Gisselquist David, Correa Mariette
29 West Governor Road, Hershey, PA 17033, USA.
Int J STD AIDS. 2006 Nov;17(11):736-42. doi: 10.1258/095646206778691022.
Through a search, we identified five models of India's HIV epidemic, all of which articulate the hypothesis that heterosexual commercial sex drives India's HIV epidemic. All five models assume more female sex workers (FSWs) than have been mapped (counted), and more than can be inferred from men's sexual behaviour. With best and highest plausible evidence-based estimates (15-20% of 300,000-700,000 FSWs are HIV-positive; FSWs have 570 client contacts per year; clients use condoms with 60-75% of FSW contacts; and the rate of HIV transmission from FSWs to clients is 0.0011-0.002 per unprotected contact), FSWs and clients account for 2-15% of HIV-infected adults, far less than model-based estimates of 44-68%. Overestimating the contribution of commercial sex to India's HIV epidemic misleads prevention programmes to ignore other risks, and promotes the stigmatizing assumption that HIV infection is a sign of immoral behaviour.
通过一项调查，我们确定了印度艾滋病流行的五种模型，所有这些模型都阐述了异性性交易推动印度艾滋病流行的假设。所有这五种模型所假定的女性性工作者（FSW）数量都超过了已统计的数量，也超过了从男性性行为中推断出的数量。根据最佳且最合理的基于证据的估计（30万至70万女性性工作者中有15% - 20%感染艾滋病病毒；女性性工作者每年有570个嫖客；嫖客在60% - 75%的性交易中使用避孕套；女性性工作者与嫖客之间未采取保护措施的每次接触的艾滋病病毒传播率为0.0011 - 0.002），女性性工作者及其嫖客占艾滋病感染成年人的2% - 15%，远低于基于模型估计的44% - 68%。高估性交易对印度艾滋病流行的影响会误导预防计划，使其忽视其他风险，并助长一种将艾滋病感染视为不道德行为标志的污名化假设。
