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Although sex work and younger age increase HIV vulnerability, empirical data regarding the impacts of underage sex work are lacking. We explored associations between features of the risk environment, sex work and drug use history, and underage sex work entry among female sex workers FSWs in Tijuana and Ciudad Juarez, Mexico. Factors independently associated with increased odds of underage sex work were inhalants as the first drug used, forced first injection, number of drug treatment attempts, and recent receptive syringe-sharing.
Number of recent condom negotiation attempts with steady partners and depression as a reason for first injecting were negatively associated with underage entry. These results underscore the importance of efforts to prevent underage sex work and the wider factors contributing to HIV risk among vulnerable youth and underage FSWs. Sex work, defined as selling or trading sex for money, drugs, or other goods, represents a serious health concern among vulnerable youth.
The estimated prevalence of runaway and homeless youth who have been involved in sex work in North America ranges from percent 1 - 7. The health and social impacts of youth sex work include HIV infection and AIDS, sexually transmitted infections STIs , sexual victimization, physical violence and insecurity, substance use, and mental health disorders 2 - Among sex trafficked females in Nepal, those trafficked prior to age 15 years experienced over three and a half times higher odds of HIV infection than those trafficked as adults Among young injection drug users IDUs in Vancouver, sex work strongly predicted incident HCV infection, and younger age was associated with sex work, HIV infection, and female gender 12 , Research also suggests that early experiences play an important role in determining exposure to future risks.
However, data regarding the relationship between early experiences and future exposure to HIV risk among younger FSWs are scarce. Juarez, underage sex work is visibly widespread and practiced with the collaboration or knowledge of police. Substance use — especially injection drug use — is also a widespread and serious concern in Tijuana and Cd.
Juarez, where approximately 10, and IDUs live, respectively 39 , FSWs often use drugs to cope with the stressors of sex work, which can inhibit safer sex considerations, lead to desperation to obtain drugs, and increase the likelihood of acquiescing to unprotected sex Prior research in Mexico-U.