Transient India Sex Trade Threatens Faster HIV Pace

By Gilbert Le Gras

WASHINGTON (Reuters) – India’s transient sex trade is one of South Asia’s biggest challenges in the fight against HIV, with difficulties tracking sex workers and customers, the World Bank said in a report on Monday.

"A high proportion of female sex workers in India move, often as frequently as every two weeks," said the bank’s "AIDS in South Asia" report prepared for the 16th International Aids Conference in Toronto, Canada.

"Clients of female sex workers are also highly mobile … increasing the pace at which high-risk networks are linked, and this pattern can amplify local epidemics," the report added.

India accounts for about 40 percent of all Asia’s population and has more than 60 percent of the continent’s estimated HIV infections, according to UNAIDS 2004, a global report on the AIDS epidemic.

Mobility is also a key factor in HIV’s spread among injecting drug users in northern India as well as Afghanistan, Pakistan and Bangladesh, countries between the Gold Crescent and Golden Triangle opium poppy growing regions, it added.

There are about 5.5 million people infected with HIV in South Asia. One study found evidence that HIV prevalence is declining in some southern Indian states, possibly because many young women are using condoms in commercial sex, it said.

But a big risk is in following up on sex trade workers and clients.

"Programming for mobile sex workers presents tactical challenges, given the difficulty of maintaining continuous outreach and peer education and condom supplies," it said.

Nepal, from where a high number of women migrate or are trafficked to work in India’s sex trade, appears to have the potential for a "substantial epidemic" among high-risk groups.

Sex workers returning to Nepal from Mumbai have much higher HIV prevalence and returning to their home country’s sex trade could quickly ramp up HIV prevalence there, the report said.

"Preventing HIV infection among sex workers in Nepal would certainly be more effective if they were coordinated with efforts in India focusing on migration and sex worker trafficking, especially in Mumbai, said report co-author Mariam Claeson.