A study comparing sexually transmitted infections and hiv among ex-red-light district and non-red-light district sex workers after the demolition of baina red-light district

OBJECTIVES: In June 2004, the red-light area of Goa was demolished. We compare HIV and sexually transmitted infections (STIs) between sex workers who had been based in Baina red-light district (ex-RLD-SWs) with sex workers who had never worked in Baina (non-RLD-SWs). METHODS: Three hundred twenty-six sex workers recruited using respondent-driven sampling, completed interviewer-administered questionnaires, and were tested for Trichomonas vaginalis, Neisseria gonorrhoeae, Chlamydia trachomatis, and antibodies to HIV. The association between ever working in Baina red-light area and HIV and STIs was examined using multivariate analysis. RESULTS: Non-RLD-SWs made up 55.3% (n = 201) of the sample, 48% of whom had entered sex work since the demolition. Non-RLD-SWs more likely to be less than 20 years old, Goan, have experienced sexual and intimate partner violence, to work part time, from home or the streets, and to have fewer clients. Ex-RLD-SWs were less likely to have curable STIs adjusted odds ratio of 0.27 (95% confidence interval: 0.10 to 0.73) and were more likely to have been exposed to HIV prevention and report consistent condom use with clients. CONCLUSIONS: Non-RLD-SWs were more likely to be engaged in high-risk sexual activity. Although partly explained by lack of exposure to HIV prevention and inconsistent condom use, social and professional isolation and greater experience of intimate partner and sexual violence may play a role.