High prevalence of HIV and sexually transmitted infections among female sex workers associated with injection drug use in two Mexico-U.S. border cities
Background: Mexico is considered a country of low HIV prevalence, but HIV may be increasing in cities bordering the U.S., where sex work is quasi-legal and injection drug use is widespread. We compared prevalence of HIV/STIs and risk behaviors among FSWs who ever injected drugs (FSW-IDUs) versus other FSWs in Tijuana (N=412) and Ciudad Juarez (N=408).
Methods: From 03/04-01/06, FSWs in Tijuana and Ciudad Juarez without known HIV infection who reported unprotected sex with >1 client within the previous two months were recruited into an ongoing behavioral intervention study. Participants underwent baseline interviews and antibody testing for HIV, syphilis, gonorrhea and Chlamydia. Correlates of HIV infection were identified using logistic regression.
Results: Overall (N=820), median age and duration of sex work was 32 (IQR: 26-40) and 4 years (IQR: 2-10) respectively, with a median of 28 clients within the previous two months (IQR: 9-66); 94% had children. Only 49% had ever had an HIV test. The proportion of FSW-IDUs was 21% in Tijuana and 12% in Ciudad Juarez (p=0.0007). Prevalence of HIV, syphilis, gonorrhea and Chlamydia was 6%, 27%, 6% and 12% overall, 16%, 49%, 15% and 24% among FSW-IDUs and 4%, 22%, 4% and 10% among other FSWs (p<0.001). Overall, 36% had at least one STI. Factors independently associated with HIV infection were ever injecting drugs (AdjOR=2.5; 95% CI:1.3-4.6) and testing positive for syphilis (AdjOR=4.1; 95% CI:2.2-7.6).
Conclusions: Although these preliminary results cannot be generalized to all FSWs in Tijuana and Ciudad Juarez, prevalence of HIV and STIs in these border cities was extremely high and closely linked to injection drug use. A binational response including expanded access to HIV/STI testing, expanded access to sterile syringes and behavioral interventions is urgently needed to reduce high risk behaviors among FSWs in the Mexico-U.S. border region, especially those who inject drugs.
AIDS 2006 - XVI International AIDS Conference
"T.L.Patterson, et al.
High prevalence of HIV and sexually transmitted infections among female sex workers associated with injection drug use in two Mexico-U.S. border cities.
AIDS 2006 - XVI International AIDS Conference: