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Sex-trafficked girls have a higher risk to contract STIs and HIV

Nusa Dua, Indonesia - Sex-trafficked women and girls in South East Asia are at substantial risk of sexually transmitted infections including HIV, and a majority of them are under 17 years of age, according to a new independent regional research study by the Harvard School of Public Health and UNDP released here today.

Girls who are trafficked into sex work suffer qualitatively and quantitatively different levels of sexual risk as compared with non-trafficked sex workers, and are less likely to be reached by HIV prevention programmes, the study said. It also reveals the extent of sexual exploitation, physical, sexual and psychological violence experienced by trafficked women and girls.

Titled, “Sex Trafficking and STI/HIV in Southeast Asia: Connections between Sexual Exploitation, Violence and Sexual Risk, and financially supported by the Government of Japan, the study also demonstrates that denial of the most basic elements of human dignity, health and wellbeing are associated with the trafficking of women and girls for sexual exploitation. The report included studies covering Thailand, Cambodia and Indonesia.

Other highlights of the study:

Thailand

• Trafficked Female Sex Workers (FSWs) reported significantly greater numbers of male clients, reporting an average of 33.4 vaginal sex episodes with clients in the past month as compared with only 24.6 such acts among those non-trafficked (p=0.03).
• Anal sex, which represents a relatively high level of HIV risk, was three times as common among sex trafficked FSWs (8.2% vs. 2.6%; p<0.01).
• Trafficked FSWs faced greater difficulties regarding condom use; 22.4% of trafficked women reporting recent condom failure compared to 12.4% of nontrafficked FSWs.
• Recent condom non-use was far more prevalent among trafficked FSWs compared to non-trafficked FSWs (8.2% vs. 3.1%; p=0.02).
• Women who reported having been trafficked were far less knowledgeable regarding HIV transmission.
• Trafficked women were three times as likely to experience violence at initiation to sex work as compared to non-trafficked women and girls, as well as being more likely to report recent violence or mistreatment in the context of sex work.

Indonesia

• The prevalence of HIV among trafficking survivors was 5.7%, rising to 19.4% among those trafficked for sexual exploitation one year or more.
• 1 in 7 (14%) trafficking survivors tested for at least one of 4 sexually transmitted infections, including HIV, were infected.
• The prevalence of HIV among those trafficked within Indonesia was found to be 5.4%.
• Slightly less than half (46.5%) of sex trafficking survivors were exploited under the age of 18 years; notably a substantial number experienced trafficking for sexual exploitation at very young ages, with approximately one-quarter (24.5%) of survivors trafficked under 15 years of age.
• Most women and girls were trafficked within Indonesia (61.4%), with Malaysia being the destination for the majority of those trafficked across national borders (32.7%).
• Conditions and treatment were oppressive; most (76.6%) survivors were denied all movement, and many were forced to use drugs or alcohol (24.8% and 36.4%, respectively).
• 75% of trafficked women and girls experienced sexual violence.

Cambodia

• The majority (52.2%) of female sex trafficking survivors identified were under the age of 17 at the time of trafficking
• 3 out of 4 (74.1%) survivors were trafficked internally within Cambodia
• Sexual violence was prevalent, with 1 in 4 (25.0%) reporting forced sex acts in the context of trafficking and sex work
• A similar majority (73.4%) of survivors tested positive for sexually transmitted infections
• Contrary to previous findings in this area, duration of exploitation was related to STI
  • 90% of survivors exploited for 2 months or less were STI infected, suggesting tremendous risk for acquisition in the initial phases of sexual exploitation
  • Among victims that were exploited for longer than 2 months, the risk of STI infection decreased and then increased over time, with 100% of those exploited for over one year infected.

Addressing a press conference, Mr. Hakan Bjorkman, Country Director, UNDP, Indonesia, said “women in the sex industry are already highly at risk of HIV. But women who are sex trafficked experience even more extreme levels of HIV risk, abuse and violence. This screams out for action”

According to Jeff O’ Malley, Director, HIV/AIDS Practice, UNDP, New York, “It calls for a rights-based approach rather than an inappropriate law enforcement approach, which can result in victimising trafficked women, driving sex work underground, and making it even more difficult to reach sex workers and trafficked women to protect their rights and health.”

On the importance and urgency of creating a space for dialogue across partners, Caitlin Wiesen, Regional HIV/AIDS Team Leader and Programme Coordinator for Asia-Pacific at UNDP Regional Centre in Colombo said: “Often due to differences in ideological standpoints, collaboration among communities working on prevention of trafficking, HIV and the empowerment of sex workers has been limited in the region. However, partnerships across these communities, that engage Ministries of Justice, Health, Interior, are indispensable to preventing HIV and protecting the rights and health of women who have been trafficked as well as the rights of women in sex work.“

The study calls for an integrated approach to prevent trafficking and HIV in the context of sex work. “To achieve this goal, greater dialogue is required across the spectrum of responses to sex trafficking and HIV within sex work, including advocates for the rights of both sex workers and children, advocates for the prevention of trafficking, law enforcement policy-makers and practitioners, as well as those leading public health efforts to reduce HIV in the context of sex work,” it said.

Dr. Jay Silverman, Director of Violence Against Women Prevention Research at the Harvard School of Public Health and lead author of the study, said “This work further confirms the high risks for HIV infection faced by those coerced or forced into sex work. To confront this reality, anti-trafficking and HIV prevention professionals must work together to develop programs that can both reduce HIV risk among all those involved in sex work and assist women and girls trapped in these settings.”

Related information:

9th International Congress on AIDS in Asia and the Pacific