Skip to main content
SpringerLink
Log in

HIV Infection and Risk Heightened Among Female Sex Workers Who Entered the Sex Trade as Adolescents in Guatemala

  • Original Paper
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

A dearth of empirical research exists on female sex workers in Central America who begin selling sex under age 18. Data were collected from adult female sex workers (N = 1216) sampled using census and modified time-location sampling in three urban centers of Guatemala. In adjusted analyses, female sex workers who entered the sex trade under age 16 years were more likely to be HIV positive (AOR = 4.6, 95% CI 1.6, 13.2), have not received HIV education in their first year of sex trade (AOR = 2.8, 95% CI 1.5, 5.5), have experienced violence to force commercial sex (AOR = 4.6, 95% CI 2.2, 9.8) and have not used condoms in their first month (AOR = 2.8, 95% CI 1.3, 6.1) , relative to those who entered as adults. An interaction between age at entry and foreign migration at entry was found for HIV risk. Efforts to prevent adolescent sex trade entry are needed and may also help to reduce HIV rates in Guatemala.

Resumen

Existe una escasez de investigaciones emperícas sobre mujeres trabajadoras sexuales en Centroamérica que inician en el trabajo sexual antes de los 18 años. Se colectaron datos de trabajadoras sexuales adultas (N=1216) usando un censo y muestreo de tiempo y lugar modificado, en tres centros urbanos de Guatemala. El análisis de datos ajustado mostró que las trabajadoras sexuales que iniciaron en el trabajo sexual a través de trata de personas antes de los 16 años de edad tuvieron una mayor probabilidad de ser VIH positivas (AOR=4.6, 95% CI=1.6, 13.2), no haber recibido educación sobre el VIH en el primer año de trabajo sexual (AOR=2.8, 95% CI=1.5, 5.5), y haber sido forzadas con violencia para hacer trabajo sexual (AOR=4.6, 95% CI=2.2, 9.8) y no usar condones (AOR=2.8, 95% CI=1.3, 6.1) en el primer mes, en comparación con aquellas que iniciaron el trabajo sexual cuando ya eran adultas. Encontramos una interacción entre la edad de inicio en el trabajo sexual y la migración al extranjero relacionado con el riesgo de infección por el VIH. Es necesario reforzar los esfuerzos para prevenir la trata de personas para el trabajo sexual, especialmente el ingreso de las mujeres menores de edad además ayudaría en la reducción de tasa de infecciones del VIH en Guatemala.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Silverman JG, Raj A, Cheng DM, et al. Sex trafficking and initiation-related violence, alcohol use, and HIV risk among HIV-infected female sex workers in Mumbai. India. J Infect Dis. 2011;204(suppl_5):S1229–S12341234.

    Article  PubMed  Google Scholar 

  2. McCauley HL, Decker MR, Silverman JG. Trafficking experiences and violence victimization of sex-trafficked young women in Cambodia. Int J Gynaecol Obstet. 2010;110(3):266–7.

    Article  PubMed  Google Scholar 

  3. Decker MR, McCauley HL, Phuengsamran D, Janyam S, Silverman JG. Sex trafficking, sexual risk, sexually transmitted infection and reproductive health among female sex workers in Thailand. J Epidemiol Community Health. 2011;65(4):334–9.

    Article  PubMed  Google Scholar 

  4. Goldenberg SM, Silverman JG, Engstrom D, et al. Exploring the context of trafficking and adolescent sex industry involvement in Tijuan, Mexico. Violence Against Women. 2015;21(4):478–99.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Miller-Perin C, Wurtele SK. Sex trafficking and the commercial sexual exploitation of children. Women Ther. 2017;40:123–51.

    Article  Google Scholar 

  6. Silverman JG, Servin A, Goldenberg SM, et al. Sexual violence and HIV infection associated with adolescent vs adult entry into the sex trade in Mexico. JAMA. 2015;314(5):516–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Grosso A, Busch S, Mothopeng T, et al. HIV risks and needs related to the sustainable development goals among female sex workers who were commercially sexually exploited as children in Lesotho. J Int AIDS Soc. 2018;21(S1):e25042.

