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Sex Slaves Returning Home Raise AIDS Risks, Study Says   By DONALD G. McNEIL Jr.  Published: August 1, 07

Adding another bleak dimension to the sordid world of sex slavery, young girls who have been trafficked abroad into prostitution are emerging as an AIDS risk factor in their home countries, according to a study being released today.

Girls who were forced into prostitution before age 15 and girls traded between brothels were particularly likely to be infected, the study found. Shunned by their families and villages on their return, they sometimes end up selling themselves again, increasing the risk.

The study, in the Journal of the American Medical Association , concerns girls from Nepal trafficked into bordellos in India , but the problem is also emerging elsewhere, said the lead author, Jay G. Silverman, a professor of human development at Harvard’s School of Public Health.

Girls from China’s Yunnan Province sold to Southeast Asian brothels, Iraqi girls from refugee camps in Syria and Jordan, and Afghan girls driven into Iran or Pakistan all appear to be victims of the same pattern, he said, and are presumably contributing to the H.I.V. outbreaks in southern China, Afghanistan and elsewhere.

“Most authorities fighting human trafficking don’t see it as having anything to do with H.I.V.,” Dr. Silverman said. “It is just not being documented.”

Aurorita M. Mendoza, a former Nepal coordinator for Unaids, the United Nations AIDS agency, called the study “very important.”

“It’s the first I know of that’s linked H.I.V. to sex-trafficked girls,” she said.

Nepal — a poor, religiously conservative country in the Himalayas — has until recently had relatively few AIDS cases. The government estimates that it has only about 10,000. The official Unaids estimate is 75,000, but that may be too high, given that some previous estimates for other countries have been wrong. One month ago, for example, Unaids cut its official estimate for neighboring India by 56 percent, to about 2.5 million infected, more than anywhere except South Africa and Nigeria.

The study, which was paid for by the State Department’s Office of Trafficking in Persons and by Harvard and Boston Universities, tested 287 girls and women being helped by a charity called Maiti Nepal, or Nepali Mother’s Home, in the capital, Katmandu. Most had been sent home by Indian anti-prostitution groups working with the police.

Thirty-eight percent of the Nepali women tested by Dr. Silverman’s team were infected with H.I.V., the virus that causes AIDS. But among the youngest — the 33 girls who had been sent into sex slavery before they were 15 years old — the infection rate was 61 percent.

Brothel owners pay twice as much for young girls, Dr. Silverman said, and charge more for sex with them, sometimes presenting them as virgins, because men think young girls have fewer diseases or believe the myth — common in some countries — that sex with a virgin cures AIDS.

“It’s absolutely heartbreaking,” Dr. Silverman said. “Some of them are just shells — and shells of very young human beings. It’s every father of a daughter’s worst nightmare.”

About half of those tested had been lured to India by promises of jobs as maids or in restaurants. Some were invited on family visits or pilgrimages and then sold — sometimes by relatives. Some were falsely promised marriage. Some were simply drugged and kidnapped, often by older women offering a cup of tea or a soft drink in a public market or train station, Dr. Silverman said.

Not all Nepali women are kidnapped or tricked, Miss Mendoza, the former Unaids official, noted; poverty drives some into the profession knowingly.

“This heartless ‘trade’ has been popular for more than six decades in the subcontinent,” said Romesh Bhattacharji, a former national law enforcement official in India. “In some parts of northern Nepal, one can tell which house has a girl working in an Indian brothel by its roof. If it’s tin, that’s brothel money.”

Miss Mendoza said returning girls may be rejected by their families and villages because of fear that they will either corrupt other girls or will so taint the village’s reputation that no one will marry its young women.

As a result, these victims of kidnapping and rape may be forced to keep selling themselves. One survey of Katmandu prostitutes, Dr. Silverman said, found that half had worked in India. They may also become pregnant and, without treatment, infect their children.

Working in a brothel in Mumbai — India’s financial capital and one of the world’s largest cities — was a risk factor in itself, the study found. The youngest also tended to have been in multiple brothels and in them for more than a year, raising their risk.

India’s epidemic, concentrated among prostitutes, truckers, men who have sex with men and people who inject drugs, is most common in its industrialized south and in the heroin-smuggling areas near Pakistan and Myanmar, not in regions bordering Nepal.

Worldwide, about 500,000 young women are trafficked each year, according to the State Department. Most of the 150,000 trafficked in southern Asia end up working as prostitutes in Indian cities, according to the United States Congressional Research Service. Rights agencies said a decade ago that up to 7,000 women from Nepal were trafficked to India each year; civil strife has presumably increased that number.

Global Surveillance & Statistics

HIV InSite: Countries and Regions
Global, regional, and country-level information on HIV/AIDS, including statistics, key indicators, maps, reports, and links.


Data Online for Population, Health and Nutrition
(DOLPHN) An online USAID statistical data resource containing selected current and historical country-level demographic and health indicator data, designed to provide users with quick and easy access to frequently used statistics.


HIV/AIDS Survey Indicators Database
Designed to be a comprehensive source of information on HIV/AIDS indicators derived from sample surveys, the database allows the user to produce tables for specific countries by select background characteristics. Advisory committee includes representatives from USAID, UNICEF, CDC, UNAIDS, WHO , U.S. Census Bureau, FHI, MEASURE Evaluation, Synergy Project, and MEASURE DHS+.


Monitoring the AIDS Pandemic (MAP) Network
A network of internationally recognized technical experts seeking to assess the status and trends of the global HIV/AIDS pandemic.


Provides citations with abstracts of the worldwide literature on population, family planning, and related issues such as HIV/AIDS.


Population Reference Bureau
(PRB) Provides timely and objective information on U.S. and international population trends and their implications.


An interactive mapping application which allows users to create maps from a database of Demographic and Health Survey findings from more than 75 countries.


Includes the "AIDS Epidemic Update: December 2006" and "2006 Report on the Global AIDS Epidemic."


U.S. Census Bureau: HIV/AIDS Surveillance
Site resources include: HIV/AIDS Surveillance Data Base International data, updated twice a year


HIV/AIDS Country Profiles
HIV/AIDS demographic indicators for countries in Africa, Asia, Latin America, and the Caribbean .


World Health Organization - WHO and HIV/AIDS
As the directing and coordinating authority on international health, the World Health Organization (WHO) takes the lead within the UN system in the global health sector response to HIV/AIDS.


HIV/AIDS country information
Includes comprehensive information on 50 countries implementing HIV/AIDS treatment and prevention scale up under the "3 by 5" global target and epidemiological fact sheets.


The 3 by 5 Intiative - AIDS Medicines and Diagnostics Service
The AMDS operates a clearing house, collecting and disseminating global level information on selection and use of antiretroviral drugs and HIV diagnostics.


Virtual Libraries:

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U.S. Surveillance & Statistics


Centers for Disease Control and Prevention

HIV/AIDS Surveillance Report


The most current U.S. data published twice a year

Statistics and Trends in HIV and AIDS in the United States
Features include basic statistics and slide sets .


Kaiser Family Foundation: State Health Facts Online

Contains the latest state-level data on demographics, health, and health policy, including HIV/AIDS, health coverage, access, financing, and state legislation.



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