Teenagers working in the sex trade industry in border cities are three times more likely to become infected with HIV than adult sex workers, according to new research from the University of California San Diego School of Medicine.
The UC San Diego School of Medicine published a study Tuesday in the “Journal of the American Medical Association” about minors working in the sex trade industry in two Mexican cities located on the U.S.-Mexico border.
The study focuses on 603 female sex workers 18 years old and younger recruited from Tijuana and Ciudad Juarez between March 2013 and January 2014. The participants were asked about their age when they joined the sex trade, their experiences with violence when forced into commercial sex, client volume and condom use.
They also provided blood samples for HIV testing.
Researchers found that six percent of those who reported entering the sex trade as teenagers tested positive for HIV. The study says this is compared to slightly less than two percent among those who started sex work as adults – or three times as high.
Researchers say poor condom use and effects of injection drug use contribute to the high rates of HIV infection among those entering the sex trade industry compared to those who enter as adults.
“The far higher rates of HIV infection among those women reporting being a minor in the sex trade is likely, at least in part, due to the combination of being violently compelled to have sex with male clients, being exposed to significantly more male sex clients each day and the lack of any condom use during their initiation to the sex industry,” said the study’s first author Jay Silverman, PhD, director of research for the Center on Gender Equity and Health and professor of medicine in the Division of Global Public Health at UC San Diego School of Medicine.
The study says more than 25 percent of sex workers in these two cities reported entering the sex trade before the age of 18. Nearly 12 percent – or one in eight – said they joined the sex trade before their 16th birthday.
The research also found that, compared with adult sex workers, those who started in the sex trade as adolescents were three times more likely to be violently coerced into sex with male clients.
Many of these young women reported having more than 10 male clients per day. They were also seven times less likely to use a condom during their first 30 days in the sex trade industry, the study says.
“Our study highlights the importance of social and structural factors, especially high levels of violence encountered by adolescents in the sex trade, in understanding vulnerability to HIV,” said senior author Kimberly Brouwer, PhD, director of the Prevention Scientific Working Group of the UC San Diego Center for AIDS Research and associate professor of medicine in the UC San Diego School of Medicine Division of Global Public Health.
The research was funded, in part by grants from the National Institutes of Health. The study was also co-authored by Carlos Magis-Rodriguez, MD, Phd, Argentina Servin Julie Ritter and Anita Raj, all of UC San Diego, and Shira M. Goldenberg of University of British Columbia.