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have sex without a condom (Loff et al., 2003). Johns’ culpability for their own failure to use condoms was ignored.

Responding to pressure from HIV educators that women should initiate and enforce condom use with customers, a group of Nicaraguan women in prostitution urged that customers, not prostitutes, be compelled to use condoms (Gorter et al., 2000). This recommendation rarely comes from pimps, brothel owners, HIV educators, and government regulators, who instead unite to enforce women’s sole responsibility for condom use, rather than holding male customers accountable.

Globally, the incidence of HIV seropositivity among prosti- tuted women is devastating. Homeless children and adolescents in Romania and Colombia, for example, are at highest risk for sex- ual predation as well as HIV. Piot (1999) noted that one half of new AIDS cases are people younger than age 25 years, and that girls are likely to become infected at a much younger age than boys, in part, because of the acceptance of violence perpetrated against girls and women in most cultures.

Violence against women is a primary risk factor for HIV (Garcia- Moreno & Watts, 2000; Matsamura, 2003; Piot, 1999; United Nations, 2003). Aral and Mann (1998), at the U.S. Centers for Dis- ease Control, emphasized the importance of addressing human rights issues in conjunction with public health campaigns against STD. They noted that because most women enter prostitution as a result of poverty, rape, infertility and subsequent abandonment, or divorce, public health programs must address the social factors that contribute to STD/HIV. Gender inequality in any culture normalizes sexual coercion thereby promoting domestic violence and prostitution, ultimately contributing to women’s likelihood of becoming HIV infected (Pyne, 1995; Raymond, 1998)

Understanding the connection between partner violence, rape, and HIV/AIDS is crucial to understanding the continued vulner- ability of women in prostitution, despite condom distribution programs. For example Kalichman, Kelly, Shaboltas, and Granskaya (2000) and Kalichman, Williams, Cheery, Belcher, and Nachimson (1998) noted the coincidence of the HIV epidemic and domestic violence in Russia, Rwanda, and the United States. STD and HIV have increased exponentially in states of the former Soviet Union since 1995. From 1987 to 1995, fewer than 200 new

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