HIV Risk Profile and Prostitution Among Female Street Youths

Abstract

The objective of this study was to compare human immunodeficiency virus (HIV) risk factors among female street youths involved in prostitution and those with no history of prostitution. Youths aged 14 to 25 years were recruited into the Montreal Street Youth Cohort. Semiannually, youths completed an interviewer-administered questionnaire. Statistical analyses comparing characteristics and HIV risk factors for girls involved in prostitution and those never involved were carried out using parametric and nonparametric methods. Of the girls, 88 (27%) reported involvement in prostitution, and 177 girls reported no history of prostitution at the baseline interview. Girls involved in prostitution were two times and five times more likely to have reported bingeing on alcohol and on drugs, respectively. A history of injection drug use was four times more likely to have been reported by girls involved in prostitution. Further, these girls were 2.5 times more likely to have reported injected cocaine as their drug of choice. Girls involved in prostitution were younger the first time they had consensual sex and were twice as likely to have reported anal sex. Consistent condom use for anal, vaginal, and oral sex was low for all girls. Girls involved in prostitution reported more risky sexual partners. In conclusion, girls involved in prostitution may be at increased risk of HIV infection due to their injection drug use and risky sexual behaviors. Unique intervention strategies are necessary for reducing HIV infection among female street youths involved in prostitution.

HIV Epidemics in the European Region: Vulnerability and Response

“…Regarding gender, women who inject drugs tend to be younger than their male counterparts, engage in higher rates of needle and syringe sharing, are more likely to share their sex partners' injecting equipment, and engage in riskier sexual practices [53][54][55][56][57][58][59][60]. Regarding the legal environment, ever having been arrested and ever having spent time in prison emerged as risk factors for HIV.…”

“…Despite this issue, the efficacy estimate for NSP seems reasonable because it coincides with the possible HIV-impact of widespread NSP in Tallinn [42] and the impact of high-coverage NSP on other blood-borne infections [56]. It also seems reasonable that ART will have a large impact on parenteral HIV transmission, as evidence shows a huge decrease in plasma viral load when individuals start treatment, and ecological studies have shown associations between PWIDcommunity viral load and HIV incidence at the population level in Vancouver, British Columbia, and Baltimore, Maryland [59]. Due to the uncertainty in the exact effect of ART on HIV transmission in PWID, and because of the low adherence observed among PWID [49], we used a conservative estimate of 80% for the efficacy of ART in reducing HIV transmission risk among PWID.…”

“…Poly-drug use can be associated with increased harm to health through interactions between drugs, psychoactive substances increasing risk behaviors, and reduced cognition that can lead to injury [59]. Cocaine use is also associated with cardiovascular problems [60].…”

Sexual Minority Status and Violence Among HIV Infected and At-Risk Women

“…Transactional sex is associated with increased physical and sexual violence, from clients and intimate partners, 9,[16][17][18][19][20][21] as well as higher numbers of sex partners [22][23][24][25] and increased substance use. 22,24,26 Substance use may also contribute to poor decision-making and aggressive behaviors of both victims and perpetrators that increase violence, as well as participation in risky activities to obtain drugs. 7,10 Substance use can also lead to and stem from transactional sex 21 and is associated with multiple partners.…”

“…Studies have shown that women identifying as lesbian, bisexual or WSMW have increased odds of binge drinking and drug use. [22][23][24][25] WMSW have been associated with high-risk sex; in two studies at sexually transmitted infection (STI) clinics, WSMW reported more transactional sex compared to heterosexual or WSW women. 28,29 Among drug using women, those who had sex with women had increased transactional sex and numbers of sex partners.…”