I Will Never Go to Tijuana Brothels Again
Public Wellness Rep. 2010; 125(Suppl 4): 101–109.
A Comparison of Registered and Unregistered Female Sex Workers in Tijuana, Mexico
Nicole Sirotin
aPartitioning of Global Public Health, Department of Medicine, University of California—San Diego, La Jolla, CA
bAlbert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY
Steffanie A. Strathdee
aDivision of Global Public Health, Section of Medicine, Academy of California—San Diego, La Jolla, CA
Remedios Lozada
cPatronato Pro-COMUSIDA (Comité Municipal de Prevención del SIDA), Tijuana, Baja California, Mexico
Lucie Nguyen
aPartitioning of Global Public Wellness, Section of Medicine, Academy of California—San Diego, La Jolla, CA
Manuel Gallardo
dCAPASITS (Centros Ambulatorios de Prevención y Atención en SIDA e ITS), Tijuana, Baja California, Mexico
Alicia Vera
aSectionalization of Global Public Wellness, Department of Medicine, University of California—San Diego, La Jolla, CA
Thomas L. Patterson
eDepartment of Psychiatry, University of California—San Diego, La Jolla, CA
fVeterans Administration, San Diego Medical Center, San Diego, CA
SYNOPSIS
Objective
Sex work is regulated in Tijuana, Mexico, but only half of the urban center's female sex workers (FSWs) are registered with the municipal health department, which requires regular screening for sexually transmitted infections (STIs) and human immunodeficiency virus (HIV). We examined correlates of registration to determine if it confers measurable wellness benefits.
Methods
From 2004 to 2006, we interviewed FSWs in Tijuana ≥xviii years of historic period who reported recent unprotected sex with at least ane client and were not knowingly HIV-positive, and tested them for HIV, syphilis, gonorrhea, and chlamydia. Logistic regression identified factors associated with registration.
Results
Of 410 FSWs, 44% were registered, 69% had been tested for HIV, 6% were HIV-positive, and 44% tested positive for whatsoever STI. Compared with unregistered FSWs, registered FSWs were more likely to take had HIV testing (86% vs. 56%, p<0.001) and less likely to test positive for any STI (33% vs. 53%, p<0.001) or HIV (3% vs. eight%, p=0.039). Factors independently associated with registration included always having an HIV test (adjusted odds ratio [AOR] = 4.19) and earning >$30 per transaction without a condom (AOR=two.41), whereas working on the street (AOR=0.34), injecting cocaine (AOR=0.06), snorting or smoking methamphetamine (AOR=0.27), and being born in the Mexican state of Baja California (AOR=0.35) were inversely associated with registration.
Determination
Registered FSWs were more probable than unregistered FSWs to accept had HIV testing and to engage in less drug employ, just did not have significantly lower HIV or STI prevalence after adjusting for confounders. Current regulation of FSWs in Tijuana should exist further examined to enhance the potential public health benefits of registration.
Female sex workers (FSWs) stand for a vulnerable population at risk for human immunodeficiency virus (HIV) and sexually transmitted infections (STIs). Governments in many countries have regulated sex piece of work as a public health measure, and traditionally such regulation has focused on increasing condom use or STI diagnosis and treatment.1 In United mexican states, some cities (such equally Tijuana) annals FSWs, but the outcome such registration has on health outcomes is unknown.
