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HIV Prevalence and Predictors Among Rescued Sex-Trafficked Women and Girls in Mumbai, India

Silverman, Jay G PhD*; Decker, Michele R MPH*; Gupta, Jhumka MPH*; Maheshwari, Ayonija MD, MPH; Patel, Vipul; Raj, Anita PhD§

JAIDS Journal of Acquired Immune Deficiency Syndromes: December 15th, 2006 - Volume 43 - Issue 5 - p 588-593
doi: 10.1097/01.qai.0000243101.57523.7d
Epidemiology and Social Science

Objective: Despite the rapid spread of India's HIV epidemic through commercial sex and the large numbers of minor girls trafficked to India for sex work each year, little HIV research has been conducted among victims of sex trafficking. The present study examines the prevalence and predictors of HIV infection among sex-trafficked women and girls rescued from brothels in Mumbai, India.

Design and Methods: Case records and HIV testing results of sex-trafficked women and girls (N = 175) were reviewed. HIV prevalence and HIV risk were assessed based on demographics and exposure to sex work.

Results: Approximately one quarter (22.9%) of trafficked individuals tested positive for HIV. The mean age at trafficking was marginally younger for women and girls infected with HIV (15.9 years) as compared to those not infected (17.2 years; P = 0.06). Girls trafficked as minors reported longer periods of brothel confinement as compared to those trafficked at older ages (18.5 vs. 9.6 months; P = 0.007). Among Indian victims, those trafficked from the states of Karnataka or Maharashtra were more likely than those trafficked from West Bengal to be HIV-positive (odds ratio [OR] = 7.35, 95% confidence interval [CI]: 2.23 to 24.21). Longer duration in brothels was associated with greater likelihood of HIV infection; a 3% to 4% increased risk for HIV was observed for each additional month of brothel captivity.

Conclusions: Findings demonstrate the need for increased attention to HIV among young victims of sex trafficking in research and practice and to the rescue of sex trafficking victims as a form of HIV prevention.

From the *Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, MA; †Yale University School of Medicine, New Haven, CT, and Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; ‡Rescue Foundation, Mumbai, Maharashtra, India; and §Department of Social and Behavioral Sciences, Boston University School of Public Health, Boston, MA.

Received for publication May 1, 2006; accepted July 27, 2006.

Supported by grants to J. Silverman from the Harvard South Asia Initiative and to J. Silverman and A. Raj from the MIT/Mellon Fellowship on Nongovernmental Organizations and Forced Migration.

Reprints: Jay G. Silverman, PhD, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115 (e-mail:

© 2006 Lippincott Williams & Wilkins, Inc.