Sex-trafficked girls and women from south Asia have high prevalence of HIV infection

July 31, 2007

Nearly 40 percent of repatriated Nepalese sex-trafficked girls and women tested were positive for HIV infection, with girls trafficked before age 15 having higher rates of infection, according to a study in the August 1 issue of JAMA, a theme issue on violence and human rights.

"Trafficking across or within national borders for purposes of sexual exploitation including forced prostitution, i.e., sex trafficking, is recognized as a major gender-based human rights violation with significant individual and public health consequences and is increasingly discussed as a potentially critical mechanism in the spread of human immunodeficiency virus (HIV) across developing nations," the authors write.

There are an estimated 150,000 girls and women trafficked each year within and across the countries of South Asia, with approximately 5,000 to 7,000 Nepalese girls and women trafficked to India's commercial sex industry each year, according to background information in the article. Data on HIV prevalence among survivors of sex trafficking and roles of trafficking-related exposures in HIV infection have been limited.

Jay G. Silverman, Ph.D., of the Harvard School of Public Health, Boston, and colleagues examined the prevalence and risk factors for HIV infection among 287 repatriated Nepalese girls and women sex trafficked to brothels in India. Medical and case records were reviewed of the girls and women, who received rehabilitative services between January 1997 and December 2005.

The researchers found that among the 287 girls and women, 38.0 percent tested positive for HIV. Among those with complete documentation of trafficking experiences (n = 225), median (midpoint) age at time of trafficking was 17.0 years, with 33 girls (14.7 percent) trafficked prior to age 15 years. Compared with those trafficked at 18 years or older, girls trafficked prior to age 15 years had an increased risk for HIV, with 20 of 33 (60.6 percent) infected among this youngest age group.

Additional factors associated with being HIV positive included being trafficked to Mumbai (India's second largest city) and longer duration of forced prostitution (indicating increased risk per additional month in a brothel). Additional analyses indicated that girls trafficked prior to age 15 years had five times the increased odds of having been detained in multiple brothels and more likely to be in brothels for a duration of 1 year or more vs. those trafficked at age 18 years or older.

The authors write, "Findings of the present study emphasize the critical need to strengthen efforts to prevent sex trafficking and to intervene to protect trafficking survivors so as to shield young girls and women, both from this form of sexual violence and from the high risk of HIV infection. Currently, relatively few such efforts exist, and organizations that do engage in this work often lack adequate political or financial support. Furthermore, the high rates of HIV documented herein support concerns that sex trafficking may be a significant factor in the expansion of the South Asian HIV epidemic, both within higher-prevalence nations such as India and also from such nations to their lower-prevalence neighbors (e.g., Nepal). Moreover, the current demonstration of the very young age of many of those trafficked and sexually exploited, and the further harm to these young lives through high rates of HIV infection, requires attention from public health researchers and strategists to better understand and reduce the demand for sexual services from prostituted girls and women."
-end-
(JAMA. 20017;298(5):536-542. Available pre-embargo to the media at www.jamamedia.org)

Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

For More Information: Contact the JAMA/Archives Media Relations Department at 312-464-JAMA or email: mediarelations@jama-archives.org.

The JAMA Network Journals

Related HIV Articles from Brightsurf:

BEAT-HIV Delaney collaboratory issues recommendations measuring persistent HIV reservoirs
Spearheaded by Wistar scientists, top worldwide HIV researchers from the BEAT-HIV Martin Delaney Collaboratory to Cure HIV-1 Infection by Combination Immunotherapy (BEAT-HIV Collaboratory) compiled the first comprehensive set of recommendations on how to best measure the size of persistent HIV reservoirs during cure-directed clinical studies.

The Lancet HIV: Study suggests a second patient has been cured of HIV
A study of the second HIV patient to undergo successful stem cell transplantation from donors with a HIV-resistant gene, finds that there was no active viral infection in the patient's blood 30 months after they stopped anti-retroviral therapy, according to a case report published in The Lancet HIV journal and presented at CROI (Conference on Retroviruses and Opportunistic Infections).

Children with HIV score below HIV-negative peers in cognitive, motor function tests
Children who acquired HIV in utero or during birth or breastfeeding did not perform as well as their peers who do not have HIV on tests measuring cognitive ability, motor function and attention, according to a report published online today in Clinical Infectious Diseases.

Efforts to end the HIV epidemic must not ignore people already living with HIV
Efforts to prevent new HIV transmissions in the US must be accompanied by addressing HIV-associated comorbidities to improve the health of people already living with HIV, NIH experts assert in the third of a series of JAMA commentaries.

The Lancet HIV: Severe anti-LGBT legislations associated with lower testing and awareness of HIV in African countries
This first systematic review to investigate HIV testing, treatment and viral suppression in men who have sex with men in Africa finds that among the most recent studies (conducted after 2011) only half of men have been tested for HIV in the past 12 months.

The Lancet HIV: Tenfold increase in number of adolescents on HIV treatment in South Africa since 2010, but many still untreated
A new study of more than 700,000 one to 19-year olds being treated for HIV infection suggests a ten-fold increase in the number of adolescents aged 15 to 19 receiving HIV treatment in South Africa, according to results published in The Lancet HIV journal.

Starting HIV treatment in ERs may be key to ending HIV spread worldwide
In a follow-up study conducted in South Africa, Johns Hopkins Medicine researchers say they have evidence that hospital emergency departments (EDs) worldwide may be key strategic settings for curbing the spread of HIV infections in hard-to-reach populations if the EDs jump-start treatment and case management as well as diagnosis of the disease.

NIH HIV experts prioritize research to achieve sustained ART-free HIV remission
Achieving sustained remission of HIV without life-long antiretroviral therapy (ART) is a top HIV research priority, according to a new commentary in JAMA by experts at the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health.

The Lancet HIV: PrEP implementation is associated with a rapid decline in new HIV infections
Study from Australia is the first to evaluate a population-level roll-out of pre-exposure prophylaxis (PrEP) in men who have sex with men.

Researchers date 'hibernating' HIV strains, advancing BC's leadership in HIV cure research
Researchers have developed a novel way for dating 'hibernating' HIV strains, in an advancement for HIV cure research.

Read More: HIV News and HIV Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.