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Convention on the Rights of the Child. Copyright notice. The views expressed in Prostitutes Inhambane report do not necessarily reflect the views of the CDC or the U.

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 Prostitutes Inhambane safe environment to victims of violence.

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They were also referred to the Mozambican League of Human Rights which provides legal counsel 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 from different cities with distinct Prostitutes Inhambane and cultural contexts.

We ran several diagnostics, including Prostitutes Inhambane plots, to assess that the underlying assumptions of RDS had been met. Having found no evidence of bottlenecking or trapping of chains within Prostitutes Inhambane networks with respect to key variables e. A total of FSW aged 15 years 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, and 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 Prostitutes Inhambane nodes indicating participant age group age 15—17 vs 18 and older. Recruitment homophily was close to one in all three cities Prostitutes Inhambane.

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 About one in 10 had initiated sex work over two years before the survey, with In Maputo, Beira, and Nampula, the majority of underage FSW Prostitutes Inhambane having performed sex work in the past Prostitutes Inhambane months in order to meet daily needs and 8 In Maputo, Beira, Prostitutes Inhambane 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 Prostitutes Inhambane their last client was partner refusal 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 Prostitutes Inhambane had contact with peer educators was lower in Maputo and Nampula 3.

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Between All HIV test results among participants younger than 18 in Maputo were negative, while In Beira, HIV prevalence was 4. Our data provide new insight to Prostitutes Inhambane understudied sample of FSW in Mozambique and can help fill gaps in our understanding of this vulnerable population in the country. The study revealed that an important proportion of FSW one in six Prostitutes Inhambane under the Prostitutes Inhambane of 18, Prostitutes Inhambane that approximately one in five underage FSW initiated sex work when younger than To put into context, in Prostitutes Inhambane approximately one in five adolescents age 15—17 had sex for the first time within 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 Prostitutes Inhambane 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 in Maputo and Nampula were at least 10 Prostitutes Inhambane younger than their last client. The proportion of girls ages 15—17 in the general population of Mozambique having intergenerational sex is 8.

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This finding is concerning in that Prostitutes Inhambane sex often compromises the ability of younger women to use a condom. Further, this acquisition from older men may Prostitutes Inhambane a source of infection to boys and young men who are also the partners of these FSW. These boys and young men, in turn may later transmit Prostitutes Inhambane infection to their younger female partners—a cycle that is a Prostitutes Inhambane condition to propagate a generalized, heterosexual epidemic.

The phenomenon may be widespread as general population studies in Mozambique [ 7 ] and throughout sub-Saharan Africa [ 28 ] have shown a pattern of young age of infection among 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 Prostitutes Inhambane 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 the study.

The surveys on Prostitutes Inhambane this analysis is based may not have included those held forcibly or under close scrutiny in such venues as brothels, as described elsewhere in the world [ 3 ]. Our cross-sectional study does not capture the sequence of events that might force or lead an underage Prostitutes Inhambane into sex work. Moreover, Prostitutes Inhambane 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 be 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 Prostitutes Inhambane 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 levels of education. This may well be a primary driver of underage sex work in Nampula, located in 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 and STIs, while also increasing school attendance [ 3031 ].

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

These results point to the opportunity to expand prevention interventions in this population. Moreover, interventions need to Prostitutes Inhambane several other underlying factors contributing to underage sex work; such as social e.

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

While such interventions Prostitutes Inhambane underage women will be politically challenging, findings Prostitutes Inhambane here provide evidence of their need and provide a platform for advocacy.

The views expressed in this report do not necessarily reflect the views of the CDC or the U. Questions about HIV transmission and prevention where a people can reduce their risk of HIV by having only one sexual partner who does not have other sexual partners; b people can protect themselves from HIV by using a Prostitutes Inhambane 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 Prostitutes Inhambane mosquito bite; and b people can become infected with HIV by sharing a meal with a person infected with HIV.

Prostitutes Inhambane Center for Biotechnology InformationU. AIDS Behav. Author manuscript; available in PMC Dec 1.

Celso Inguane1, 2 Roberta Z. Miranda4 Peter W. Young5 Isabel Prostitutes Inhambane2 Beverley E. Raymond3 and Willi Mcfarland 3. Roberta Z. Peter W. Beverley E. Henry F.

Author information Copyright and License information Disclaimer. Corresponding author. Celso Inguane: ude. Copyright notice. See other articles in PMC that cite the published article. Abstract Characteristics, HIV risk, and program coverage for underage female sex workers Prostitutes Inhambane are Prostitutes Inhambane systematically described worldwide.

Open Prostitutes Inhambane a Prostitutes Inhambane window. Had more than 3 clients in the last month 22 Discussion Our data provide new insight to an understudied sample of FSW in Mozambique and can help fill gaps in our understanding of this vulnerable population in the country.

Footnotes 1 Comprehensive knowledge about HIV meant correctly responding to questions about the means of transmission and prevention of HIV and rejecting the major misconceptions about HIV transmission.

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References 1. Socio-demographic characteristics and behavioral risk Prostitutes Inhambane of female sex workers in Sub-Saharan Africa: a systematic Prostitutes Inhambane. Silverman JG. Adolescent female sex workers: invisibility, violence and HIV.

Arch Dis Child. A systematic review of the correlates of violence against sex workers. Am J Public Health. Age differences among female sex workers in the Philippines: sexual risk negotiations and perceived manager advice. Child prostitution: global health burden, research needs, and interventions.

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Given the high proportion of underage FSW currently studying, schools may be a viable avenue to reach them. Over half reported performing sex work to afford daily living, and