XVIII International AIDS Conference


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HIV vulnerability of adolescent sex workers in Romania

J. Busza1, M. Preda2, D. Buzducea2, V. Grigoras2, F. Lazar2

1London School of Hygiene & Tropical Medicine, Centre for Population Studies, London, United Kingdom, 2University of Bucharest, Faculty of Sociology and Social Work, Bucharest, Romania

Background: Evidence from a range of settings suggests that younger sex workers are more vulnerable to HIV than adults, due to inexperience and poor access to services. A survey of sex workers in three Romanian cities explored injecting drug and sexual risk behaviours among both adolescents and young adults.
Methods: We recruited 295 sex workers aged 15-24 in Bucharest, Constanta and Timisoara, using key informants and snowball sampling. A standardised questionnaire included questions on injecting drug use, equipment sharing, condom use, and use of harm reduction or other health services. Analysis compared sex workers aged 15-17 with those 18-24 to assess the specific needs of legal minors.
Results: Close to one fifth of the sample were younger than 18 (19.7%) and about one third were of Roma ethnicity. Overall, 22.2% had ever injected drugs, and this varied significantly by age. A quarter of 18-24 year olds had ever injected compared to 8.9% of adolescents. Among both age groups, 29.0% of injectors reported sharing injecting equipment in the past month. Condom use varied significantly by age: compared to adults, adolescent sex workers reported a lower rate of consistent use with commercial partners (46.5% vs. 70.0%) as well as at last sex with a casual partner (38.5% vs. 83.9%). Adolescents also exhibited poorer knowledge about HIV transmission, and were less likely to have ever had an HIV test (33.9% vs. 57.6%).
Conclusions: As found in other settings, younger sex workers in Romania appear to be less well informed about HIV and less able to negotiate preventive measures during commercial and casual sex compared with older peers. They are also less likely to consider themselves at risk for HIV, as demonstrated by low testing rates. On the other hand, they display a lower prevalence of injecting drug use, providing a window of opportunity for prevention interventions.

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