interval, 4.47–21.91), indicating a significant correlation between inflammatory cervical smears and bacterial vaginosis (P b 0.001). The present data indicate that cervical leukorrhea may be one of the factors associated with bacterial vaginosis, consistent with the results of Hakakha et al. [3]. Cervical leukorrhea leads to a more alkaline cervical discharge, which can result in bacterial vaginosis. Follow-up studies of cervical leukorrhea are required. Conflict of interest The authors have no conflicts of interest. References [1] Fethers KA, Fairley CK, Hocking JS, Gurrin LC, Bradshaw CS. Sexual risk factors and bacterial vaginosis: a systematic review and meta-analysis. Clin Infect Dis 2008;47(11): 1426–35. [2] Sha BE, Chen HY, Wang QJ, Zariffard MR, Cohen MH, Spear GT. Utility of Amsel criteria, Nugent score, and quantitative PCR for Gardnerella vaginalis, Mycoplasma hominis, and Lactobacillus spp. for diagnosis of bacterial vaginosis in human immunodeficiency virus-infected women. J Clin Microbiol 2005;43(9):4607–12. [3] Hakakha MM, Davis J, Korst LM, Silverman NS. Leukorrhea and bacterial vaginosis as in-office predictors of cervical infection in high-risk women. Obstet Gynecol 2002;100(4):808–12. 0020-7292/$ – see front matter © 2011 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.ijgo.2010.11.008 Trafficking mechanisms and HIV status among sex-trafficking survivors in Calcutta, India Kathryn L. Falb a, ⁎, Heather L. McCauley a , Michele R. Decker b , Shagun Sabarwal c , Jhumka Gupta d , Jay G. Silverman a a Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, USA b Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA c Population Council, New Delhi, India d Chronic Disease Epidemiology Faculty, Yale School of Public Health, New Haven, USA article info Article history: Received 22 October 2010 Received in revised form 17 November 2010 Accepted 23 December 2010 Keywords: HIV India Sex trafficking ⁎ Corresponding author. Department of Society, Human Development, and Health, Harvard School of Public Health, 401 Park Drive, Landmark Center 428-F, 4th Floor West, Boston, MA 02215, USA. Tel.: +1 617 384 8219; fax: +1 617 432 3123. E-mail address: kfalb@hsph.harvard.edu (K.L. Falb). The fact that India has been identified as a destination country for the estimated 150000 women and girls trafficked for sexual exploitation each year within and across South Asia draws attention to Calcutta, a potential sex-trafficking hub [1]. Although Calcutta has been the site of sex-worker collectivization efforts— including advocacy and community mobilization via the Sona- gachi Project [2]—that are intended to reduce trafficking, the city's proximity to Bangladesh highlights the potential for cross- border trafficking for sexual exploitation. Moreover, recent evidence from South Asia indicating that 1 in 4 women enter sex work via trafficking [3] emphasizes the importance of understanding trafficking mechanisms. The present study focused on women and girls who had been trafficked for sexual exploitation, were either removed by police or escaped, and were receiving help from Sanlaap, a non-governmental organization based in Calcutta. Case records of sex-trafficked women presenting to Sanlaap between January 1, 1997, and December 31, 2005, were collected in January 2006. Secondary data analyses of deidentified data were deemed exempt from review by the Harvard School of Public Health Human Subjects Committee, Boston, USA. The present sample comprised 188 women and girls who had been directly affected by “trafficking in persons,” which is defined as forced, coerced, fraudulent, or deceitful entry into sex work; entry by abduction; or entry into such work under the age of 18 years [4]. Selected characteristics of the women and girls are presented in Table 1. Of the 188 women and girls in the present sample, 66 (35.1%) were of an unknown age at the time of trafficking. Of the remaining 122 (64.9%), 95 (77.9%) were younger than 18 years of age when trafficked and 25 (20.5%) were aged between 6 and 14 years. The majority of women and girls (163 [86.7%]) were trafficked within India, including 18 (11.0%) who were trafficked within Calcutta. Overall, 98/176 (55.7%) were lured by the prom- ise of economic opportunity, 45/176 (25.6%) were kidnapped, and 17/176 (9.7%) were tricked via another activity. In total, 72/171 (42.1%) reported that the trafficker was a stranger, with a similar proportion (67/171 [39.2%]) indicating that the trafficker was a friend or acquaintance. Of the 44 (23.4%) women and girls tested for HIV, 10 (22.7%) were seropositive. Girls aged 17 years or younger accounted for 30 (68.2%) of the total number tested for HIV and 6 (60.0%) of the total positive cases. These findings highlight the persistence of sex trafficking within Calcutta and indicate that the mechanisms of trafficking are not dissimilar to those found in other areas of India [5]. The high rate of HIV infection among women and girls in the present study highlights the need for trafficking prevention efforts, from both a human rights and an HIV prevention perspective. Programs and policies that simultaneously assist female sex workers and support HIV prevention among them are urgently required. 86 Brief communications