title: Life circumstances of women entering sex work in Nagaland, India.
abstract: OBJECTIVE
  The study objective was to enhance understanding of female sex workers' lives in Nagaland, India (one of the country's highest HIV prevalence states), to inform the development of interventions to reduce HIV transmission and assist women who want to leave sex work.
  
  
  METHODS
  A cross-sectional survey (n = 220) and semi-structured interviews (n = 30) were conducted with sex workers. Topics included the following: life situation currently and at time of initial engagement in sex work, circumstances of first sex work occasion, and current patterns of sex work.
  
  
  RESULTS
  Participants' lives at time of entry into sex work were socio-culturally and economically vulnerable as evidenced by the early age of sexual debut, low levels of education, unemployment, absence of protective male partners, and poor relationships with families. Participants experienced high levels of mobility, insecure accommodation, the need to financially support family, and the demand to give a portion of their income to others. The use of alcohol and other drugs, including heroin, was widespread.
  
  
  CONCLUSIONS
  For these women, sex work can be seen as a pragmatic option for earning sufficient income to live. The women's lives would be improved by strategies to promote their health, ensure their safety, and protect their rights as long as they are engaging in sex work. This is likely to benefit not only the sex workers but also their children, their families, and the wider community. The development of alternative employment opportunities is vital to protect against entry into sex work and to support women who want to exit sex work.
authors.affiliation: National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT, Australia. kathryn.bowen@anu.edu.au
authors.forename: Kathryn J
authors.initials: KJ
authors.lastname: Bowen
authors.forename: Bernice
authors.initials: B
authors.lastname: Dzuvichu
authors.forename: Rachel
authors.initials: R
authors.lastname: Rungsung
authors.forename: Alexandra E
authors.initials: AE
authors.lastname: Devine
authors.forename: Jane
authors.initials: J
authors.lastname: Hocking
authors.forename: Michelle
authors.initials: M
authors.lastname: Kermode
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D057217:Economic Development; D005260:Female; D006801:Humans; D007194:India; D007407:Interviews as Topic; D008016:Life Change Events; D008875:Middle Aged; D011477:Sex Work; D055815:Young Adult