This paper highlights important environmental dimensions of HIV vulnerability by describing how the sex trade operates in Nairobi, Kenya. Although sex workers there encounter various forms of violence and harassment, as do sex workers globally, we highlight how they do not merely fall victim to a set of environmental risks but also act upon their social environment, thereby remaking it, as they strive to protect their health and financial interests. In so doing, we illustrate the mutual constitution of ‘agency’ and ‘structure’ in social network formations that take shape in everyday lived spaces. Our findings point to the need to expand the focus of interventions to consider local ecologies of security in order to place the local knowledges, tactics, and capacities that communities might already possess on centre stage in interventions. Planning, implementing, and monitoring interventions with a consideration of these ecologies would tie interventions not only to the risk reduction goals of global public health policy, but also to the very real and grounded financial priorities of what it means to try to safely earn a living through sex work.
Tetyana I. Vasylyeva, Samuel R. Friedman, Lenore Gensburg, Pavlo Smyrnov; Engagement in sex work does not increase HIV risk for women who inject drugs in Ukraine, Journal of Public Health, Volume 39, Issue 3, 1 September 2017, Pages e103–e110, https://doi.org/10.1093/pubmed/fdw070
We studied the association between sex in exchange for money, drugs or goods and HIV for women who inject drugs (WWID) in Ukraine, as previous data on this association from the post-USSR region are contradictory.
Data come from the Integrated Bio-Behavioral Survey of Ukrainian people who inject drugs collected in 2011 using respondent-driven sampling. Participants were interviewed and tested with rapid HIV tests.
The sample included 2465 WWID (24% HIV positive); 214 (8.7%) of which reported having had exchange sex during the last 90 days. Crude analysis showed no association between exchange sex and HIV (OR = 0.644; 95% CI 0.385–1.077). No confounders were found to alter this result in a multivariable analysis. Further modeling showed that exchange sex modifies association between HIV and alcohol use: no association between HIV and daily alcohol use was found for those women who exchanged sex (OR = 1.699, 95% CI 0.737–3.956); while not engaging in sex work and daily using alcohol reduced odds to be HIV infected (OR = 0.586, 95% CI 0.389–0.885).
Exchange sex may have less impact on the HIV status of WWID who are exposed to injecting risks. The finding that daily alcohol use appears protective against HIV among WWID who do not exchange sex requires more research.
This article explores how women working as prostitutes in Orizaba, Mexico, laid claim to a more revolutionary vision of women’s citizenship. Prostitutes pushed the state to realize the promises of the Mexican Revolution, even as officials and many local residents—rich and poor—retained outmoded notions of gender and citizenship. This research indicates that “respectable” poor and working-class individuals gravitated toward traditional gender values so as to position themselves as respectable in the eyes of state agents charged with policing morality and public health. State officials’ rhetoric of egalitarianism that followed the Mexican Revolution fell flat for the public women whose pecuniary position persisted long after the guns fell silent.
The article aims at illustrating the main features of the medical debate about prostitution and venereal diseases in the first Yugoslavia, and the role played by physicians in shaping prostitution policies in that country between the two world wars. The Yugoslav medical debate, while sharing many of the same arguments and characteristics with analogues debates in Europe and beyond, also reveals some peculiar aspects. These aspects were related to the Habsburg and Ottoman legacies, the phenomenon of Bosnian endemic syphilis, the establishment of the new Yugoslav state, and the South-East European context. This resulted firstly in a multifaceted debate, with internal discrepancies and a dynamic development during the time; secondly, in a relevant role played by physicians as policy consultants and even policy makers with marked eugenic tones, which were in full accordance with the social engineering and nation-building projects of the political elite of this newly founded state.
The position of sex workers in society ranges across a wide spectrum. At one end of the spectrum there are slaves and the victims of inhumane traffickers. On the other end sex workers can enjoy a high position in society and are celebrated in the highest art forms such as in paintings or like in the opera la Traviata by Giuseppe Verdi. However, Eduard Manet’s painting of Olympia of 1863 brought some realism into this glamorous stereotypical portrayal by painting an image of a woman with a black cat—symbolizing promiscuity.1 This image of glamor lived on into the 20th century in films like Pretty Woman with its totally unrealistic Cinderella ending.
While the sex industry is present in every country, the reality for many sex workers is far from glamorous. A sex worker is defined by the World Health Organization as a “person who engages in sex work, or exchanges sex for money, which includes many practices and occurs in a variety of settings.” These may include workers who work full time in registered premises, to part time and casual workers working in informal locations.2
Decriminalisation: A harm minimisation and human rights approach to regulating sex work.
Author: Gillian Abel, PhD 2010
Ph.D. Thesis, University of Otago, Public Health Research
This thesis takes a community-based participatory approach, using mixed methods to examine the impact of the decriminalisation of sex work in New Zealand through the lens of a public health discourse of harm minimisation. The key question addressed in this thesis is whether decriminalisation has minimised the harms experienced by sex workers. Rather than taking a narrow view of harm minimisation and looking merely at the practices of sex workers, I have taken a more holistic stance, taking into account structural social issues which contribute to the health and wellbeing of sex workers. Data were collected through a survey of 772 sex workers and in-depth interviews with 58 sex workers in Auckland, Wellington, Christchurch, Napier and Nelson. Estimates were done of the number of sex workers in these cities which show little change post-decriminalisation compared to estimates done prior to decriminalisation. There has been some change in the shape of the industry with more people working privately in the suburbs and fewer in the brothels and escort agencies but little change in size of the street-based sector. Such minimal change in the size of the sex industry is not surprising as the underlying motivations for working in this industry have not changed in a decriminalised environment. As this thesis demonstrates, structural factors (such as economic climate, employment opportunities, welfare, housing and sickness benefits) are associated with the entry into sex work rather than the way the industry is regulated.