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AIDS Behav. Was away from home more than 1 month in the last 6 months.

However, the factors that Prostitutes Inhambane put these underage women at risk of HIV infection have yet to be documented in Mozambique. Additionally, few studies have focused specifically on underage women involved in commercial sex exchange of sex explicitly for money Prostitutes Inhambane, as opposed to transactional sex.

Three integrated bio-behavioral surveillance IBBS surveys implemented in — in Mozambique estimated that 2. The surveys do not, however, provide population size estimates for underage FSW Prostitutes Inhambane. The present analysis, focusing Prostitutes Inhambane on commercial sex, is based on data from the three IBBS surveys in Mozambique.

Experienced sexual or physical violence in the past 6 months.

FSW were defined as biological females aged 15 years or older, who had Prostitutes Inhambane money in Prostitutes Inhambane for sex from a man other than a main partner in the 6 months preceding Prostitutes Inhambane participation in the survey. An underage person was defined as per Article I of the United Nations Convention on the Rights of a Child as a human being under the age of 18 [ 17 ]. The decision to include underage women age 15—17 in the survey was carefully assessed [ 18 ]. Based on evidence from other studies in Mozambique [ 1214 ], the exclusion of this age group from surveillance would result in failure to collect valuable data, useful for policy and programmatic purposes, Prostitutes Inhambane causing more harm to the population.

For the individual participant, the survey provided a unique opportunity to receive free Prostitutes Inhambane specific to their individual needs and risk factors, in a safe environment, where participants were linked to FSW and youth friendly health and social services.

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Additionally, the results of the survey provide valuable information that can be used to develop much needed interventions aimed at the prevention of underage sex work and mitigation of health problems for this vulnerable population. The aim of this analysis is to draw attention to the problem of underage women engaging in sex work, contribute to understanding of characteristics and factors that can place underage FSW at risk of HIV infection and provide information to assist with the design of HIV prevention programs relevant to this sub-population in Mozambique and in Southern Africa [ 3 ].

These IBBS surveys aimed to estimate HIV prevalence and associated Prostitutes Inhambane factors, evaluate access to and use of healthcare services, and estimate the size Prostitutes Inhambane the FSW population aged 15 years and over in each area. Respondent-driven sampling RDS has been used Prostitutes Inhambane several other countries to study hard to reach populations Prostitutes Inhambane has been described in detail elsewhere [ 19 — 22 ]. The studies began with a formative assessment phase that included ethnographic mapping of FSW venues and social networks.

Data Prostitutes Inhambane this phase were collected through focus group discussions, observation, and key informant interviews with active FSW, former FSW, and providers working with FSW. Seeds were drawn from distinct geographic areas and comprised a diverse set of demographic characteristics in each area.

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Participants were recruited in each survey area using RDS, an approach of long-chain peer referral sampling which, if theoretical assumptions are met and implemented, can provide probability-based or representative estimates of the target population [ 22 ].

Study eligibility criteria included: being a biological female aged 15 years or older; having received money in Prostitutes Inhambane for sex from a man other than a main partner in the last 6 months; living, working, or socializing Prostitutes Inhambane the survey areas; being in possession of a valid referral coupon received from an FSW Prostitutes Inhambane and being capable and willing to provide a written Prostitutes Inhambane consent.

Previous participation in the survey or inability to provide informed consent, including being under the influence of alcohol and drugs, were reasons for exclusion. Nationality was not an exclusion criterion.

This pattern of recruitment through referral using a coupon was maintained until the desired survey sample size was achieved and equilibrium i.

Equilibrium was checked weekly during recruitment. Equilibrium variables included age group, educational level, student status, marital status, place of Prostitutes Inhambane client pick-up, contact with peer educators, neighborhood of residence, network size, number of clients in the last month, known HIV status and rapid HIV test result. Each participant received Prostitutes Inhambane primary incentive for their participation in the survey and a secondary incentive for each additional participant successfully recruited someone they referred, who was eligible and who Prostitutes Inhambane in the survey.

These costs were decided upon in the Prostitutes Inhambane research, which ensured that values were sufficient to cover costs while not overly high so as to be Prostitutes Inhambane.

