Across Latin America, virtually no empirical data exist on the subject of sex trafficking, defined by the United Nations as forced, coerced, fraudulent or deceitful entry in to sex work, entry by abduction, or entry into such work under age 18. Recent media reports support that trafficking of women and girls into sex work, and drug cartel involvement in this form of sexual exploitation, is on the rise in the U.S. Mexico border region, constituting a major human rights crisis. Further, previous research by the PI in South and Southeast Asia has established that entry into sex work via trafficking confers elevated HIV/STI risk. Although the nature and context of sex trafficking in the US-Mexico border region likely differ significantly from that of Asia (e.g., the likely role of illicit drugs), research of our binational research team has found that factors often associated with trafficking among FSWs (e.g., young age, violence) relate to increased HIV risk, illicit drug use and forced injection drug use in Tijuana and Ciudad Juarez, suggesting that sex trafficking may be promoting vulnerability to HIV in this region. To both prevent sex trafficking and reduce risk for HIV among women and girls who have been trafficked, data is required a) on how sex trafficking is occurring and what structures facilitate this crime, and b) on whether and how victims, once trafficked, are made vulnerable to HIV. Despite the clear and urgent need in the region, no study of these issues has been conducted to date. The proposed study aims to describe the nature of sex trafficking in two major border cities (Tijuana and Ciudad Juarez) including major structural factors (e.g., those related to drug cartel activities, police violence, northward migration, access to health services) that may affect both sex trafficking and HIV risk among trafficking victims. To accomplish this, we propose to conduct a mixed-methods study of 800 FSWs from Tijuana and Ciudad Juarez in consultation with multiple national and state-level systems key informants (SKI) to inform the content, ensure the relevance, and maximize the acceptability and dissemination of our work. As an estimated 70% of FSWs in these cities originate from other Mexican states or Central and South America, these locations offer an unparalleled opportunity within Latin America to study these concerns, as well as to inform the development of much- needed interventions. In-depth interviews will be conducted with 30 FSWs (15 per city) screening positive for sex trafficking (minor or forced/coerced sex work entry). Data will be collected from 800 FSWs (400 per city) identified using venue-based sampling, via self-report survey and biologic HIV/STI testing. Based on interview, survey and laboratory data and SKI consultation, targets will be identified and prioritized for region-specific, structural interventins (i.e., those focused structural factors found to be associated with sex trafficking and HIV risk among trafficked FSWs) to prevent sex trafficking and reduce coincident HIV risk along the US.- Mexico border. Development and piloting of indicated structural interventions will be proposed within a subsequent R34 application.

Public Health Relevance

The proposed study aims to describe the nature of sex trafficking in two major U.S.-Mexico border cities (Tijuana and Ciudad Juarez) including major structural factors (e.g., those related to drug cartel activities) that may affect both sex trafficing and HIV risk among trafficking victims. To accomplish this, we propose to conduct a mixed-methods study of 800 FSWs from Tijuana and Ciudad Juarez in consultation with multiple national and state-level systems key informants (SKI) to inform the content, ensure the relevance, and maximize the acceptability and dissemination of our work. Methods include a) in-depth interviews with 30 FSWs (15 per city) screening positive for sex trafficking (minor or forced/coerced sex work entry); b) survey and HIV testing of 800 FSWs (400 per city) identified via venue-based sampling; and c) identification and prioritization of targets for region-specific, structural interventions.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Project (R01)
Project #
5R01DA033194-04
Application #
8865582
Study Section
Behavioral and Social Science Approaches to Preventing HIV/AIDS Study Section (BSPH)
Program Officer
Hartsock, Peter
Project Start
2012-07-01
Project End
2016-06-30
Budget Start
2015-07-01
Budget End
2016-06-30
Support Year
4
Fiscal Year
2015
Total Cost
Indirect Cost
Name
University of California San Diego
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
804355790
City
La Jolla
State
CA
Country
United States
Zip Code
92093
Boyce, Sabrina C; Brouwer, Kimberly C; Triplett, Daniel et al. (2018) Childhood Experiences of Sexual Violence, Pregnancy, and Marriage Associated With Child Sex Trafficking Among Female Sex Workers in Two US-Mexico Border Cities. Am J Public Health 108:1049-1054
Servin, Argentina E; Reed, Elizabeth; Brouwer, Kimberly C et al. (2017) Motherhood and Risk for Human Immunodeficiency Virus/Sexually Transmitted Infections Among Female Sex Workers in the Mexico-US Border Region. Sex Transm Dis 44:477-482
Servin, Argentina E; Brouwer, Kimberly C; Gordon, Leah et al. (2015) Vulnerability Factors and Pathways Leading to Underage Entry into Sex Work in two Mexican-US Border Cities. J Appl Res Child 6:
Silverman, Jay G; Servin, Argentina; Goldenberg, Shira M et al. (2015) Sexual Violence and HIV Infection Associated With Adolescent vs Adult Entry Into the Sex Trade in Mexico. JAMA 314:516-8