Table 1.

Summary trends in economy, migration, sex work and HIV.

	1980–1998	1999–2008	2009–2015
Economy and migration	GDP growth averaged about 5.5% during 1980–1990. The general trend of the 1990s is that the economy showed signs of weakening, with cutbacks in production by manufacturing and other industries [5]. Migration began to slow (proxy measure: F : M ratio from 2.9 to 2.3).	The political and economic crises between 2000 and 2008 nearly halved GDP, raising poverty rates to more than 72% [5]. Migration declined and many more men were found at home during household surveys (F : M ratio reaches nadir at 1.2).	During 2009–2012, the economy rebounded, with growth rates averaging 8.7% per year. Growth slowed sharply during 2012–2015, because of shifts in trade and major droughts [5]. Migration variable (F : M ratio increases from 1.2 to 1.8 then slides back to 1.2).
Sex work demand, supply and client numbers	High levels of sex work were reported during the 1980s [1–3,31–33]. Early interventions with sex workers achieved partial coverage and raised condom use to moderately high levels [13,14]. Condom distribution continued to rise steadily across all the three periods.	Demand for sex work declined abruptly as unemployment rose, migrant workers returned home an incomes fell [47,49]. Supply increased as more poor women turned to sex work [48,49]. Low demand and higher supply led to a sharp decline in client number [47].	Sex workers reported a return to higher numbers of clients from 2009 as the economy improved [52,53,56]. More recently, sex workers report falling demand and lower prices (CeSHHAR reports).
HIV incidence/prevalence	HIV incidence is estimated to have peaked in the early 1990s and prevalence by mid-1990s [9]. The general pattern for the 1990s is progressive decline in urban areas and flat but lower incidence in rural areas reflecting slower rates of secondary transmission [9].	Modelled incidence suggests an abrupt decline at the beginning of this period, then levelling off, again with similar urban/rural pattern [9].	Modelled HIV prevalence (Spectrum) is estimated to have levelled off [8]. HIV incidence from 2015/2016 survey was 0.48.