Other countries accept shown success in decreasing HIV and STI rates through regulation of sexual practice work. In Thailand, the federal government's "100% prophylactic campaign" increased condom utilize in brothels from xiv% to 94% inside 5 years, and decreased HIV incidence from two.48 to 0.55 per 100 person-years and STI prevalence by 79% in men.2 – five Brothels that were not-compliant faced loss of their sexual activity-work license, which was a powerful incentive; nevertheless, this approach was less effective in increasing condom employ among FSWs not working in brothels.five , 6
Systems to screen and treat STIs among FSWs have been employed effectively in such low-resource settings equally Senegal,7 Kenya,8 Bolivia,9 and Côte d'Ivoire,x although show to uncrease their impact from other programs is lacking. A multi-city written report conducted amidst FSWs in the Dominican Republic evaluated the addition of regional regime sanctions to an intervention that included a 100% rubber campaign, improved STI screening and treatment, and women's empowerment and performance reports that were shared with brothel owners. Pregnant improvements in FSWs' self-reported ability to turn down unsafe sex and increment condom use with clients and intimate partners were observed simply in the metropolis that offered additional regime enforcement through sanctions. In the one regulated city, STI prevalence was reduced by 43%.11 , 12
Other models of legalization and registration of sexual practice workers be. In Nevada, legalized brothels require that FSWs undergo mandatory weekly testing for HIV and STIs,thirteen – 15 with brothel owners being held legally liable for clients who learn HIV from an FSW.16 , 17 In kingdom of the netherlands, FSWs are non registered with the authorities nor do they have mandatory wellness screenings, but STI clinics offering free, bearding STI testing.xviii
In Mexico, commercial sex is culturally accepted.nineteen United mexican states'due south 32 states have developed either abolitionist policies (Puebla, Guanajuato, and the Federal District), where sex work is a misdemeanor, or reglamentarist policies, where sex work is express to zones of tolerance (zonas rojas). The latter type of state, which includes the Mexico-U.S. border states of Baja California and Tamaulipas, requires that FSWs exist registered and subjected to regular health exams.xx , 21 Due to the unique characteristics of the border region—including the existence of zonas rojas, populations that are highly mobile, and major drug trafficking—several Mexico-U.S. border cities are experiencing rapidly escalating HIV epidemics.22
Due to Tijuana's proximity to San Diego, the city's zona roja is a destination for sex activity tourism.23 This area is in a neighborhood with the city's highest concentration of injection drug apply, HIV infection, and STIs.24 , 25 In Tijuana and Ciudad Juarez, prevalence of HIV, Neisseria gonorrhoeae (Due north. gonorrhoeae), Chlamydia trachomatis (C. trachomatis), and active syphilis among FSWs was six%, vi%, thirteen%, and 14%, respectively, in 2006.26 FSWs who inject drugs in these cities had an even higher prevalence of HIV (12%), and 46% had at least i STI.27
The municipal government of Tijuana has adult a organisation of regulation that issues registration cards to FSWs through the municipal wellness section (Servicios Médicos Municipales; future, MHD). Registration with the MHD costs $360 per person a twelvemonth; fee waivers are not provided. Monthly HIV testing and quarterly STI screening is mandated and occurs at the MHD. Women registering equally FSWs are treated with antibiotics co-ordinate to federal STI guidelines,28 and if they are found to exist HIV-positive, their registration cards are revoked, and they are referred to specialty care (Personal advice, Clark-Alfaro V, manager of the Binational Heart for Human Rights, Tijuana, Mexico, May 2009). At the time of this written report, approximately half of the city's 5,000 sex activity workers were registered with the MHD,29 enabling them to work legally in the zona roja. Enforcement of registration is hard; anecdotal reports indicate that some bars and dance halls require women to be registered to piece of work on their premises and, to evade such requirements, many women work on street corners, where they are often harassed past constabulary.30
No systematic evaluation of the sex activity-piece of work registration organization in Tijuana has been conducted. We hypothesized that registered FSWs would be more likely to always have had an HIV test and less likely to test positive for STIs and HIV than would unregistered FSWs. Due to the financial burden registration poses, nosotros likewise predicted that poorer women would be less likely to exist registered. To understand the role of government registration and health screening as public health measures, we compared the characteristics and health outcomes of registered vs. unregistered FSWs. These results will assist inform systems of sex-work regulation to effectively operate every bit public wellness programs.
METHODS
Population and settings
Tijuana, in the state of Baja California, United mexican states, is situated on the U.S. border and is dwelling to the busiest country border crossing in the world, with more than 46 million northbound crossings into San Diego per twelvemonth.31 Due to the development of the maquiladora (factory) manufacture and the proximity to the U.S., more than half of the metropolis's residents are migrants.32
From 2004 to 2006, 924 FSWs in Tijuana and Ciudad Juarez were enrolled in a behavioral intervention study to increase condom use, as previously described.33 Due to the lack of FSW registration in Ciudad Juarez, this assay was restricted to the 474 FSWs enrolled in Tijuana. FSWs were recruited by outreach workers and at customs health clinics. Eligibility requirements included aged ≥18 years (the legal historic period for sex work in Mexico); ability to give consent; having traded sexual practice for coin, goods, or drugs within the previous 2 months; and having had unprotected sex with at least one client in the last ii months. Because the intervention aimed to reduce HIV incidence, women who were knowingly HIV-infected were excluded.
