Examining Link Between Commercial Sex Work, HIV Transmission In Baltimore

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The Baltimore Sun this week published a two-part series examining the link between commercial sex work and HIV transmission in Baltimore. Summaries of the articles appear below:

"An Epidemic's Unseen Cause: Women Trade Sex for Drugs, With AIDS the Result": The association between commercial sex work and HIV transmission "is an important but largely overlooked reason" why the Baltimore metropolitan area has the second-highest rate of new AIDS cases in the country after Miami, the Sun reports. According to the Sun, public health authorities have been slow to respond to the link between HIV and what some experts call "survival sex," in part because those involved are "elusive and their role [is] hard to quantify." Studies have found that among sex workers who trade sex for drugs, HIV infection rates are as high as 30%, the Sun reports.

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Many sex workers who trade sex for drugs also have sexually transmitted infections such as syphilis, gonorrhea and chlamydia, which increase their susceptibility to HIV and the potential to transmit the virus to another person, the Sun reports. "The likelihood they will infect someone [with HIV] keeps going up because of the probabilities," Thomas Quinn, infectious diseases professor at the Johns Hopkins Bloomberg School of Public Health, said, adding, "If the odds are one out of 10, and someone has sex with 10 people, then one is going to get infected" with HIV. CDC, the Maryland AIDS Administration and Johns Hopkins University currently are recruiting 750 adults in the Baltimore area to take part in a national survey that aims to provide an outlook for heterosexual HIV transmission in the U.S. (Bor, Baltimore Sun, 11/4).

"Many Steps to a Fresh Start: Women Getting Out of the Sex Trade and Drugs Need Housing, Treatment and Counseling": Despite millions of dollars spent on HIV/AIDS programs in Baltimore, the city "until recently" took only a "piecemeal approach to helping" commercial sex workers "break the cycle" of trading sex for drugs, the Sun reports. Joshua Sharfstein, the city's health commissioner, recently said that Baltimore lacks a comprehensive prevention strategy to fight HIV, in part because the services performed by a number of organizations receiving public funds have not been assessed. Sharfstein recently announced a pilot program that will twice weekly send a van with needle-exchange, testing and outreach services to locations known for commercial sex work. The city aims to start the program in January 2008.

The city Health Department also aims to determine which neighborhoods and risk groups are being neglected by the city's efforts to curb HIV/AIDS. According to William Blattner -- director of epidemiology at the University of Maryland Institute of Human Virology and co-chair of the Baltimore City Commission on HIV/AIDS Prevention and Treatment -- sex workers might be the direct or indirect cause of 20% to 40% of new HIV cases in the city. According to the Sun, some advocates say that it will be difficult to reach untreated HIV-positive people until they are provided with decent housing (Bor, Baltimore Sun, 11/5).

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