HIV prevalence and predictors of infection in sex-trafficked Nepalese girls and women
HIV prevalence and predictors of infection in sex-trafficked Nepalese girls and women
复制标题
DOI：
10.1001/jama.298.5.536
复制
发表时间：
2007-08-01
影响因子：
120.7
通讯作者：
Raj, Anita
中科院分区：
文献类型：
--
作者：
Silverman, Jay G.;Decker, Michele R.;Raj, Anita
贩运女童和妇女从事色情活动在南亚十分普遍，被认为是一种基于性别的暴力犯罪和严重侵犯人权的行为。没有充分的经验数据来描述这一现象及其相关的健康后果，目的确定被遣返的性贩运尼泊尔女孩和妇女中艾滋病毒感染的流行率，并确定被贩运的尼泊尔妇女和女孩中艾滋病毒感染的流行率。287名被遣返的女孩和妇女报告说，她们被从尼泊尔贩运到尼泊尔进行性剥削，2006年1月，对1997年1月至2005年12月期间在一个主要非政府组织接受康复服务的情况进行了系统的审查。结果在287名被遣返的尼泊尔性贩运女孩和妇女中，109人（38.0%）艾滋病毒检测呈阳性。在有完整的贩运经历记录的人（n=225）中，贩运时的中位年龄为17.0岁，33人（14.7%）在15岁之前被贩运。与18岁或18岁以上被贩运的女孩相比，15岁以前被贩运的女孩感染艾滋病毒的风险增加（调整后的比值比[AOR]，3.70; 95%置信区间[CI]，1.32-10.34），33人中有20人（60.6%）在这个最年轻的年龄组中感染。与艾滋病毒阳性相关的其他因素包括被贩运到孟买（AOR，4.85; 95% CI，2.16-10.89）和被迫卖淫的时间较长（AOR，1.02; 95% CI，1.01-1.03;表明妓院奴役每增加一个月的风险增加）。在事后分析中，15岁之前被贩运的女孩被拘留在多个妓院的可能性增加（比值比[ OR]，5.03; 95% CI，1.96-12.93）和在妓院持续1年或更长时间（OR，2.67; 95%CI，1.12-6.33）与18岁或以上的被贩运者相比。结论在这项研究中，遣返的尼泊尔性贩运女孩和妇女被发现有很高的艾滋病毒感染率，15岁以前被贩运者的风险更大。目前的调查结果表明，需要更加重视减少和干预南亚的性贩运，特别是在非常年轻的人中。
Context Sex trafficking of girls and women is widespread across South Asia and is recognized as both a violent gender-based crime and major human rights violation. Inadequate empirical data exist to characterize this phenomenon and its related health consequences, such as human immunodeficiency virus (HIV) infection.Objective To determine the prevalence of HIV infection among repatriated sex-trafficked Nepalese girls and women and to identify trafficking-related predictors of such infection.Design Medical and case records of 287 repatriated girls and women reporting being trafficked from Nepal for sexual exploitation and receiving rehabilitative services between January 1997 and December 2005 at a major nongovernmental organization were systematically reviewed in January 2006.Setting Major Nepalese nongovernmental organization providing shelter and care to repatriated survivors of sex trafficking.Main Outcome Measures Prevalence of and risk for HIV based on demographic characteristics and on trafficking- and prostitution-related experiences.Results Among 287 repatriated Nepalese sex-trafficked girls and women, 109 (38.0%) tested positive for HIV. Among those with complete documentation of trafficking experiences (n=225), median age at time of trafficking was 17.0 years, with 33 (14.7%) trafficked prior to age 15 years. Compared with those trafficked at 18 years or older, girls trafficked prior to age 15 years were at increased risk for HIV ( adjusted odds ratio [AOR], 3.70; 95% confidence interval [CI], 1.32-10.34), with 20 of 33 (60.6%) infected among this youngest age group. Additional factors associated with HIV positivity included being trafficked to Mumbai ( AOR, 4.85; 95% CI, 2.16-10.89) and longer duration of forced prostitution ( AOR, 1.02; 95% CI, 1.01-1.03; indicating increased risk per additional month of brothel servitude). In post hoc analyses, girls trafficked prior to age 15 years had increased odds of having been detained in multiple brothels ( odds ratio [ OR], 5.03; 95% CI, 1.96-12.93) and in brothels for a duration of 1 year or more ( OR, 2.67; 95% CI, 1.12-6.33) vs those trafficked at 18 years or older.Conclusions In this study, repatriated Nepalese sex-trafficked girls and women were found to have a high prevalence of HIV infection, with increased risk among those trafficked prior to age 15 years. Present findings demonstrate the need for greater attention to reducing and intervening in sex trafficking in South Asia, particularly among the very young.