Data drove
Castilian-speaking counselors conducted baseline interviews. Trained study nurses obtained venous blood samples and cervical swabs. Interview questions covered demographics, socioeconomic factors, working conditions, price per sex activity human action with and without condoms, and sexual and drug-related behaviors. In addtion, participants were asked, "Are you currently registered with the Tijuana MHD equally a sexual practice worker?" Participants were compensated $thirty for their fourth dimension for the baseline interview and brief intervention session. Institutional Review Boards at the University of California—San Diego and the Universidad Autónoma de Baja California in Tijuana reviewed and canonical the study protocol.
Laboratory evaluation
Specimen testing was conducted at the San Diego Canton Health Department. We used the Determine® rapid HIV antibody test (Abbott Pharmaceuticals, Boston, Massachusetts) to detect HIV antibodies; all positive tests were confirmed by enzyme immunoassay and western blot. N. gonorrhoeae and C. trachomatis were detected from cervical samples using the APTIMA Philharmonic two® collection device (Gen-Probe, San Diego). We used a rapid plasma reagin test (BD Macro-Vue™ RPR, Becton Dickinson, Cockeysville, Maryland) to detect antibody to Treponema pallidum (T. pallidum); positive samples were confirmed by T. pallidum hemagglutinin assay (Fujirebio, Wilmington, Delaware). Any level of syphilis titer was considered consistent with prior or latent infection; titers ≥one:8 were considered consequent with active infection.34 We provided all examination results to participants; those with positive results were referred to the MHD for free treatment and follow-up.
Statistical analyses
Statistical assay compared FSWs who reported being registered with the MHD to those who were non, using Wilcoxon's rank sum for continuous variables and Fisher'due south exact exam for dichotomous variables. To preserve statistical power, we generated a combined measure out reflecting exam results for HIV and whatever STIs. We used univariate and multivariate logistic regression to evaluate factors associated with registration using manual, astern stepwise elimination; variables attaining p<0.10 significance in univariate analysis were considered in the multivariate regression, retaining only variables achieving p<0.05 significance in the final model.
RESULTS
Of 474 FSWs enrolled, registration information were missing from 64 (14%), and these participants were appropriately excluded from the analysis. Of the 410 FSWs remaining, 181 (44%) were currently registered with the MHD.
Demographic and socioeconomic factors
Tabular array 1 shows the baseline demographic, socioeconomic, and working atmospheric condition of the 410 FSWs. The median age was 32 (interquartile range [IQR]: 25–38), and about women were migrants to Baja California (78%). Less than i-5th were married (19%). Although the majority had children (92%) and listed children every bit financial dependents (73%), only one-3rd rated themselves as in a bad financial situation (34%). In general, participants had little formal education, with a median of six years, and almost did non speak any English (74%).
Table one.
Characteristics of registered and unregistered FSWs in Tijuana, Mexico (due north=410)a
Compared with registered FSWs, unregistered FSWs were more probable to be native to Baja California (30% vs. 11%, p<0.001), to have worked longer in the sex trade (median four years vs. three years, p<0.001), and to rate their fiscal situation equally bad (41% vs. 25%, p<0.001). Interestingly, registered FSWs were twice as probable every bit unregistered FSWs to have more two financial dependents (51% vs. 33%, p<0.001) and to alive with a greater number of people (median 2.0 vs. 1.0, p<0.001). Historic period did non differ significantly between the groups.
Working conditions
Overall, most FSWs worked in a bar (61%) for a mean of 44 hours per calendar week, and only well-nigh one-fifth (21%) rated their working weather condition as good. Registered FSWs were more likely than unregistered FSWs to piece of work in an institution such equally a bar (77% vs. 49%, p<0.001) or live and work in the same place (22% vs. 11%, p=0.004) as opposed to working on the street (29% vs. 70%, p<0.001). There were no statistically significant differences between registered and unregistered FSWs in terms of their working at brothels, hotels, or shooting galleries (a designated place where drugs are purchased and used). Registered FSWs earned significantly more than money per transaction than unregistered FSWs for sex both with a condom (earning >$xxx per transaction, 59% vs. 23%, p<0.001) and without a condom (earning >$thirty per transaction, 74% vs. 44%, p<0.001) (Tabular array 1).
