CHICAGO Intervention to release sex-trafficked girls and women from forced prostitution may be an important strategy in preventing the spread of HIV/AIDS, according to a study released in August by the Journal of the American Medical Association.
Researchers called for strengthened efforts to prevent sex trafficking and to protect trafficking survivors after they found that victims of forced prostitution in India contributed to the HIV/AIDS epidemic when they were repatriated into their native country of Nepal.
"Currently, relatively few such efforts exist, and organizations that do engage in this work often lack adequate political or financial support," the authors of the report from the Harvard School of Public Health wrote in reference to intervention work.
The study's authors worked with a nongovernmental organization to examine the medical records of 287 girls and women who were rescued and repatriated after being sex-trafficked from Nepal to India between 1997 and 2005, and 38 percent of them tested positive for HIV. About 14 percent of the girls were trafficked before they were 15, and 60.6 percent of that age group was infected with HIV, researchers found.
Most victims were transported by people they knew on promises of domestic jobs or offers of marriage. Others were drugged and kidnapped. More than half of the girls and women were trafficked to Mumbai, the most populous city in India.
A decade ago, researchers said, international human rights organizations calculated that between 5,000 and 7,000 Nepalese girls and women were sex trafficked to India each year, and the study's authors predicted that number has risen significantly because of recent civil conflict in Nepal.
India has about 2.5 million people living with HIV/AIDS, ranking third in the world behind South Africa and Nigeria. The U.S. State Department estimates that 800,000 people are trafficked worldwide each year, and 80 percent are women and girls. The Associated Press noted that 150,000 are trafficked annually across South Asia and most end up in major Indian cities.
"The high rates of HIV we have documented support concerns that sex trafficking may be a significant factor in both maintaining the HIV epidemic in India and in the expansion of this epidemic to its lower-prevalence neighbors," Jay Silverman, an associate professor at the Harvard School of Public Health and a lead author in the study, said.
Researchers found that individuals trafficked at 14 years or younger may be at greater risk for HIV infection, and girls trafficked before age 15 were more likely to be detained in brothels for one year or longer compared with those trafficked as adults.
The reasons they gave include the fact that brothel owners place an increased value on younger girls because male clients prefer them. That preference often is caused by a belief that sex with a virgin will prevent HIV infection and may even cure a man who already contracted the disease, the authors said.
"Demand from clients is consistently described as the major driver of sex trafficking and likely also underlies HIV infection and transmission among the survivors of this criminal enterprise," the study said.
Also, young girls are less likely to negotiate the use of condoms during forced sex. Researchers said HIV-prevention approaches relying on prostituted girls to use condoms more regularly should be reconsidered.
"Approaches to HIV risk reduction that are oriented toward male clients, including reducing demand for sex from young prostituted girls, should receive greater emphasis," the authors said.
Jeffrey Barrows, a medical consultant on health and human trafficking for the Christian Medical Association, said the link between sex-trafficking and the spread of HIV/AIDS is significant.
"Very few published medical studies to date have addressed this link, so this study is a real breakthrough that we hope will stimulate concrete action in our government and the public health community," Barrows said in a statement Aug. 1. "This study should help U.S. and international government officials better recognize and emphasize the public health implications of human trafficking, and sex trafficking in particular."
Barrows said sex trafficking intervention should be more strongly emphasized in the President's Emergency Plan for AIDS Relief (PEPFAR) and other AIDS-related programs.
"Anti-trafficking measures should be specifically and consistently emphasized in AIDS-related grant stipulations and proposal evaluations," he said.
The U.S. Department of Health and Human Services is leading a nationwide effort to curb sex trafficking in the United States, where between 14,500 and 17,500 victims are brought into the country each year, according to the State Department.
In 2000, the Trafficking Victims Protection Act became the first comprehensive federal law addressing the trafficking issue. The act established a T visa for rescued victims of trafficking, which allows them to become temporary U.S. residents. Prior to the act, many victims were eventually deported as illegal aliens.
Advocates, including the Christian Medical Association, are calling for the United States to take a stronger stance in reducing sex trafficking worldwide, and as the study suggests, slowing the spread of the AIDS epidemic.