Nearly 40 percent of Nepalese women and girls rescued after being forced into prostitution in India are HIV positive, a study by the Harvard School of Public Health has found.
Appearing in the latest issue of the Journal of the American Medical Association, the study highlights concerns over India's HIV/AIDS problem and shows how it may be spilling into neighbouring countries.
One in seven Nepalese in the study was trafficked into sexual servitude before the age of 15 and the HIV infection rate exceeded 60 percent.
"The high rates of HIV we have documented support concerns that sex trafficking may be a significant factor in both maintaining the HIV epidemic in India and in the expansion of this epidemic to its lower-prevalence neighbours," said Jay Silverman, an associate professor at HSPH.
India has around 2.5 million people living with HIV/AIDS, the world's third highest caseload after South Africa and Nigeria, and about 40 percent are women.
Nepal has a far lower but rising number of cases and the World Bank has cited the trafficking of Nepalese women and girls to India as a risk factor for HIV transmission in the region.
Up to 800,000 people are trafficked across the world each year, 80 percent of them women and girls, according to the U.S. State Department. Of these, 150,000 are trafficked annually within and across South Asia with the majority of them destined for major Indian cities.
Silverman and his team studied medical records of 287 girls and women who were rescued and repatriated after being sex-trafficked from Nepal to India between 1997 and 2005; and 38 percent of them tested positive for HIV.
Of these 287, 225 had full documentation of their trafficking experiences and their median age at the time of trafficking was 17. The youngest was 7.
The mean time served in brothels was 25.8 months and 17.3 percent reported being forced to work in multiple brothels.
Most were tricked into leaving Nepal with promises of domestic or restaurant jobs, offers of marriage and others were drugged and kidnapped.
More than half were trafficked by people known to them, such as friends, sex partners and family.
Thirty-three girls, or 14.7 percent, were trafficked before they were 15.
"Girls trafficked prior to age 15 had an increased risk for HIV, with 60.6 percent infected among this youngest age group. Risk was also associated with being trafficked specifically to Mumbai," the researchers said.
The researchers said the higher incidence of HIV among the younger girls may be due to a widespread myth that sex with virgins could cure HIV/AIDS, which resulted in them being kept longer in brothels than the older girls.