HIV-related risk behaviors
Table two shows the overall adventure behaviors and prevalence of STIs and HIV in our sample. The median number of unprotected vaginal sex acts in the last calendar month was five (IQR: 2–14). One-5th of the sample had always injected drugs, and almost 40% had used methamphetamine in the last month. Interestingly, compared with unregistered FSWs, registered FSWs had lower risk profiles for both sexual and drug-related behaviors, and fewer sex activity partners in the last month (median: seventy vs. 145, p<0.001). As for drug-related risk behaviors, registered FSWs were less likely than unregistered FSWs to report ever having injected drugs (8% vs. 31%, p<0.001), having clients who currently use drugs (62% vs. 83%, p<0.001), or having had a sexual activity partner who had always injected drugs (vii% vs. 25%, p<0.001).
Table 2.
Risk behaviors and STIs of registered and unregistered FSWs in Tijuana, Mexico (north=410)a
Prevalence of HIV and STIs
More than ii-thirds had been tested for HIV prior to enrollment (69%); 6% tested HIV-positive at enrollment, and virtually half tested positive for at to the lowest degree 1 STI (44%). Compared with unregistered FSWs, registered FSWs were more probable ever to have been tested for HIV (86% vs. 56%, p<0.001) and less likely to test positive for HIV (3% vs. viii%, p=0.039), gonorrhea (4% vs. 12%, p=0.005), syphilis (any titer) (18% vs. 40%, p<0.001), or any STI (including HIV) (33% vs. 53%, p<0.001). However, prevalence of agile syphilis (titer ≥1:eight) and chlamydia were like in both groups (Table 2).
Factors independently associated with FSW registration
Factors associated with FSW registration identified in univariate and multivariate regression models are shown in Tabular array 3. In univariate analyses, factors associated with increased odds of registration included having a greater number of people living with 1, living and working in the aforementioned location, earning more money for sexual transactions with a condom, and always having been tested for HIV. Factors inversely associated with registration included having migrated to Baja California; working on the street; having clients who inject drugs; ever having injected drugs; injecting cocaine; non-injection utilize of methamphetamine; and testing positive for HIV, syphilis, gonorrhea, or any STI (including HIV). Variables not associated with registration were age, lifetime duration of sex work, and the pct of unprotected sex acts with clients.
Table 3.
Selected factors associated with FSW registration in Tijuana, United mexican states
In multivariate analyses, four factors were found to be independently associated with elevated odds of registration. FSWs who were registered were more likely e'er to take had an HIV test (adjusted odds ratio [AOR] = four.19; 95% confidence interval [CI] 2.33, vii.54) and to brand more money (>$30) per transaction without a condom (AOR=2.41; 95% CI 1.39, 4.17). They also were more than likely to live with more people (AOR=1.26; 95% CI 1.eleven, one.43) and live and piece of work in the same identify (AOR=ii.33; 95% CI 1.ten, four.95). In addition, 4 factors were inversely associated with registration, including working on the street (AOR=0.34; 95% CI 0.20, 0.59), injecting cocaine (AOR=0.06; 95% CI 0.01, 0.59), snorting or smoking methamphetamine (AOR=0.27; 95% CI 0.16, 0.47), and having been born in Baja California (AOR=0.35; 95% CI 0.17, 0.70). To eliminate the effects of collinearity, we repeated the model, removing the variable for previous HIV testing, and the remaining variables and their respective parameter estimates were essentially unchanged.
Give-and-take
In examining the arrangement for regulating FSWs in Tijuana, we establish that registration with the MHD was associated with college odds of HIV testing, as i would expect, but registration was not associated with lower risk of testing positive for HIV or STIs, afterwards adjusting for other confounders associated with registration.
We identified 2 patterns related to sex-worker registration that have implications for HIV and STI prevention and policies. First, registered FSWs tended to work in venue-based establishments, lived and worked in the same location, and earned more than money per transaction. Conversely, women who worked primarily on the street were less likely to exist registered, equally were FSWs who injected drugs and those who used stimulants (i.e., cocaine or methamphetamine). These results provide the first analysis of the current organization of regulation of FSWs on the United mexican states-U.S. border and offering an opportunity to inform HIV-prevention efforts in this region.