Questionnaire domains included: socio-demographic information; sex work and sexual history; sexual behavior and risks with the two most recent clients and two most recent non-clients; condom usage; HIV and AIDS program exposure; Prostitutes Inhambane knowledge; knowledge of STI and self-reported STI infection; healthcare access and healthcare-seeking behavior; HIV testing history; HIV care and treatment; experience of stigma and discrimination; use of alcohol and non-medically prescribed drug use; and social network size.

Study participants gave separate written informed consent before engaging in each procedure, including: completion of the Prostitutes Inhambane questionnaire, rapid HIV testing with return of results, and preparation of DBS samples to be sent to the INS for storage and laboratory testing for HIV.

The age of Prostitutes Inhambane in Mozambique is 18 years old. However prior qualitative studies have found that underage women were also engaged in sex work [ 241214 ]. Ethical approval to interview sex workers aged 15—17 who Prostitutes Inhambane able to provide consent based on their status as emancipated underage persons was granted by the committees above. If desired, women, including underage FSW, were linked to the Office for Women and Children of the Mozambican police, under the Ministry of the Interior, which provides access to the legal system in a safe environment to victims of violence.

They were also referred to the Mozambican League of Human Rights which provides legal Prostitutes Inhambane free of charge. The databases were merged, checked and cleaned using R version 2. Data from the three surveys were not merged given the RDS sample was drawn Prostitutes Inhambane different cities with distinct networks and cultural contexts.

We ran several diagnostics, including bottleneck plots, to assess that Prostitutes Inhambane underlying assumptions of RDS had been met. Having found no evidence of bottlenecking or trapping of chains within distinct networks with respect to key variables e. A total Prostitutes Inhambane FSW aged 15 Prostitutes Inhambane and older participated in the three surveys; in Maputo, in Beira, and in Nampula. Of these, Survey recruitment was completed in 14 waves in Maputo, Prostitutes Inhambane 19 in Beira and Nampula.

Equilibrium was achieved in all three areas for key variables, including age group, educational level, place of last client pick-up, and contact with peer educator. Figure 1 presents recruitment tree diagrams with color nodes indicating participant age group age 15—17 vs 18 and older.

Recruitment homophily was close to one in all three Prostitutes Inhambane 1. Table 1 presents socio-demographic and sex work characteristics of underage FSW for each urban area. Among underage FSW, The majority of underage FSW In Maputo, Beira, and Nampula, 14 Six Prostitutes Inhambane one in 10 had initiated sex work over two years before the survey, with In Maputo, Beira, and Nampula, the majority of underage FSW reported having performed sex work in the past 6 months in order to meet daily needs and 8 In Maputo, Beira, and Nampula, Approximately half of underage FSW The main reasons given by participants ages 15—17 for not having used a condom the last time they had sex with their last client was partner refusal Prostitutes Inhambane In Maputo and Nampula, about one-third of underage FSW were at least 10 years younger than their last client.

The proportion of underage FSW who Prostitutes Inhambane contact with peer educators Prostitutes Inhambane lower in Maputo and Nampula 3.

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Between All HIV test results among participants younger than 18 in Maputo were Prostitutes Inhambane, while In Beira, HIV prevalence was 4. Our data provide new insight to an understudied sample of FSW in Mozambique and can help fill gaps in Prostitutes Inhambane understanding of this vulnerable population in the country.

The study revealed that an important proportion of FSW one in six Prostitutes Inhambane under the age of 18, and that approximately one in five underage FSW initiated sex work when younger than To put into context, in Mozambique approximately Prostitutes Inhambane in five adolescents age 15—17 had sex for the first time Prostitutes Inhambane the same time frame underage FSW in our sample initiated sex work [ 27 ].

Unprotected sex and pregnancy were common among underage FSW in the three surveys, and prevention services were far less likely to reach underage than adult FSW. Moreover, fewer underage FSW in our study knew where to get tested and had accessed prevention or health services than adult FSW, including services such as peer outreach, educational sessions on HIV, free condoms, and healthcare.

As many as one-third of underage FSW Prostitutes Inhambane Maputo and Nampula were at least 10 years younger than their last client. The proportion of girls ages 15—17 in the general population of Mozambique having intergenerational sex is 8. This finding is concerning in that intergenerational sex often compromises the ability of younger women to use a condom.

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Further, this acquisition from older men may be a source of infection to boys and young Prostitutes Inhambane who are also the partners of these FSW.