    Article  PubMed Central  Google Scholar 

  8. Silverman JG. Adolescent female sex workers: invisibility, violence and HIV. Arch Dis Child. 2011;96(5):478–81.

    Article  PubMed  Google Scholar 

  9. Guardado Escobar ME, Oliva S, Hernández M, Peren J. Encuesta de medicion de prevalencia, comportamiento, actitudes, y practicas en poblaciones de mayor riesgo al VIH-sida en Guatemala [Measurement survey of the prevalence, behavior, attitudes, and practices of populations at high risk for HIV/AIDS in Guatemala]. TEPHINET, HIVOS, MSAPAS. 2017.

  10. Flores Reyna R, Montes Romero SM. Resultados del informe nacional de progreso de la respuesta contra el VIH y el sida [Results from the national progress report of the response against HIV/AIDS]. Comision Nacional del SIDA de Honduras (CONASIDA). 2015.

  11. Informe nacional de progreso en la lucha contra el sida—El Salvador [National progress report on the fight against AIDS—El Salvador]. Comision Nacional Contra el SIDA (CONASIDA). 2014.

  12. 2017 Guatemala country fact sheet. UNAIDS. 2017. https://www.unaids.org/en/regionscountries/countries/guatemala. Accessed 19 March 2020.

  13. USAID. HIV/AIDS health profile. USAID Latin America and the Caribbean Bureau. 2012.

  14. Morales-Miranda S, Alvarez-Rodríguez B, Aguilar J, Arambu A. Encuesta centroamericana de vigilancia de comportamiento sexual y prevalencia de ITS y VIH. Integrated bio-behavioral and surveillance survey 2013. Unidad de VIH Centro de Estudios en Salud Universidad del Valle de Guatemala. 2013.

  15. Morales-Miranda S, Jacobson JO, Loya-Montiel I, et al. Scale-up, retention and HIV/STI prevalence trends among female sex workers attending VICITS clinics in Guatemala. PLoS ONE. 2014;9(8):e103455.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Goldenberg SM, Strathdee SA, Perez-Rosales MD, Sued O. Mobility and HIV in Central America and Mexico: a critical review. J Immigr Minor Health. 2012;14(1):48–644.

    Article  PubMed  Google Scholar 

  17. UNICEF. Trafficking of persons for sexual exploitation in Guatemala. UNICEF & International Commission Against Corruption in Guatemala. 2016.

  18. Bliss K. Gender based violence in Latin America. Center for Strategic and International Studies. 2010. https://www.csis.org/blogs/smart-global-health/gender-based-violence-latin-america. Accessed 19 Mar 2020.

  19. McClure C, Chandler C, Bissell S. Responses to HIV in sexually exploited children or adolescents who sell sex. Lancet. 2015;385(9963):97–9.

    Article  PubMed  Google Scholar 

  20. UNHCR. Children on the run. The United Nations Refugee Agency. 2014. https://www.unhcr.org/56fc26d27.html. Accessed 19 Mar 2020.

  21. Goldenberg S, Silverman J, Engstrom D, Bojorquez-Chapela I, Strathdee S. "Right here is the gateway": mobility, sex work entry and HIV risk along the Mexico-US border. Int Migr. 2014;52(4):26–40.

    Article  PubMed  Google Scholar 

  22. Adanu RMK, Johnson TRB. Migration and women's health. Int J Gynaecol Obstet. 2009;106(2):179–81.

    Article  PubMed  Google Scholar 

  23. Rocha-Jiménez T, Brouwer KC, Silverman JG, Morales-Miranda S, Goldenberg SM. Migration, violence, and safety among migrant sex workers:a qualitative study in two Guatemalan communities. Cult Health Sex. 2016;18(9):965–79.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Rocha-Jimenez T, Brouwer KC, Salazar M, et al. He invited me and didn't ask anything in return” migration and mobility as vulnerabilities for sexual exploitation among female adolescents in Mexico. Int Migr. 2018;56(2):5–17.

    Article  Google Scholar 

  25. 2011 Trafficking in persons report - Guatemala. United States Department of State. 2011.

  26. Rocha Jimenez T, Salazar M, Boyce SC, Brouwer K, Staines Orozco H, Silverman JG. “We were isolated and we had to do whatever they said”: Violence and coercion to keep adolescents girls from leaving the sex trade in two US–Mexico border cities. J Hum Traffick. 2019;5(4):312–24.

    Article  Google Scholar 

  27. Platt L, Grenfell P, Fletcher A, et al. Systematic review examining differences in HIV, sexually transmitted infections and health-related harms between migrant and non-migrant female sex workers. Sex Transm Infect. 2013;89:311–9.