Considering HIV testing is a requirement for all women who are registered, nosotros expected that 100% of registered women would take been tested, instead of 85%, as reported by our participants. This may imply that FSWs, or the establishments for which they work, are finding a way to buy a registration carte and bypass the regulation system, or the FSWs may be unaware that they have been tested. These findings also may indicate that HIV testing is not a strong motivator for FSWs to register with the MHD. Although registered FSWs are more likely to accept been tested for HIV, registration did not ultimately serve as an independent predictor of lower STI and HIV prevalence. Earlier studies in the Philippines have as well showed that STI screening and treatment, in the absence of other prevention -strategies, are not effective for long-term control of STIs or HIV in sex workers.1 , 35
As in previous studies, sex-work venue was an of import correlate of registration, with street-based sex activity workers being less likely to be registered.6 , 36 This finding highlights three important observations. First, street-based sex workers often take higher risk profiles, and they may have decreased access to condoms and fewer contacts with screening and treatment services for HIV and STIs. The current registration organisation may be excluding sex workers who operate outside of a specific venue, and thus the MHD may not be reaching women at highest risk for HIV and STIs. Because street-based FSWs are more than likely to exist infected with HIV and STIs and to use drugs,37 efforts are needed to achieve out to these women, who may fright they volition be denied registration if they test HIV-positive. Since our study was conducted, a mobile HIV-prevention campaign has been initiated in Tijuana, representing a partnership betwixt a local nongovernmental system and the municipal, land, and federal governments.22 Efforts such as these may encourage FSWs to seek testing for HIV and other STIs without fear of repercussions.
The HIV epidemic among FSWs living in some United mexican states-U.S. border cities has increased rapidly in the last 10 years, especially among FSWs who inject drugs.26 , 27 Our study plant that unregistered women were more than likely to have injected drugs and peculiarly more likely to take used stimulants in the last month. Previous studies found that both injection of cocaine and non-injection utilise of methamphetamine are associated with high-risk sexual beliefs in FSWs and are independently associated with HIV infection.26 , 38 , 39 This supports the hypothesis that the current registration system is not serving the wellness needs of street-based, drug-using FSWs, who are at highest risk for HIV and STIs.
A novel finding in our written report was the human relationship betwixt income and registration. Registered sex workers earned more coin per sexual activity act compared with unregistered FSWs. This finding has significance for the goal of addressing social determinants of health amid sex workers. Poverty, income inequality, and decreased social upper-case letter accept been linked to women's decisions to engage in risky transactional sexual activity.40 – 43 At the Mexico-U.S. edge, fiscal need is a major motivation for women to initiate and proceed in sex activity work.23 In add-on to depressed economic condition, FSWs at the border have other poverty-related take a chance factors for HIV, such as depression educational level, multiple financial dependents, low literacy, and inconsistent knowledge of HIV and STIs.23 , 26 Due to the heavy burden that the price of registration may pose for some FSWs, it is possible that the system is price-prohibitive to poorer sex workers, who make less money per transaction, further marginalizing these at-take a chance women.
Lastly, migration condition was an important correlate of registration. Unregistered women were more than likely to have been born in Baja California. This finding is interesting in light of newer data associating time spent in Tijuana with take chances behavior and HIV prevalence. In a study evaluating injection drug users who had recently been deported or who had migrated to Tijuana, the odds of HIV infection among females increased with time spent in Tijuana, but the tendency was contrary among males.44 Our findings may suggest that women who are migrants to Tijuana are routed into sex work through establishments (such as bars) that may encourage them to go registered.
Limitations
Several limitations with our written report should be noted. Commencement, the study's cantankerous-sectional nature does not let us to draw causal inferences. Second, because the population was recruited via convenience sampling and the eligibility criteria for the subsequent intervention report required that women have had recent unprotected sex with clients, our sample likely had a higher risk profile than the general FSW population in Tijuana or other border cities. Our study included FSWs from Tijuana merely and may not be generalizable to other cities, although the most mutual Mexican FSW workplace venues were represented. Participants were all ≥18 years of age (18 existence the legal historic period for FSW registration in Mexico); therefore, our results do non address the bug of underage sex workers.
Although participants were asked if they were registered with the MHD, nosotros were unable to confirm if women who were registered actually sought services from the department. In that location is potentially a reporting bias toward registration, if the women feared penalties in being unregistered; all the same, we found little evidence of reporting bias in other sensitive areas, with many women reporting unprotected vaginal sex with clients and drug apply.
Finally, our study did not arm-twist details on cost of the registration carte. Since this study was completed, the cost has reportedly increased from $360 per person per year to $450 per person per yr (Personal communication, Clark-Alfaro V, director of the Binational Centre for Man Rights, Tijuana, Mexico, May 2009). Future studies will address how the cost of the registration card may affect which women are registered, if the increase in cost has deterred registration, and if anyone other than the sex worker herself is paying for the card.
