Sexual and drug use behaviors associated with HIV and other sexually transmitted infections among female sex workers in the Mexico–US border region

Abstract

The purpose of this review is to summarize the latest research regarding HIV/sexually transmitted infection (STI) risk among female sex workers (FSWs) along the Mexico-US border. Although Mexico has a low prevalence of HIV overall, HIV prevalence among FSWs in Tijuana is quite high, and even higher among FSWs who inject drugs (FSW-IDUs). Efforts to better understand and curtail the HIV epidemic among FSWs in this region are greatly needed. A brief HIV/STI risk reduction intervention for FSWs was successful in decreasing HIV/STI sexual risk behavior with clients among FSWs in Tijuana and Ciudad Juarez, Mexico. However, the intervention was less effective among FSW-IDUs, and had no effect on FSWs' condom use with their noncommercial partners. Whereas the majority of research thus far has focused on FSWs' individual-level risk factors, comparatively less is known about their clients and noncommercial sexual partners who may heavily influence their behavior, and engage in high-risk behaviors themselves. Further studies including FSWs' intimate partners and clients are needed as well as interventions specific to FSW-IDUs. Targeting the most at-risk populations and reducing both sexual and injection-risk behaviors simultaneously may curb the growing HIV epidemic in the Mexico-US border region.