Highly mobile female sex workers in India present a challenge to HIV-control efforts, according to a World Bank report prepared for the 16th International AIDS Conference.

India has 40 percent of Asia's population but accounts for 60 percent of its HIV infections, according to a 2004 UNAIDS report. Increased condom use among many young female sex workers may have tamped HIV prevalence in some southern Indian states, one study said. Following highly mobile risk groups, such as immigrant sex workers and their clients, however, is a prevention hurdle.

"A high proportion of female sex workers in India move, often as frequently as every two weeks," said the World Bank's report "AIDS in South Asia." "Clients of female sex workers are also highly mobile … increasing the pace at which high-risk networks are linked, and this pattern can amplify local epidemics."

"Programming for mobile sex workers presents tactical challenges, given the difficulty of maintaining continuous outreach and peer education and condom supplies," noted the report.

Nepalese sex workers returning from Mumbai have a much higher HIV prevalence and could aggravate Nepal's epidemic, the report said. "Preventing HIV infections among sex workers in Nepal would certainly be more effective if they were coordinated with efforts in India focusing on migration and sex worker trafficking," especially in Mumbai, said report coauthor Mariam Claeson.

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