Researchers from the Universities of Oxford, Nairobi, and Manitoba are collaborating on a project to develop an HIV vaccine based on the immunological protection mechanisms found in commercial sex workers from the Majengo slum in Nairobi. This group consists of educationally and economically disadvantaged women who resort to commercial sex work for a living. A clinic was established in the slum to study sexually transmitted diseases, which now includes HIV/AIDS. The clinic serves as a research facility for the collaborating researchers (...) who have been using the women's blood, cervical, vaginal, and saliva samples for the ongoing studies. The clinic runs two HIV-integrated activities: HIV research and HIV care and treatment. For HIV negative participants, samples are collected and used for research and care after they give informed consent. (shrink)

Background:Stigma is considered a major barrier to accessing healthcare services by female sex workers. Current knowledge of nurses’ attitudes appears to imply a stigma toward female sex workers. But in-depth understanding of their perceptions is scarce. Furthermore, factors that inform a conceptual understanding of how this occurs are lacking.Objectives:The study aimed to explore nurses’ attitudes toward female sex workers and factors affecting caring for female sex workers.Research design:This was a qualitative study. A content analysis approach was adopted in analyzing the (...) data.Participants and research context:Thirty-three practicing nurses participated in seven semi-structured focus group interviews and three key informants participated in three individual interviews in Hong Kong.Ethical considerations:This study was approved by the Ethics Committee of one university in Hong Kong.Findings:The findings revealed three themes: (1) accept, stigmatize, or against sex work; (2) reluctance, hesitation, or willingness to care for female sex workers; and (3) factors affecting the care of female sex workers.Discussion and conclusion:This study found that nurses held different attitudes toward female sex workers, and they experienced feelings of reluctance, hesitation, or willingness to care for female sex workers. Multi-level factors could affect their level of comfort of caring for female sex workers. Intervention should be developed to encourage health professionals to examine their personal views toward female sex workers introspectively, how their attitude may have affected the provision of quality services, and to enhance the provision of sensitive non-discriminative services to female sex workers. (shrink)

This study examined female sex workers’ evaluation of ethically relevant experiences of participating in an HPV4 vaccine clinical trial conducted in Lima, Peru. The Sunflower Study provided all participants with HPV testing, treatment for those testing positive, and access to the vaccine for all testing negative. Themes that emerged from content analysis of interviews with 16 former participants included the importance of respectful treatment and access to healthcare not otherwise available and concerns about privacy protections, the potential for HIV stigma, (...) and poststudy abandonment. (shrink)

This article examines the St. James Infirmary, a nonprofit occupational health and safety clinic for sex workers in San Francisco, to consider how particular organizational spaces and practices may challenge gender ideologies in the United States—in this case, of women sex workers as “victim-criminals.” Drawing empirically from multimethod qualitative research and theoretically from feminist institutionalism, I indicate how the SJI’s broader institutional context has produced a victim-criminal ideology of women in prostitution. Next, I consider the SJI’s organizational emergence and operations (...) to argue that, by deploying particular spatial-discursive practices and operational procedures, nonprofits with legacies of activism may draw from these to challenge dominant gender ideologies, even as they work alongside the broader institutional structures that promote them. Although single case studies like the SJI cannot establish broad theoretical generalizations and propositions, I use it to build knowledge and highlight important lessons about nonprofits, gender, and institutional change. (shrink)

This paper sketches the emergence of, and shifts within, the social, legal, and political figurations of sex workers in Poland. By adopting a genealogical perspective, I investigate how sex workers have been (re)constituted as subjects of governance and unimaginable social justice claimants in legislation, political debates, and law enforcement strategies. With a broad temporal scope, this article traces continuities, transformations, and disruptions within modes of sex work governance in Poland from the adoption of the first laws relating to sex work (...) enacted during the early 19th century to the present day. Through analysis of policy documents, scholarly work on the history of sex work policies in Poland, and personal accounts by sex workers, I identify and examine two dominant discursive and legal figurations of a sex worker: as a threat, and as a victim in need of rescue and protection. While analysing the emergence of and interplay between these two figurations, this article demonstrates how these seemingly contradictory frames of recognition gradually conjoined within 20th-century Polish sex work governance strategies, rendering sex workers unimaginable subjects of rights and social justice claimants. (shrink)

In Catholic social thought (CST), work that is exploitative, immoral, or hopelessly monotonous can be labeled alienating: its performance makes the worker a stranger to her own, God-given human nature. CST traditionally understands sex work, which directs the human sexual faculties to ends other than the unitive and procreative, as a paradigmatic example of alienating work, and this paper will not disagree. Instead, I will show how accepting sex worker advocates’ claim that “sex work is work” reveals that (...) while sex work is indeed alienating by CST’s standards, many forms of paid work available today are alienating in similar ways. Listening to sex worker advocates helps CST strengthen its critique of alienating work while acknowledging sex workers’ moral agency. (shrink)

