US researchers suggest that the trafficking of young girls and women as sex slaves is helping to spread HIV in South East Asia. A study on the prevalence of HIV infection in Nepalese girls and women who were trafficked to India as sex slaves and then repatriated shows that 38 per cent of them were HIV positive.
For the girls who were sex-trafficked before they reached the age of 15, the HIV infection rate was above 60 per cent. One in seven of the women and girls had been forced into prostitution when they were younger than 15.
The study is published in the Journal of the American Medical Association (JAMA) and was carried out by researchers from Harvard School of Public Health (HSPH), Boston, Massachussets and colleagues from other US research centres.
According to the US Department of State, between 600,000 and 800,000 people, 80 per cent of them female, are trafficked across the globe every year. They estimate that the majority of these are girls and women who are forced into sex slavery or commercial sexual exploitation.
A report by the Congressional Research Service estimates that 150,000 girls and women are trafficked every year throughout South Asia, with most of them taken to large cities in India.
There are 2.5 million people with HIV/AIDS in India, the third largest population of infected individuals. Nepal is next to India and has a much lower prevalence of HIV/AIDS but this is increasing. The World Bank has suggested that sex trafficking of girls and women from Nepal to India is a significant cause of HIV spread in the region.
Jay Silverman, Associate Professor of Society, Human Development, and Health at HSPH and lead author of the study said that:
“HIV infection has been seen as perhaps the most critical health consequence of sex trafficking, but sex-trafficked girls and women are rarely studied; leaving the prevalence of HIV and other health issues among this highly vulnerable population little understood.”
“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,” he added.
Silverman and colleagues reviewed medical records and other documentation of 287 girls and women who had been sex-trafficked from Nepal to India between 1997 and 2005.
All the victims had been repatriated to Nepal and in rehabilitation with “Maiti Nepal”, a non-government organization that helps victims of trafficking. The word “Maiti” means “mother’s home” in Nepali.
When they analysed the records, the researchers found that:
- Of 287 repatriated Nepalese sex-trafficked girls and women, 38 per cent (109 subjects) tested HIV positive.
- Of the 225 girls and women with complete documentation of trafficking experiences, the median age when they were trafficked was 17.0 years, with 14.7 per cent of them (33 subjects) being under 15 at the time.
- Compared with girls and women trafficked at 8 years of age or older, those under 15 when trafficked had an increased risk for HIV (adjusted odds ration 3.70).
- The HIV infection rate among the girls trafficked prior to age 15 was 60.6 per cent (20 of 33 subjects).
- Being trafficked to Mumbai, and enduring a longer duration of forced prostitution, further increased the risk of being HIV positive.
- Girls trafficked before age of 15 were also more likely to have been held captive in several different brothels, and to have been held in brothels for at least one year, compared to those trafficked at 18 or older.
- Every extra month the young girls spent in a brothel increased their HIV risk by 2 per cent.
The researchers concluded that repatriated Nepalese sex-trafficked girls and women had a “high prevalence of HIV infection, with increased risk among those trafficked prior to age 15 years”.
They said these findings showed “the need for greater attention to reducing and intervening in sex trafficking in South Asia, particularly among the very young”.
Silverman said that their study “sheds new light on infection rates among a sex-trafficked population and exposes both the tragic existence of the youngest victims and the dire health consequences of this crime”.
Speculating on why the youngest victims had a much higher rate of HIV infection, the researchers said that previous studies in India on male brothel clients showed that they prefer very young girls who are often portrayed as virgins. Many of these men think that having sex with a virgin will protect them from HIV and other infections or even cure such diseases.
Also, because of the high demand for and profit to be made from offering very young girls, brothel owners keep them captive for longer.
Addressing how to tackle the problem, the researchers pointed at the demand by men for sex with young girls.
“Just as in other areas of HIV prevention, we can no longer afford to ignore the behavior of men and boys,” said Silverman.
“Addressing the widely accepted male demand for commercial sex is critical to ending this modern day form of female slavery,” he said.
“HIV Prevalence and Predictors of Infection in Sex-Trafficked Nepalese Girls and Women.”
Jay G. Silverman; Michele R. Decker; Jhumka Gupta; Ayonija Maheshwari; Brian M. Willis; Anita Raj.
JAMA 2007 298: 536-542.
Vol. 298 No. 5, August 1, 2007.
Written by: Catharine Paddock