9 [CI: 1.7–2.0] and 2.1 [CI: 1.9–2.4] in Eastern and Southern Africa. Prevalence among MSW was significantly higher in both Nigeria (PR: 12.4 [CI: 7.3–21.0]) and Kenya (PR: 8.6 [CI: 4.6–15.6]). Extrapolating our findings for MSM and transgender women resulted in an estimated HIV prevalence of 15% or higher for about 60% of all sub‐Saharan African countries for MSM, and for all but two countries for transgender women. Conclusions: HIV prevalence among MSM and transgender women throughout sub‐Saharan Africa is alarmingly high. This high prevalence, coupled with the specific risks and vulnerabilities faced by these populations, highlights the urgent need for risk‐group‐tailored prevention and treatment interventions across the sub‐continent. There is a clear gap in knowledge on HIV prevalence among transgender men, MSW and TGSW in sub‐Saharan Africa., INTRODUCTION Sub‐Saharan Africa (SSA) is the epicentre of the HIV pandemic, with about 21 million people living with HIV [1]. Especially countries in Eastern and Southern Africa (ESA) are faced [...]

Objectives: To determine associations between the banning of sex work during the COVID-19 pandemic, and work, financial problems, mental well-being and HIV/sexually transmittable infection (STI) testing among sex workers in the Netherlands., Design: Two cross-sectional online surveys. The first survey covered two time-periods: pre-COVID-19 (1 January 2019 to 31 December 2019) and period 1 (15 March 2020 to 1 July 2020). The second survey covered period 2 (1 January 2021 to 31 December 2021)., Setting: The Netherlands PARTICIPANTS: In total, 106 (first survey) and 196 (second survey) sex workers participated. Most of the participants in the first and second survey were cisgender women (respectively, 76.4% and 66.5%), followed by cisgender men (respectively, 12.3% and 15.7%) and the combination of transgender men, transgender women, non-binary or other (respectively, 11.3% and 17.6%). Most participants were born in the Netherlands (respectively, 61.4% and 69.7%)., Primary and Secondary Outcome Measures: We provide descriptive statistics of self-reported work during and prior to COVID-19 measures, financial problems due to COVID-19 measures and HIV/STI testing and mental well-being during the COVID-19 pandemic. We also performed logistic and linear regression analyses to identify risk factors associated with reporting financial problems due to COVID-19 measures, not testing for HIV/STIs and lower mental well-being during the COVID-19 pandemic., Results: In periods 1 and 2, respectively, 69.6% and 62.0% reported financial problems due to the COVID-19 measures. Among those who reported to have had sex with clients, the percentage not HIV/STI testing was: 4.5% (95% CI: 0.9; 12.5) pre-COVID-19, 28.2% (95% CI: 15.0; 44.9) in period 1, and 15.2% (95% CI: 9.7; 22.3) in period 2. In the multivariate analysis, reported financial problems due to the COVID-19 pandemic was associated with not HIV/STI testing (OR: 12.1, p<0.001) and lower mental well-being (B: -2.7, p<0.001)., Conclusion: The COVID-19 pandemic control measures in the Netherlands were associated with major financial problems, low mental well-being and reduced HIV/STI testing among sex workers., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)