In 1987, apprehension that “unreasonable mistakes of fact” might negative mens rea in sexual assault cases led the Canadian Parliament to enact “reasonable steps” requirements for mistakes of fact with respect to the age of complainants. The role and operation of the “reasonable steps” provisions in ss. 150.1(4) and (5) and, to a lesser extent, s. 273.2 of the Criminal Code, must be reassessed. Mistakes of fact are now largely addressed at common law by jurisprudence that has re-invigorated judicial awareness (...) of the evidentiary requirements for the availability of defences at common law and explicitly defines “honest belief” as a belief that is neither reckless nor willfully blind. As a consequence of these common law developments, the defence of mistake of fact with respect to age is rarely available as a matter of law. Properly used, these common law analytic tools afford minors and under-age sex-workers better legal protection from sexual exploitation than has often been achieved in practice over the last 25 years with the “reasonable steps” requirement under ss. 150.1(4) and (5). -/- Socio-economic inequalities ensure that aboriginal children and youth are disproportionately affected by the non-enforcement, under-enforcement, and selective enforcement of laws enacted to protect minors against sexual assault and participation in sex work. Continued reliance by prosecutors and judges on out-moded jurisprudence in the screening, prosecution, and disposition of these cases in the criminal justice system reinforces existing patterns of inequality and disadvantage and violates basic principles of human rights. (shrink)

This study explored perceived benefits and risks of participation in HIV research among 33 female sex workers in Tecún Umán, Guatemala. Stigma associated with sex work and HIV was a critical barrier to research participation. Key benefits of participation included access to HIV/sti prevention and testing, as well as positive and trusting relationships between sex workers and research teams. Control exerted by managers had mixed influences on perceived research risks and benefits. Results underscore the critical need for HIV investigators to (...) develop population-tailored procedures to reduce stigma; engage managers; and reinforce trusting, reciprocal relationships between sex work communities and researchers. (shrink)

Sex workers in the Netherlands experienced severe financial and social distress during the COVID-19 health crisis. Notwithstanding them paying taxes over the earnings, they were excluded from government financial support, faced discriminatory treatment concerning safe reopening, and experienced increased repression and stigmatization. In this contribution, I explore whether the concept of “vulnerability” contributes to understanding (and addressing) that situation. Data acquired through participatory action research, partly taking place online during lock-down measures, and literature and content analysis show that labeling sex (...) workers “vulnerable” deflects attention away from the (in)actions of Dutch authorities responsible for sex workers’ precarious conditions during the pandemic. Government denial and strategies of abjection explain these conditions better than “vulnerability” does, as they return the gaze to actors and processes accountable for sex workers’ exclusion and criminalization during the COVID-19 health crisis and thereby put responsibility where it belongs. (shrink)

The purpose of the paper is to present the challenges and difficulties that may be encountered in the process of the evaluation of qualitative research on sex workers by ethics committees. Such research is usually subject to review by ethics committees because of the risk of harm to participants, who are considered “vulnerable”. At the same time, due to the social stigma arising from the provision of sex services, researchers, research participants, and ethics committee members may have their own ideas (...) and expectations about how ethical research in this area should be conducted. Referring to the experience of researchers from common law countries, this paper will discuss how these expectations and the requirements of ethics committees collide, confronting the researcher with the need to meet the divergent or even contradictory expectations of various social actors. I will also propose alternative procedures for Polish ethics committees to ensure that the process of obtaining their approval is more democratic and open to the diverse needs of both researchers and research participants. (shrink)

In the street life of the Mission District in San Francisco, two opposite ways of understanding the female ownership of the body circulate among women who are drug-using sex workers: sexual slavery and women's liberation. This article analyzes how both models obfuscate the manner in which lack and scarcity govern the economy of needs and desires when drug abuse intersects with sex work. Lack and scarcity are shown to pervade not only economic resources but also drug-related gratification, bodily well-being, sexual (...) desire and body commitment during sexual practices. Even though both women and men are involved in this economy, there is an `artificial scarcity' of drug-related gratification for women. Controlling women's ability to close this circuit, men reinstate and reproduce the gender stereotypes that dominate in the street culture. (shrink)

A population at the intersection between criminality and victimhood, sex workers1 have contact with myriad service providers in the fields of mental health, housing, child welfare, and criminal jus...

