Epidemiology of Sex Trafficking, Drug Use and HIV at the U.S.-Mexico Border

Trafficking of women and girls into sex work, some of which involving drug cartels, is on the rise in the U.S. Mexico border region. Previous research by Dr. Silverman in South and Southeast Asia, and existing research, has established that entry into sex work via trafficking confers elevated HIV/STI risk. To prevent sex trafficking and reduce risk for HIV among women and girls who have been trafficked, data is required a) on how sex trafficking is occurring and what structures facilitate this crime, and b) on whether and how victims, once trafficked, are made vulnerable to HIV.

As an estimated 70% of FSWs in two major border cities, Tijuana and Ciudad Juarez, originate from other Mexican states or Central and South America. Dr. Silverman’s mix methods study assesses experiences of forced, coerced, and underage entry to the sex trade among FSW in these two cities, including looking at major structural factors such as police violence and northward migration that may affect both sex trafficking and HIV risk among trafficking victims. Preliminary findings from the study reveal that more than 1 in 4 female sex workers in these northern Mexican cities reported entering the sex trade as minors, which is associated with three times greater risk for HIV infection. Family dysfunction (domestic violence, parental drug use and neglect), physical and sexual abuse, and teen pregnancy appear to be key factors shaping girls’ vulnerability to underage entry into sex work and these vulnerabilities often combine to create a pathway that leads to underage entry.
*Funded by the National Institutes of Health/NIDA (R01 DA033194 01A1)


Silverman JG, Servin A, Goldenberg SM, Magis-Rodriguez C, Ritter J, Raj A, Brouwer KC. Sexual violence and HIV infection associated with adolescent vs adult entry into the sex trade in Mexico. Journal of the American Medical Association (JAMA). 2015;314:516-8.

Servin AE, Brouwer KC, Gordon L, Rocha-Jimenez T, Staines H, Vera-Monroy RB, Strathdee SA, Silverman JG. Vulnerability Factors and Pathways Leading to Underage Entry into Sex Work in two Mexican-US Border Cities. Journal of Applied Research on Children. 2015;6(.

Servin A, Brouwer K, Reed E, Magis-Rodriguez C, Boyce SC, Strathdee S, Silverman S. Motherhood and Risk for HIV/STIs among Female Sex Workers in the US - Mexico border region. Sexually Transmitted Diseases. In press.

Rocha-Jimenez T, Brouwer KC, Salazar M, Boyce SC, Servin A, Goldenberg SM, Staines-Orozco H, Vera-Monroy R, Silverman JG. “He invited me and didn’t ask anything in return” Migration and Mobility as Vulnerabilities for Sexual Exploitation among Female Adolescents in Mexico. J Urban Health. 2017. Online publication ahead of print.

Primary Investigator
Jay Silverman, PhD

Nicole Carter

Where We Work
  • Central America & Mexico
Related Work
  • Sex/Labor Trafficking