HIV/AIDS risk behavior of female sex workers in Mexico: Comparison of interviews with a cohort study in San Bernardino, California

Abstract

To compare exposure to Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS) by Mexican and Southern California female street sex workers (FSWs), 72 Intravenous Drug Using (IDU) FSWs in San Bernardino, California (1988) and 102 FSWs in four Mexican cities (1998) were interviewed. Both the American and Mexican FSWs were afraid of AIDS. However, the American FSWs were rarely tested for sexually transmitted diseases (STDs). Unlike their American counterpart, Mexican FSWs were usually not IDUs and knew less about HIV transmission. Still, the fear of AIDS and other STDs is not as much of a burning concern among FSWs south of the border because of the legalized prostitution system and use of condoms. Significant differences exist between the two groups at risk of exposure to HIV and other STDs because of the legal environment, sociology, and economics of street sex work. Prostitution is a means of livelihood for the Mexican FSWs compared with their American counterparts north of the border who engage in prostitution for drug money and are at greater risk for acquiring STDs. The inexorable conclusion of this study is that to reduce AIDS and other STDs among American FSWs, a Mexican‐style decriminalization of commercial sex work and registration system with needle‐exchange, free methadone, and heroin maintenance must be instituted in the U.S. However, political, economic, and moral constraints color the context of these decisions making them unlikely in the near term.