Date of Award

11-15-2006

Document Type

Thesis

Degree Name

Medical Doctor (MD)

First Advisor

Kaveh Khoshnood

Abstract

Sex trafficking, recognized by the United Nations as a major human rights violation, disproportionately affects women and girls in Asia. To date, little research has investigated the health status and health needs specifically among sex trafficked women and girls (STWG). This report will assess general and reproductive health concerns including HIV prevalence among STWG recently rescued from brothels in Mumbai, India, and identify associations with age at trafficking and time spent in brothel. We hypothesize that among somatic complaints, reproductive health needs predominate and are largely unmet with a positive association of HIV infection with young age at trafficking and longer duration in brothels. 195 medical records of STWG rescued from various Mumbai brothels by a non-governmental organization (NGO) were retrospectively reviewed for demographics, trafficking experiences, and HIV status. All subjects indicated that they had been tricked and/or forced into commercial sex work. Once rescued, they received a detailed health check-up by an NGO affiliated health care professional, and were tested for HIV. Participants ranged in age from 9 to 30 years (mean age =18.8 years, sd = 3.3 years). Age at trafficking varied from 8 to 29 years (mean age = 17 years, sd = 3.4 years). 29% of rescued STWG were married, 62% were illiterate, and an additional 20% indicated an education of grade 6 or less. Approximately half (51%) originated from India, 27% from Nepal, and 3% were from Bangladesh. Of those indicating their length of time at the brothel, 22% had been there 1 month or less, 45% had been there for between 2 months to 1 year, and the remaining 33% had been at the brothel for a year or more. On average, women and girls provided services to 6.9 clients/day (sd = 3.1) averaging 8.9 hours (sd =2.9) of work per day. Reproductive health concerns were the predominant health issues in this sample accounting for 42.5% of all concerns; 29.2% of STWG were found to have a urinary tract infection based on self reported symptoms while 11.8% complained of abnormal vaginal discharge. Over one quarter (25.2%) were found to be HIV positive. Women trafficked at younger ages were more likely to be found to have HIV (p=0.003). Brothel duration was significantly associated with positive HIV status; a 3% increased risk of HIV was found for each additional month of brothel duration (OR = 1.03, CI= 1.01-1.06, p<0.05). There exists sparse knowledge on the health and health needs of STWG. These findings indicate large unmet health needs, and a high prevalence of HIV infection among sex trafficking victims; further, this risk appears to be exacerbated by young age at trafficking and increased brothel duration. Findings will be discussed in the context of related health needs of STWG with recommendations on the development of appropriate health management programs for this population.

Comments

This thesis is restricted to Yale network users only. This thesis is permanently embargoed from public release.

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