HIV and Trafficking for Sexual Exploitation in the US-Mexico Border Region

Funded by The UCSD Center for AIDS Research; Grant #P30 AI-36214; PI: Jay Silverman

Globally, violence and coercion are common experiences among female sex workers (FSWs), particularly among those pressured into sex work involuntarily and among those under age 18 (i.e., trafficked). In Dr. Silverman’s earlier research in Asia, high levels of violence, particularly sexual violence (inflicted to maintain compliance of trafficking victims) as well as multiple forms of extreme sexual risk (e.g., high volume of male clients on a daily basis, no condom use, injury to the vaginal tract) are experienced by these women and girls soon after being forced into sex work, which increases their risk of HIV and STI infection. Although trafficking for sexual exploitation is thought to be a growing concern and potentially significant factor in the spread of HIV within the U.S.-Mexico border region, research documenting the scope and role of trafficking in HIV infection for neither this region nor elsewhere in Latin America has not been conducted. With support from the UCSD Center for AIDS Research (CFAR), we are conducting a cross-sectional study of 600 FSWs from the border cities of Tijuana and Ciudad Juarez. Given that an estimated 70% of FSWs in these cities originate from other Mexican states and Central and South America, these locations offer an unmatched opportunity to study relationships between sex trafficking and HIV risk, not just in the Mexico-US border region, but across Latin America. These data will also provide the foundation for a broad, trans-disciplinary research agenda on the role of sex trafficking in HIV risk that is critical to control of both US and Mexican HIV epidemics.

The study will:

  1. Determine the prevalence and nature of trafficking as an entry mechanism into commercial sex work among FSWs in Tijuana and Ciudad Juarez
  2. Explore differences in HIV-related risks (including related drug and alcohol use) reported for the past 30 days in sex work and the first 30 days of participation in sex work between trafficked and non-trafficked FSWs
  3. Determine whether the prevalence of HIV infection and other STIs differs between trafficked vs. non-trafficked FSWs