Decision
Systems for regulating sex activity piece of work constitute an important public health mensurate in settings where HIV and other STIs are rising, equally they are in Tijuana. Our report suggests that the current organisation of registration of FSWs in Tijuana focuses on screening and treatment of HIV and STIs and may be structured in such a way that it excludes the highest take a chance subgroups, specially FSWs who are street-based and those who inject drugs or employ stimulants. Future strategies to ensure the well-nigh vulnerable FSWs are reached might include an integrated model of rapid screening and treatment for HIV and STIs using mobile clinics and partner notification, and incorporating active or former FSWs as promotoras (indigenous outreach workers). Consideration should also be given to models incorporating incentivized or enforced condom employ, which has been found to be successful in other settings.2 – half-dozen , 11 , 12 With regard to the latter, an important lesson should be gleaned from the Dominican Republic, where effectiveness was potentiated when a combined approach to prevention was grounded in female and community empowerment.11 , 12 Efforts to reach the nearly marginalized segments of the sexual practice-worker population are likely to succeed when they have gained the community's trust, rather than their fright or antipathy.
Acknowledgments
The authors thank the staffs of Patronato Pro-COMUSIDA, CAPASITS, the municipal and state health departments of Tijuana and Baja California, and the San Diego County Health and Homo Services Bureau. The authors also give special thanks to the participants for their time and cooperation.
Footnotes
Funding for this written report was provided by National Institutes of Health grants R01 MH065849 (T.50. Patterson) and T32 DA023356 (S.A. Strathdee).
REFERENCES
1. Steen R, Dallabetta G. Sexually transmitted infection control with sexual activity workers: regular screening and presumptive handling augment efforts to reduce hazard and vulnerability. Reprod Health Matters. 2003;11:74–90. [PubMed] [Google Scholar]
2. Celentano DD, Nelson KE, Lyles CM, Beyrer C, Eiumtrakul Due south, Go VF, et al. Decreasing incidence of HIV and sexually transmitted diseases in immature Thai men: testify for success of the HIV/AIDS command and prevention program. AIDS. 1998;12:F29–36. [PubMed] [Google Scholar]
3. Rojanapithayakorn W, Hanenberg R. The 100% condom program in Thailand. AIDS. 1996;x:1–7. [PubMed] [Google Scholar]
4. Hanenberg RS, Sokal DC, Rojanapithayakorn Westward, Kunasol P, Sokal DC. Affect of Thailand's HIV-control plan equally indicated by the pass up of sexually transmitted diseases. Lancet. 1994;344:243–five. [PubMed] [Google Scholar]
v. Nelson KE, Celentano DD, Eiumtrakol S, Hoover DR, Beyrer C, Suprasert Due south, et al. Changes in sexual behavior and a decline in HIV infection among young men in Thailand. Northward Engl J Med. 1996;335:297–303. [PubMed] [Google Scholar]
half dozen. Morris M, Pramualratana A, Podhisita C, Wawer MJ. The relational determinants of condom utilise with commercial sex partners in Thailand. AIDS. 1995;9:507–15. [PubMed] [Google Scholar]
7. Meda N, Ndoye I, M'Boup S, Wade A, Ndiaye South, Niang C, et al. Low and stable HIV infection rates in Senegal: natural course of the epidemic or evidence for success of prevention? AIDS. 1999;xiii:1397–405. [PubMed] [Google Scholar]
8. Kaul R, Kimani J, Nagelkerke NJ, Fonck Grand, Ngugi EN, Keli F, et al. Monthly antibiotic chemoprophylaxis and incidence of sexually transmitted infections and HIV-1 infection in Kenyan sex workers: a randomized controlled trial. JAMA. 2004;291:2555–62. [PubMed] [Google Scholar]
9. Levine WC, Revollo R, Kaune Five, Vega J, Tinajeros F, Garnica Chiliad, et al. Decline in sexually transmitted disease prevalence in female Bolivian sex workers: touch of an HIV prevention project. AIDS. 1998;12:1899–906. [PubMed] [Google Scholar]
10. Ghys PD, Jenkins C, Pisani E. HIV surveillance amongst female sex workers. AIDS. 2001;15(Suppl 3):S33–twoscore. [PubMed] [Google Scholar]
11. Kerrigan D, Ellen JM, Moreno L, Rosario S, Katz J, Celentano DD, et al. Environmental-structural factors significantly associated with consistent rubber use among female sex workers in the Dominican Republic. AIDS. 2003;17:415–23. [PubMed] [Google Scholar]
12. Kerrigan D, Moreno Fifty, Rosario South, Gomez B, Jerez H, Barrington C, et al. Environmental-structural interventions to reduce HIV/STI risk among female person sex workers in the Dominican Commonwealth. Am J Public Wellness. 2006;96:120–5. [PMC costless article] [PubMed] [Google Scholar]
13. Albert AE, Warner DL, Hatcher RA. Facilitating condom use with clients during commercial sex in Nevada'southward legal brothels. Am J Public Health. 1998;88:643–6. [PMC complimentary commodity] [PubMed] [Google Scholar]
14. Albert AE, Warner DL, Hatcher RA, Trussell J, Bennett C. Condom use among female commercial sex activity workers in Nevada's legal brothels. Am J Public Wellness. 1995;85:1514–twenty. 1992. [PMC costless article] [PubMed] [Google Scholar]
xv. Nevada Authoritative Code. 441A.800. Testing of prostitutes; prohibition of certain persons from employment every bit prostitute.
