High rates of sex trade and drug use, and the intersection of these, exacerbate the spread of HIV in Tijuana, the largest Mexican city bordering the US. Poor socioeconomic conditions are the primary driver of sex work initiation in Tijuana, as well as elsewhere. Our previous research in South Asia has established that economic debt is not only significant in terms of women’s initiating sex trade, but is also associated with elevated HIV/STI risk among female sex workers (FSW). This work indicated that the vast majority of FSW have debt (80%) and that debt appears to reduce women’s condom negotiating power with clients and increases women’s experiences of gender-based violence, both increasing HIV risk. The prevalence, nature, and effects of debt in the US-Mexico border region likely differs significantly from that of South Asia, as a result of the intersecting influence of drug use and debt on HIV risk. Thus, this project aims 1) to describe the prevalence, nature, and magnitude of debt, 2) to examine the relation between debt and HIV risk among FSW in Tijuana, and 3) to assess the contribution of drug use to debt and how this translates to increased HIV risk.
*Funded by the Center for Aids Research, University of California, San Diego
Reed, E., Gupta, J., Biradavolu, M., Devireddy, V., & Blankenship, K.M. The context of economic insecurity and relation to violence and risk factors for HIV among female sex workers in Andhra Pradesh, India. Public Health Reports. 2010;125(Suppl 4): 81–89.