    Article  PubMed  Google Scholar 

  28. Morales-Miranda S, Álvarez B, Carrillo A, et al. Estudio etnográfico caracterización de riesgo para poblaciones en condiciones de vulnerabilidad: Mujeres trabajadoras sexuales [Ethnographic study characterizing risk for populations in vulnerable conditions: female sex workers]. Unidad de VIH del Centro de Estudios en Salud de la Universidad del Valle de Guatemala (CES-UVG). 2012.

  29. Johnson AM, Copas AJ, Erens B, et al. Effect of computer-assisted self-interviews on reporting of sexual HIV risk behaviours in a general population sample: a methodological experiment. AIDS. 2001;15(1):111–5.

    Article  CAS  PubMed  Google Scholar 

  30. Garcia-Moreno C, Watts C. Violence against women: an urgent public health priority. Bull World Health Organ. 2011;89:2–2.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Decker MR, Pearson E, Illangasekare SL, Clark E, Sherman SG. Violence against women in sex work and HIV risk implications differ qualitatively by perpetrator. BMC Public Health. 2013;13:876.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Rao J, Scott AJ. On chi-squared tests for multiway contingency tables with cell proportions estimated from survey data. Ann Statist. 1984;12(1):46–60.

    Article  Google Scholar 

  33. Jewell NP. Statistics for epidemiology. 1st ed. Boca Raton: Chapman and Hall/CRC; 2003. p. 159.

    Book  Google Scholar 

  34. SAS software. Version 9.4. SAS Institute, Inc. Cary, NC.

  35. Boyce SC, Brouwer KC, Triplett D, Servin AE, Magis-Rodriguez C, Silverman JG. 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. 2018;108(8):1049–54.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Penal Code 191, Decree number 17-73. The Republic of Guatemala. https://www.redipd.org/legislacion/common/legislacion/guatemala/Codigo_Penal_Guatemala.pdf. Accessed 19 Mar 2020.

  37. Ley contra la violencia sexual, explotación y trata de personas [law against sexual violence, exploitation, and trafficking of persons]. Republic of Guatemala Congress. Chapter 6; Article 35–46. 2009. https://svet.gob.gt/leyes/ley-contra-la-violencia-sexual-explotaci%C3%B3n-y-trata-de-personas. Accessed 19 Mar 2020.

  38. Goldenberg SM, Rocha Jiménez T, Brouwer KC, Morales Miranda S, Silverman JG. Influence of indoor work environments on health, safety, and human rights among migrant sex workers at the Guatemala-Mexico border: a call for occupational health and safety interventions. BMC Int Health Hum Rights. 2018;18(1):9.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Servin AE, Brouwer KC, Gordon L, et al. Vulnerability factors and pathways leading to underage entry into sex work in two Mexican-US border cities. J Appl Res Child. 2015;6(1):3.

    PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

This study was carried out in collaboration with the HIV Unit of the Center for Health Studies from the Universidad del Valle de Guatemala. The findings and conclusions in this report are those of the author(s) and do not necessarily represent the official position of the U.S. Centers for Disease Control and Prevention.

Funding

Presidential Emergency Plan for AIDS Relief (PEPFAR) through the U.S. Centers for Disease Control and Prevention (CDC), under the terms of Cooperative Agreement GH0000575.

Author information

Authors and Affiliations

  1. Center On Gender Equity and Health, School of Medicine, University of California -San Diego, La Jolla, CA, USA

    Sabrina C. Boyce, Julie Ritter, Daniel P. Triplett & Jay G. Silverman

  2. Consorcio de Investigación Sobre VIH SIDA TB CISIDAT, A.C., Morelos, México

    Sonia Morales-Miranda & Itzel Loya-Montiel

  3. Central Services Research Facility, University of California San Diego, 9500 Gilman Dr., La Jolla, CA, 92093, USA

    Sabrina C. Boyce

Authors
  1. Sabrina C. Boyce
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sonia Morales-Miranda
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Julie Ritter
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Daniel P. Triplett
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Itzel Loya-Montiel
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jay G. Silverman
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sabrina C. Boyce.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (University of California, San Diego School of Medicine, FWA00004495) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Boyce, S.C., Morales-Miranda, S., Ritter, J. et al. HIV Infection and Risk Heightened Among Female Sex Workers Who Entered the Sex Trade as Adolescents in Guatemala. AIDS Behav 24, 2906–2917 (2020). https://doi.org/10.1007/s10461-020-02841-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-020-02841-1

Keywords

Search

Navigation