16. Brents BG, Hausbeck M. Violence and legalized brothel prostitution in Nevada: examining safety, take a chance, and prostitution policy. J Interpers Violence. 2005;20:270–95. [PubMed] [Google Scholar]
17. Brents BG, Hausbeck K. State-sanctioned sex activity: negotiating formal and informal regulatory practices in Nevada brothels. Sociol Perspect. 2001;44:307–32. [Google Scholar]
eighteen. Brants C. The fine art of regulated tolerance: prostitution in Amsterdam. J Constabulary Soc. 1998;25:621–35. [Google Scholar]
19. Carrier JM. Mexican male bisexuality. J Homosex. 1985;xi:75–85. [PubMed] [Google Scholar]
20. Uribe-Zúñiga P, Hernández-Tepichín Thou, del Río-Chiriboga C, Ortiz V. [Prostitution and AIDS in the city of Mexico] Salud Publica Mex. 1995;37:592–601. [PubMed] [Google Scholar]
21. del Rio C, Sepúlveda J. AIDS in Mexico: lessons learned and implications for developing countries. AIDS. 2002;16:1445–57. [PubMed] [Google Scholar]
23. Bucardo J, Semple SJ, Fraga-Vallejo Grand, Davila W, Patterson TL. A qualitative exploration of female sex work in Tijuana, United mexican states. Arch Sexual activity Behav. 2004;33:343–51. [PubMed] [Google Scholar]
24. Brouwer KC, Case P, Ramos R, Magis-Rodríguez C, Bucardo J, Patterson TL, et al. Trends in production, trafficking, and consumption of methamphetamine and cocaine in Mexico. Subst Use Misuse. 2006;41:707–27. [PMC gratis article] [PubMed] [Google Scholar]
25. Strathdee SA, Fraga WD, Case P, Firestone Thou, Brouwer KC, Perez SG, et al. "Vivo para consumirla y la consumo para vivir" ["I live to inject and inject to live"]: high-run a risk injection behaviors in Tijuana, Mexico. J Urban Health. 2005;82(3 Suppl 4):iv58–73. [PMC costless commodity] [PubMed] [Google Scholar]
26. Patterson TL, Semple SJ, Staines H, Lozada R, Orozovich P, Bucardo J, et al. Prevalence and correlates of HIV infection amid female sexual activity workers in 2 Mexico-Us border cities. J Infect Dis. 2008;197:728–32. [PMC free article] [PubMed] [Google Scholar]
27. Strathdee SA, Philbin MM, Semple SJ, Pu Grand, Orozovich P, Martinez G, et al. Correlates of injection drug use among female person sex workers in two Mexico-U.S border cities. Drug Alcohol Depend. 2008;92:132–40. [PMC free article] [PubMed] [Google Scholar]
28. Secretaría de Salud. Norma oficial Mexicana NOM-039-SSA2-2002, para la prevención y command de las infecciones de transmisión sexual [Mexican federal guidelines for the treatment of STIs—2002] [cited 2010 Feb three]. Bachelor from: URL: http://www.salud.gob.mx/unidades/cdi/nom/039ssa202.html.
