The Effect of Geography on HIV and Sexually Transmitted Infections in Tijuana’s Red Light District

Abstract

In Tijuana, Mexico, sex work is quasilegal and largely confined to the red light district (Zona Roja), a clustering of commercial sex establishments covering approximately 2.9 km2 around the city’s main tourist area.1 The majority of the estimated 9,000 female sex workers (FSWs) work in the Zona Roja where they are required to purchase work permits. However, nearly half are believed to work without permits.2,3 Some studies have examined the role of space in shaping epidemics of HIV and sexually transmitted infections (STIs) among FSWs;4,5 however, these findings do not generalize to settings where sex work is geographically concentrated within a formalized red light district. In a previous Tijuana study, a small number of bars accounted for a high proportion of HIV/STI prevalence among FSWs but excluded the large number of FSWs soliciting from public spaces, such as street corners.6 We extend this study by mapping the primary work location of FSWs in the Zona Roja. We hypothesized a decrease in HIV/STI risk among those working closer to the geographic center of the Zona Roja, where sex work is more commercialized and monitored.