Sex-trafficking, Violence, Negotiating Skill, and HIV Infection in Brothel-based Sex Workers of Eastern India, Adjoining Nepal, Bhutan, and Bangladesh

National Institute of Cholera & Enteric Diseases, Beliaghata, Kolkata 700 010, India.
Journal of Health Population and Nutrition (Impact Factor: 1.04). 07/2008; 26(2):223-31.
Source: PubMed


A community-based cross-sectional study was conducted among brothel-based sex workers of West Bengal, eastern India, to understand sex-trafficking, violence, negotiating skills, and HIV infection in them. In total, 580 sex workers from brothels of four districts participated in the study. A pretested questionnaire was introduced to study their sociodemography, sex-trafficking, violence, and negotiating skills. Blood sample of 4-5 mL was collected from each sex worker using an unlinked anonymous method to study their HIV status. Data were edited and entered into a computer using the Epi Info software (6.04d version). Both univariate and multivariate analyses were done to find out any association between HIV and relevant risk factors. Results of the study revealed that a sizeable number of the participants were from Nepal (9%) and Bangladesh (7%). The seroprevalence of HIV was strikingly higher among Nepalese (43%) than among Bangladeshis (7%) and Indians (9%). Almost one in every four sex workers (24%) had joined the profession by being trafficked. Violence at the beginning of this profession was more among the trafficked victims, including those sold by their family members (57%) compared to those who joined the profession voluntarily (15%). The overall condom negotiation rate with most recent two clients was 38%. By multivariate analysis, HIV was significantly associated with sexual violence (odds ratio=2.3; 95% confidence interval 1.2-4.5). The study has documented that the trafficked victims faced violence, including sexual violence, to a greater magnitude, and sexual violence was associated with acquiring HIV in them. There is a need for an in-depth study to understand the problem of trafficking and its consequences.

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Available from: Kamalesh Sarkar,
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    • "Globally, those involved in the sex industry involuntarily or as adolescents experience disproportionately high rates of gender-based violence (Decker et al., 2011; Zimmerman et al., 2008), which is associated with HIV infection (Sarkar et al., 2008). Elevated HIV vulnerability among adolescents and those coerced to exchange sex has also been linked to trauma to an immature genital tract, which increases risk of HIV transmission among younger girls; unprotected sex as a result of limited autonomy and power over sexual transactions; and poor access to HIV prevention (e.g., condoms, information) and medical care (Decker et al., 2011; Sarkar et al., 2008; Silverman et al., 2007). Vulnerability to involuntary and adolescent sex exchange ultimately results from structural factors, including poverty, gender inequalities, stigma, and laws and policies surrounding immigration and sex work (Adams, 2003; Cicero-Domínguez, 2005; Gozdziak & Collett, 2005; Langberg, 2005; Poudel & Carryer, 2000; Sex Workers Project, 2009; Vijeyarasa, 2009; Vijeyarasa & Stein, 2010). "
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    ABSTRACT: Coerced and adolescent sex industry involvement are linked to serious health and social consequences, including enhanced risk of HIV infection. Using ethnographic fieldwork, including interviews with 30 female sex workers with a history of coerced or adolescent sex industry involvement, we describe contextual factors influencing vulnerability to coerced and adolescent sex industry entry and their impacts on HIV risk and prevention. Early gender-based violence and economic vulnerability perpetuated vulnerability to coercion and adolescent sex exchange, while HIV risk mitigation capacities improved with increased age, control over working conditions, and experience. Structural interventions addressing gender-based violence, economic factors, and HIV prevention among all females who exchange sex are needed. © The Author(s) 2015.
    Violence Against Women 02/2015; 21(4). DOI:10.1177/1077801215569079 · 1.33 Impact Factor
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    • "In cases of reported trafficking or coercion, sex workers have been found to be younger and more vulnerable at the time of entry compared to women entering for other reasons (Devine et al. 2010; Gupta et al. 2011). Women who report entering into sex work through trafficking or other coercive means have been found to have a higher client volume and be exposed to more violence in comparison to non-trafficked sex workers (George and Sabarwal 2013; Gupta et al. 2011; Sarkar et al. 2008; Wirth et al. 2013). A study of sex workers in the north-eastern state of Nagaland found that women entering sex work through a 'coerced pathway' – defined as '[b]eing forced, tricked or coerced into [sex work]' (Devine et al. 2010, 232) – as opposed to other pathways, were most likely to have dropped out of, or never attended, school and to be members of minority ethnic and/or religious groups. "
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    ABSTRACT: Evidence suggests that in India, the early stages of a woman's career as a sex worker may be an important period to target for HIV and sexually transmitted infection prevention. Before such an intervention is designed and implemented, it is necessary to first understand the life circumstances of women at the start of their sex work careers. We performed a review to bring together available literature pertaining to entry into sex work in India and to highlight knowledge gaps. We found that historical traditions of dedication into sex work, financial insecurity, family discord, violence and coercion, and desire for financial independence are commonly reported reasons for entering into sex work. We also found that families and the broader sex worker community play an important role in the early stages of a woman's sex work career. We suggest that HIV-prevention programmes in India would substantially benefit from a deeper understanding of the life circumstances of new and young women sex workers. Further research should be conducted focusing on family and community involvement in women's entry into sex work, and on the important period of time after a woman's first commercial sex encounter, but before self-identification as a sex worker.
    Culture Health & Sexuality 11/2013; 16(2). DOI:10.1080/13691058.2013.845692 · 1.55 Impact Factor
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    • "There is a wide range of research from India that highlights reasons for entry into prostitution. Sarkar et al. (2008) examined brothel-based women involved in prostitution in West Bengal, India and found that 68 percent of women joined the profession of their free will due to poverty. Moreover, 24 percent were found to have been trafficked, and 8 percent were forced to "
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    ABSTRACT: In this qualitative study, 48 female prostitutes from Mumbai, India were interviewed to understand their experiences related to their entry into prostitution. Respondents’ vulnerabilities and the role of family and acquaintances in entry were researched. The findings of the study indicate that poverty, marital abuse, sexual abuse and the death of a parent or husband were the main reasons for entry into prostitution. The majority of the respondents were sold into prostitution by family members or acquaintances. This research provides recommendations for policy, practice and research in the area of sex trafficking.
    International Social Work 07/2013; 56(4):496-515. DOI:10.1177/0020872811425804 · 0.48 Impact Factor
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