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In Lesotho, 86% of women have experienced gender\u2010based violence. In addition, overall <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> prevalence is among the highest globally, and higher among adolescent girls than boys. Moreover, nearly three quarters of female sex workers (<jats:styled-content style=\"fixed-case\">FSW<\/jats:styled-content>) are estimated to be living with <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> in Lesotho. In this context, sexually exploited children may be particularly vulnerable to violence and <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> acquisition risks. This study's objective is to examine the prevalence and correlates of experiencing sexual exploitation as a child among <jats:styled-content style=\"fixed-case\">FSW<\/jats:styled-content> in Lesotho.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">FSW<\/jats:styled-content> (\u226518\u00a0years) recruited through respondent\u2010driven sampling in Maseru and Maputsoe from February to September 2014 completed <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> and syphilis testing and an interviewer\u2010administered survey, including a question about the age at which they started providing sex for money. This study examined correlates of experiencing sexual exploitation as a child (&lt;18\u00a0years) through multivariable logistic regression analyses for each city, controlling for current age.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Across both cities, 20.0% (142\/710) of participants were sexually exploited as children. Among them, 65.5% (93\/142) tested positive for <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> and 31.0% (44\/142) for syphilis, which was similar to those who started selling sex as adults, after adjusting for current age. Participants who experienced child sexual exploitation were more likely to have been forced to have sex before age 18 than those who started selling sex as adults (Maseru\u2010adjusted odds ratio (<jats:styled-content style=\"fixed-case\">aOR<\/jats:styled-content>): 3.52, 95% Confidence Interval (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>): 1.61 to 7.66, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.002; Maputsoe\u2010<jats:styled-content style=\"fixed-case\">aOR<\/jats:styled-content>: 4.39, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 1.22 to 15.75, <jats:italic>p\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.023). In Maseru, participants who were sexually exploited as children were more likely to avoid carrying condoms to prevent trouble with police (<jats:styled-content style=\"fixed-case\">aOR<\/jats:styled-content>: 3.18, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 1.50 to 6.75, <jats:italic>p\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.003).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Risk determinants for <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> and violence among sexually exploited children can be studied retrospectively through research with adult <jats:styled-content style=\"fixed-case\">FSW<\/jats:styled-content>. Further research working directly with sexually exploited children will improve understanding of their needs. Preventing commercial sexual exploitation of children and addressing the social and healthcare needs of those who are exploited are necessary to fully achieve SDGs 5, 8 and 16 and an <jats:styled-content style=\"fixed-case\">AIDS<\/jats:styled-content>\u2010Free Generation.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.25042","type":"journal-article","created":{"date-parts":[[2018,2,27]],"date-time":"2018-02-27T15:07:38Z","timestamp":1519744058000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["<scp>HIV<\/scp> risks and needs related to the Sustainable Development Goals among female sex workers who were commercially sexually exploited as children in Lesotho"],"prefix":"10.1002","volume":"21","author":[{"given":"Ashley","family":"Grosso","sequence":"first","affiliation":[{"name":"Public Health Solutions Research and Evaluation Unit New York NY USA"},{"name":"Department of Epidemiology Johns Hopkins Bloomberg School of Public Health Center for Public Health and Human Rights Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shianne","family":"Busch","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Johns Hopkins Bloomberg School of Public Health Center for Public Health and Human Rights Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tampose","family":"Mothopeng","sequence":"additional","affiliation":[{"name":"Matrix Support Group Maseru Lesotho"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Sweitzer","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Johns Hopkins Bloomberg School of Public Health Center for Public Health and Human Rights Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Nkonyana","sequence":"additional","affiliation":[{"name":"Ministry of Health Maseru Lesotho"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nkomile","family":"Mpooa","sequence":"additional","affiliation":[{"name":"Care for Basotho Maseru Lesotho"},{"name":"Care\u2010Lesotho Maseru Lesotho"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noah","family":"Taruberekera","sequence":"additional","affiliation":[{"name":"Population Services International Johannesburg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Baral","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Johns Hopkins Bloomberg School of Public Health Center for Public Health and Human Rights Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,2,27]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2009.178715"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/23322705.2017.1365567"},{"issue":"1","key":"e_1_2_8_4_1","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1504\/IJGSDS.2015.067929","article-title":"The commercial sexual exploitation of girls and young women in Namibia","volume":"1","author":"LaFont S","year":"2015","journal-title":"Int. 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