'High AIDS rate in Nepali sex workers returning from India'

CHICAGO: A study of Nepali women trafficked to India and forced into the sex trade found that nearly 40 percent of them were HIV positive by the time they were repatriated, US researchers said on Tuesday.

The findings come from a small study of 287 women who found their way home after years of sex slavery in India's brothels, but they underscore the challenge facing public health authorities as they battle to contain India's HIV epidemic and prevent it from spreading throughout the region.

"The high rates of HIV we have documented support concerns that sex trafficking may be a significant factor in both maintaining the HIV epidemic in India and in the expansion of this epidemic to its lower-prevalence neighbors," said Jay Silverman, Associate Professor of Society, Human Development, and Health at Harvard School of Public Health.

India has 2.5 million people living with HIV/AIDS, more than any other country in the world except South Africa and Nigeria, and is also a major hub for sex workers from across the region, such as Nepal and Bangladesh.

Nepal has traditionally had very low rates of HIV/AIDS infection, but thousands of Nepali women and girls are trafficked to the Indian subcontinent every year where they wind up in the sex industry.

What's more, one more recent study found that the number of infected sex workers in Nepal increased 24-fold in the decade from 1992 to 2002, a trend that experts say is probably reflected in the wider population.

While World Bank officials have warned that the cross-border sex trade presents a potential public health threat to Nepal, there has been very little data to show what's happening on the ground.

The authors of this study found that 38 percent of the returning women and girls tested positive for the HIV virus, and that infection rates were sharply higher among the youngest in the group.

Girls aged 14 and under were four times more likely to be HIV-positive than the women in the group as a whole. More than 60 percent had the virus that can lead to AIDS - Acquired Immune Deficiency Syndrome.

The higher infection rates probably reflect the fact that the Indian men who frequent brothels tend to prize younger girls, who are often presented as virgins, because they perceive them as less likely to be infected with HIV or other sexually transmitted diseases, the authors said.

The widespread myth that having sex with a virgin will cure such illnesses probably also factors into the equation, they added. Biologically, these teens and pre-teens are also more vulnerable to suffering tears and lesions during intercourse which also increases the risk of transmission.

Unfortunately, as a result of their popularity, brothel owners tend to keep these younger girls in captivity for longer - and the longer a girl is involved in prostitution, the greater her risk for contracting HIV, the Harvard researchers said.

More broadly, the women who worked in several brothels, and specifically in brothels in Mumbai, a city with a notable HIV/AIDS problem, were more likely to be infected.

This study did not track what happened to these women after they made it home, but the fear is that these former sex workers may end up prostituting again, and spreading the infection, because of the lack of support services back home, and because they cannot go back to their families due to the stigma around prostitution. "They are coming back to one of the poorest countries in the world where they are particularly ostracized," said Silverman. The study appears in the Journal of the American Medical Association.