Sex Trafficking in South and Southeast Asia: Connections to Violence and HIV

Female Sex WorkersFemale sex workers (FSWs) play a central role in the HIV epidemic in many regions, and adolescents are considered to experience heightened vulnerability to violence and HIV within sex work. Although sex trafficking has been highlighted as a priority for many governments and multi-national agencies, prior to these studies, little empirical data existed to inform our understanding of the nature of sex trafficking, vulnerability factors among trafficked women and girls, or the connection of sex trafficking to HIV risk. These ground-breaking studies were conducted by Dr. Silverman and his team across India, Nepal, Cambodia, Thailand and Indonesia. Data on the issue of trafficking among women and girls involved in sex work and their STI/HIV risk is scarce for the following reasons: As the topic has been recognized only relatively recently, it is criminal in nature; it involves an extremely vulnerable and ‘hidden’ population; it has been historically excluded from programs, surveillance or research regarding HIV and sexual risk among sex workers; and it has not been included in ongoing state-sponsored surveillance. After extensive searches, adequate samples were identified involving the efforts of academic and NGO partners. Samples from India, Nepal, Cambodia and Indonesia were comprised of sex trafficking survivors served via post-trafficking NGO services across these countries. In contrast, the data utilized in the report on Thailand is a national survey of female sex workers, some of whom reported having been trafficked. All analyses attempted to characterize the experiences of trafficking survivors, related not only directly to STI/HIV, but also to the context for such risk and infection, i.e., workplace violence and maltreatment, deprivation of basic human rights such as denial of food and water, health care and freedom of movement. The results demonstrate that, across all of these nations, trafficking of women and girls for sexual exploitation places such individuals at high risk for HIV/STI infection. Trafficking victims appear to suffer qualitatively and quantitatively different and greater levels of sexual risk and STI/HIV infection, and are less likely to be reached by HIV prevention programs. Critically, consistent across theses studies is the use of physical and sexual violence and other forms of maltreatment against trafficked women and girls in the context of sex work.

*Funders: United Nations Development Program (Asia-Pacific Regional Centre), U.S. Department of State (Office on Trafficking in Persons)

Resources

Sex Trafficking Brief November 2016. 

Publications

Silverman JG, Decker MR, McCauley HL, Mack C. A Regional Assessment of Sex Trafficking and STI/HIV in Southeast Asia: Connections between Sexual Exploitation, Violence and Sexual Risk, 2009. UNDP Regional Centre; Colombo, Sri Lanka.

Silverman JG, Decker MR, Gupta J, Maheshwari A, Willis BM, Raj A. HIV prevalence and predictors of infection among sex trafficked Nepalese girls and women.  Journal of the American Medical Association (JAMA) 2007; 298: 536-42.

Silverman JG, Decker MR, Gupta J, Maheshwari A, Patel V, Raj A. HIV prevalence and predictors among rescued sex trafficked women and girls in Mumbai, India. Journal of Acquired Immune Deficiency Syndromes (JAIDS) 2006; 43:588-93.

Silverman JG, Decker MR, Gupta J, Maheshwari A, Patel V, Willis BM, Raj A. Experiences of sex trafficking victims in Mumbai, India. International Journal of Gynecology and Obstetrics 2007; 97:221-6.

Gupta J, Decker MR, Raj A, Silverman JG. HIV vulnerabilities of sex trafficked Indian women and girls. International Journal of Gynecology and Obstetrics (IJGO) 2009;107:30-4. 2009 Oct;107(1):30-4. PubMed PMID: 19625022. PMCID: 3071755.

McCauley HL, Decker MR, Silverman JG. Trafficking experiences and violence victimization of sex trafficked young women in Cambodia. International Journal of Gynecology and Obstetrics (IJGO) 2010; 110:266-7.

Decker MR, McCauley HL, Phuengsamran D, Janyam S, Silverman JG. Sex trafficking, sexual risk, STI and reproductive health among a national sample of female sex workers in Thailand.  Journal of Epidemiology and Community Health (JECH) 2011 Apr;65(4):334-9.

 

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Jay Silverman, PhD 

Primary Investigator

Jay Silverman, PhD
jgsilverman@ucsd.edu

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