These boys and young men, in turn may later transmit the infection to their younger female partners—a cycle that is a necessary condition to propagate a generalized, heterosexual epidemic.

The phenomenon may be widespread as general population studies in Mozambique [ 7 ] and throughout sub-Saharan Africa Prostitutes Inhambane 28 ] have shown a pattern of young age of infection Prostitutes Inhambane girls and older age of infection among boys. Other factors highlight the risks to underage FSW.

As many as one quarter of underage FSW experienced violence in the 6 months preceding the interview in two urban areas. Some factors contributed differently to the risk profile for different cities.

Prostitutes Inhambane example, alcohol misuse appeared to be less of a factor for underage FSW in Nampula. There are limitations to our study.

First, peer recruitment assumes FSW are socially connected and have freedom of movement and the ability to choose to participate in Prostitutes Inhambane study.

The surveys on which this analysis is based may not have included those held forcibly or under close scrutiny Prostitutes Inhambane such venues as brothels, Prostitutes Inhambane described elsewhere in the world [ 3 ]. Our cross-sectional study does not capture the sequence of events that might force or lead an underage woman into sex work.

Moreover, the IBBS surveys were not designed specifically to examine underage FSW and the sample size for many variables was small, affecting overall precision. These limitations need to Prostitutes Inhambane addressed with studies of larger Prostitutes Inhambane that are designed to look at this underage population. Despite limitations, the surveys successfully recruited a large number of underage FSW and we were able to describe their socio-demographic characteristics, behavior, knowledge, and service access.

Our data identified the Prostitutes Inhambane of a sizeable number of underage women engaged in sex work in Mozambique, a serious violation of human rights that requires attention [ 6 ].

The gap in HIV testing and outreach to underage FSW needs to be addressed through scale up of FSW-friendly activities overall, with special emphasis on reaching younger ones.

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Given the high proportion of underage FSW currently studying, schools may be a viable avenue to reach them. In fact, our results suggest that underage FSW may be turning to sex work in order to afford secondary or higher Prostitutes Inhambane of education.

This may well be a primary driver of underage sex work in Nampula, located Prostitutes Inhambane a province lacking education infrastructure [ 29 ] where In other Southern African contexts, structural interventions such as reduction of schooling costs or cash payments have been shown to reduce HIV risks Prostitutes Inhambane STIs, while also increasing school attendance [ 3031 ].

However, less than three in 10 underage FSW had used a healthcare service and less Prostitutes Inhambane one in 10 had been in contact with a peer educator in the last 6 months.

These results point to the opportunity to expand prevention interventions in this population.

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Moreover, interventions need to address several other underlying factors contributing to underage sex work; such as social e. Other interventions could offer sexual harm reduction methods, by ensuring that evidence-based biomedical interventions such as PrEP are made available to all sex workers, including underage FSW.

Other interventions that could be implemented Prostitutes Inhambane Mozambique include public awareness through the media, such as the Meninas da noite Girls of the night investigative reports in Prostitutes Inhambane [ 33 ]; telephone hotlines that provide confidential access to information for potential victims of exploitation; and education and training for police, youth-serving agencies, and politicians [ 34 ].

While such interventions for underage women will be politically challenging, findings presented here provide evidence of their need and Prostitutes Inhambane a platform for advocacy. The views expressed in this report do not necessarily reflect the views Prostitutes Inhambane the CDC or the U. Questions about HIV transmission and prevention where a people can reduce their risk of HIV by having Prostitutes Inhambane one sexual partner who Prostitutes Inhambane not have other sexual partners; b people can protect themselves from HIV by using a condom in each sexual intercourse; and c an apparently healthy looking person can have HIV.

The major misconceptions about HIV transmission used for the indicator were a people can become infected with HIV by a mosquito bite; and b people can become infected with HIV by sharing a meal with a Prostitutes Inhambane infected with HIV. Prostitutes Buy Sluts Inhambane Mozambique. Find important research based on our field experience on our dedicated Field Research website.

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The involvement of underage women in sex work defined as FSW younger than 18 years old has been documented in sub-Saharan Africa, Asia, and the Americas [ 2 , 3 , 5 ].

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Among underage FSW, Software for the analysis of respondent-driven sampling data, Version 0. External link.