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APHA Scientific Session and Event Listing

Recorded presentation

Scott Parsons, JD, Hatfield School of Government/Portland State University, The Daywalka Foundation, P.O. Box 751, Portland, OR 97207, 410-491-5271, sparsons@daywalka.org

Background: Every year, millions of Bangladeshis and Nepalis legally and illegally migrate to India. Many Nepalis are forced to migrate due to a decade old civil war. Female migrants and refugees under the age of 18 are at high risk for human trafficking. Over 5 million people in India are HIV+. The vast majority of these infections resulted from heterosexual sex with the majority of those transmissions being linked to commercial sex work (CSW). Surveys among female sex workers (FSWs) combined with HIV testing indicate that those FSWs under the age of 18 are 4-7 times more likely to be HIV+ than the overall population of FSWs. With a brothel-based population of over 3 million, it is critical to address any increase in HIV+ minors. To date, no studies have adequately quantified the number of FSWs in South Asia entering sex work before the age of 18 or entering due to force, fraud or coercion. Under current law, either event results in trafficking. With local public health organizations, the Daywalka Foundation surveyed FSWs regarding initiation into CSW. We sought to determine the relationship between trafficking and HIV infection. Findings: Our research in India demonstrates a causal relationship between the entry of trafficking victims into CSW and a substantial increase in the spread of HIV infections. This results from the inability to negotiate condom use with clients or traffickers. There is an immediate need to adjust interventions to promote condom use among FSWs utilized by governmental agencies and nongovernmental organizations.

Learning Objectives: Participants will be able to

(
• identify the scope of the present HIV epidemic in India, (
• describe the main drivers of the recent increase in HIV infection rates among female sex workers, including accelerated trafficking of refugees from Nepal and other migrants from Bangladesh into commercial sex work in India, (
• calculate the percentage of trafficking victims in commercial sex work in India and (
• discuss sex workers' capacity to negotiate condom use.

Keywords: Condom Use, Adolescents, International

Related Web page: www.daywalka.org

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation