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Exploring the Impact of Underage Sex Work Among Female Sex Workers in Two Mexico–US Border Cities

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Abstract

Although sex work and younger age increase HIV vulnerability, empirical data regarding the impacts of underage sex work are lacking. We explored associations between features of the risk environment, sex work, and drug use history, and underage sex work entry among 624 female sex workers (FSWs) in Tijuana and Ciudad Juarez, Mexico. Forty-one percent (n = 253) of women began sex work as minors, among whom HIV and any STI/HIV prevalence were 5.2 and 60.7%. Factors independently associated with increased odds of underage sex work were inhalants as the first drug used, forced first injection, number of drug treatment attempts, and recent receptive syringe sharing. Number of recent condom negotiation attempts with steady partners and depression as a reason for first injecting were negatively associated with underage entry. These results underscore the importance of efforts to prevent underage sex work and the wider factors contributing to HIV risk among vulnerable youth and underage FSWs.

Resumen

Aunque el trabajo sexual y una edad más joven aumentan la vulnerabilidad al VIH, aun faltan datos empíricos sobre los impactos del trabajo sexual en la minoría de edad. Exploramos las asociaciones entre las características del entorno de riesgo, antecedentes de trabajo sexual y consumo de drogas y la entrada al trabajo sexual como menor de edad entre 624 trabajadoras sexuales (TS) en Tijuana y Ciudad Juárez, México. El cuarenta y un por ciento (n = 253) de las mujeres comenzaron el trabajo sexual como menores de edad, en las cuales el VIH y cualquier otra prevalencia de ITS/VIH fueron 5.2 y 60.7% respectivamente. Los factores asociados independientemente con un aumento de la probabilidad de trabajo sexual durante la minoría de edad fueron: los inhalantes como primera droga consumida, primera inyección forzada, el numero de intentos de tratamiento de rehabilitación de drogas, y recibir jeringas recientemente compartidas. El número de intentos recientes para la negociación del condón con parejas estables y la depresión como una razón por la cual se inyectaron por la primera vez fueron negativamente asociadas con la entrada al trabajo sexual en la minoría de edad. Estos resultados subrayan la importancia de los esfuerzos para prevenir el trabajo sexual en la minoría de edad y factores más amplios que contribuyen al riesgo del VIH entre jóvenes vulnerables y TS que son menores de edad.

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Acknowledgments

The authors thank our study participants and staff from Prevencasa, A.C. for their participation, time, and effort. This study was supported by the National Institutes of Health (NIDA R01 DA023877). Goldenberg is supported by doctoral awards from the Canada-U.S. Fulbright program and the Canadian Institutes of Health Research. The authors also thank Dr. Thomas Novotny from San Diego State University for reviewing this manuscript.

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Goldenberg, S.M., Rangel, G., Vera, A. et al. Exploring the Impact of Underage Sex Work Among Female Sex Workers in Two Mexico–US Border Cities. AIDS Behav 16, 969–981 (2012). https://doi.org/10.1007/s10461-011-0063-3

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