29. Patterson TL, Semple SJ, Fraga G, Bucardo J, de la Torre A, Salazar J, et al. Comparison of sexual and drug employ behaviors between female sex activity workers in Tijuana and Ciudad Juarez, Mexico. Subst Use Misuse. 2006;41:1535–49. [PubMed] [Google Scholar]
30. Ojeda VD, Strathdee SA, Lozada R, Rusch ML, Fraga Grand, Orozovich P, et al. Associations between migrant status and sexually transmitted infections amid female person sex workers in Tijuana, United mexican states. Sexual activity Transm Infect. 2009;85:420–6. [PMC costless commodity] [PubMed] [Google Scholar]
32. Instituto Nacional de Estadística y Geografía (INEGI) Resultados preliminares del XII censo nacional de población y vivienda 2000 [Preliminary results for the XII national population and housing demography 2000] [cited 2010 Feb 3]. Available from: URL: http://www.inegi.org.mx/est/contenidos/Proyectos/ccpv/cpv2000/default.aspx.
33. Patterson TL, Mausbach B, Lozada R, Staines-Orozco H, Semple SJ, Fraga-Vallejo M, et al. Efficacy of a cursory behavioral intervention to promote condom utilise among female person sexual activity workers in Tijuana and Ciudad Juarez, United mexican states. Am J Public Health. 2008;98:2051–7. [PMC free article] [PubMed] [Google Scholar]
34. Golden MR, Marra CM, Holmes KK. Update on syphilis: resurgence of an onetime problem. JAMA. 2003;290:1510–4. [PubMed] [Google Scholar]
35. Wi T, Ramos ER, Steen R, Esguerra TA, Roces MC, Lim-Quizon MC, et al. STI declines among sex activity workers and clients following outreach, one time presumptive handling, and regular screening of sexual practice workers in the Philippines. Sex Transm Infect. 2006;82:386–91. [PMC free article] [PubMed] [Google Scholar]
36. Shahmanes M, Patel V, Mabey D, Cowan F. Effectiveness of interventions for the prevention of HIV and other sexually transmitted infections in female sexual practice workers in resources poor setting: a systematic review. Trop Med Int Health. 2008;13:659–79. [PubMed] [Google Scholar]
37. Larios SE, Lozada R, Strathdee SA, Semple SJ, Roesch South, Staines H, et al. An exploration of contextual factors that influence HIV risk in female person sexual practice workers in United mexican states: the Social Ecological Model applied to HIV risk behaviors. AIDS Care. 2009;21:1335–42. [PMC free commodity] [PubMed] [Google Scholar]
38. Drumright LN, Colfax GN. HIV adventure and prevention for non-injection substance users. In: Mayer KH, Pizer HF, editors. HIV prevention: a comprehensive arroyo. London: Elsevier/Academic Press; 2009. pp. 340–75. [Google Scholar]
39. Lorvick J, Martinez A, Gee L, Kral AH. Sexual and injection take a chance among women who inject methamphetamine in San Francisco. J Urban Health. 2006;83:497–505. [PMC free article] [PubMed] [Google Scholar]
40. Holtgrave DR, Crosby RA. Social capital, poverty, and income inequality as predictors of gonorrhoea, syphilis, chlamydia and AIDS case rates in the United States. Sex Transm Infect. 2003;79:62–4. [PMC free commodity] [PubMed] [Google Scholar]
41. Gillespie S, Kadiyala Due south, Greener R. Is poverty or wealth driving HIV transmission? AIDS. 2007;(21 Suppl 7):S5–16. [PubMed] [Google Scholar]
42. Putnam R. Social capital: measurement and consequences. Can J Policy Res. 2001;two:41–51. [Google Scholar]
43. Weiser SD, Leiter Grand, Bangsberg DR, Butler LM, Percy-de Korte F, Hlanze Z, et al. Nutrient insufficiency is associated with high-take chances sexual behavior amongst women in Botswana and Swaziland. PLoS Med. 2007;4:1589–97. give-and-take 1598. [PMC free article] [PubMed] [Google Scholar]
44. Strathdee SA, Lozada R, Ojeda VD, Pollini RA, Brouwer KC, Vera A, et al. Differential furnishings of migration and deportation on HIV infection among male and female injection drug users in Tijuana, Mexico. PLoS I. 2008;iii:e2690. [PMC free article] [PubMed] [Google Scholar]
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Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2882980/
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