Young women and girls who have been repatriated to Nepal after being trafficked to India for commercial sex work are emerging as an HIV/AIDS risk factor, according to a study published Wednesday in the Journal of the American Medical Association, the New York Times reports.
The study was conducted by Jay Silverman, a professor of human development at Harvard’s School of Public Health, and colleagues. It was funded by the State Department’s Office of Trafficking in Persons, as well as Harvard and Boston University. Silverman examined medical records of 287 former sex workers who had been rescued and repatriated between 1997 and 2005 by the Katmandu, Nepal-based charity Maiti Nepal, or Nepali Mother’s Home. Most of the young women and girls had been sent home by Indian advocacy groups working with police. The study found that 38% of the participants tested positive for HIV. Among the 33 girls in the study who were trafficked into sex work before age 15, 61% tested positive for HIV, the researchers found.
According to Aurorita Mendoza, a former Nepal coordinator for UNAIDS, when girls return to their home countries, they might be ostracized by their families and villages because of fear that they either will pressure other girls to enter the trade or ruin the village’s reputation. This often leads the returning girls to continue commercial sex work, the Times reports. Silverman said these women also might become pregnant, and because they cannot access antiretroviral treatment, they transmit HIV to their infants. According to the study, the youngest girls also tended to have worked in numerous establishments for more than one year, which also increased their risk of contracting HIV.
According to Silverman, owners of sex work establishments pay double for young girls and increase the price they charge customers to have sex with them. He added that owners “sometimes presen[t] them as virgins” because men sometimes think young girls have fewer diseases, or they believe a common myth in some countries that sex with a virgin can cure HIV/AIDS, the Times reports.
Silverman said about 50% of the women and girls in the study were promised work as maids or in restaurants before going to India. Some were invited to visit family or make pilgrimages and then sold to establishment owners by relatives, while some went to marry men in India. Others were drugged and kidnapped, sometimes by older women who offered them a cup of tea or a soft drink in a public market or train station, Silverman said. Mendoza said some girls enter the sex trade knowingly because of poverty (McNeil, New York Times, 8/1).
“The repatriation of Nepalese survivors of sex trafficking may play a critical role in spreading HIV across South Asian borders,” Silverman said, adding, “They are extremely vulnerable to being coerced into unsafe sexual behavior and being retrafficked for sexual exploitation, either within Nepal or back in India” (AP/San Jose Mercury News, 8/1). He added that 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” (Reuters, 7/31). Mendoza called the study “very important,” adding, “It’s the first I know of that linked HIV to sex-trafficked girls.” According to Silverman, the problem is emerging in other parts of the world. Girls from China’s Yunnan province trafficked to Southeast Asia, Iraqi girls from Syrian and Jordanian refugee camps and Afghan girls trafficked to Iran or Pakistan appear to experience the same circumstances as the study participants and likely are contributing to the spread of HIV in southern China, Afghanistan and elsewhere, Silverman said.