This article problematizes the usual Christian motif of rescue of sex workers that is disseminated by most faith-based groups working in the field. By focusing upon the problem of prostitution and individual rescue as the primary solution, broader relationships of accountability are neglected and complicated sex worker identifications become impossible. New strategies for thinking about human sexuality are needed that incorporate indecency as a way of questioning traditional moral representations reproduced by Christian outreach projects. In addition, three strategies are (...) outlined that could form counter-narratives for ministry and feminist theological reflection not based upon sex work as a problem to be resolved but instead carving out creative space for mutual engagement between pastoral practitioners and sex industry workers. (shrink)

This paper examines the ethical issues faced by health workers managing a fictional case of a female sex worker who is hepatitis B positive with a high level of virus but is asymptomatic. According to guidelines she does not require treatment herself, but is potentially highly infectious to others. Recent legal cases in the UK show it can be criminal to pass on HIV or hepatitis B infection sexually if the risk is known and the partner has not been (...) informed. However, there is no statute or case law showing that health workers are required to intervene to prevent such a potential ‘crime’, particularly when the partners are unknown, as in this case. The health workers could respond in various ways. They could do nothing, thus making further infection probable. They could advise the sex worker to use condoms and to inform her clients. They could treat the sex worker to reduce her level of infectivity, although there is no benefit to her. They could disclose the sex worker's status, although breaking confidentiality is a serious matter ethically and may be of no benefit to the unknown client group. Regulating prostitution might help; but sex workers with infection may work off licence. This paper discusses the clinical, moral and ethical issues associated with such a scenario and concludes that the most beneficial course is to target clients, through health education, to recognise the potential risks of infection from a sex worker and to take suitable precautions including immunisation against hepatitis B. (shrink)

Humans have a complex and dynamic mating system, and there is evidence that our modern sexual preferences stem from evolutionary pressures. In the current paper we explore male use of a dual mating strategy: simultaneously pursuing both a long-term relationship (pair-bonding) as well as short-term, extra-pair copulations (variety-seeking). The primary constraint on such sexual pursuits is partner preferences, which can limit male behavior and hence cloud inferences about male preferences. The aim of this study was to investigate heterosexual male mating (...) preferences when largely unconstrained by female partner preferences. In service of this goal, female full-service sex workers (N = 6) were surveyed on the traits and behaviors of their male clients (N = 516) and iterative cluster analysis was used to identify male mating typologies. Two clusters emerged: clients seeking a pair-bonding experience and clients seeking a variety experience. Results also suggested that romantically committed men were more likely to seek a variety experience than a relationship experience. We conclude that men desire both pair-bonding and sexual variety, and that their preference for one might be predicted by fulfilment of the other. These findings have implications for relationships, providing insight into motivations for male infidelity. (shrink)

The paper aims to provide evidence on consistent condom use dynamics among sex workers in Central America between 1997 and 2000, and to examine the most important predictors of use behaviour important for policy and programme interventions in the region. Data on 3500 sex workers, 1500 from 1997 and 2000 from the year 2000, were analysed. The samples represented sex workers in low socioeconomic neighbourhoods who met their clients at known sex establishments or by the roadside. Sex workers were more (...) likely to have used condoms consistently in 2000 than in 1997 (Odds Ratio (OR)=1·4, p[less-than-or-equal]0·05). Sex workers who discussed condoms with their partners or lovers used them consistently with all clients more than those who did not (OR=1·3, p[less-than-or-equal]0·10). Knowledge of condom advantages had a positive influence on consistent use. Sex workers who reported using condoms to prevent pregnancy or STDs used them consistently with all clients more than those who did not (OR=1·2, and 1·3 respectively, p[less-than-or-equal]0·10). The source of condoms is an important predictor of consistent condom use. Sex workers who bought condoms from health establishments or from brothels used them consistently more than those who did not (both OR=1·3, p[less-than-or-equal]0·10, and p[less-than-or-equal]0·05, respectively). Self-efficacy had a positive effect on consistent condom use. Sex workers who reported that they would use condoms even if clients offered to pay more for unprotected sex used them consistently with all clients more than those who did not (OR=1·8, p[less-than-or-equal]0·001). The findings suggest that having condom skill is positively related to condom use. Sex workers who had all four skills used condoms more consistently than those who had none (OR=1·6, p[less-than-or-equal]0·01). In order to increase consistent condom use and avert more incidences of HIV/AIDS and other STIs, programme interventions need to use the most efficient way to provide quality information, and provide repeated training on condom negotiation and use skills to sex workers. (shrink)

This article examines how migrant and immigrant sex workers have been rendered invisible before the courts and parliament in the reform of laws regarding sex work in Canada. A discourse analysis of the expansive legal record in the Bedford case and the transcripts of Parliamentary debates and testimony before Standing Committees confirm the lack of nuanced discussion on how criminal law reform could impact migrant and immigrant sex workers. As such, while the case of Bedford and the resulting change in (...) the law made by Parliament have been celebrated as a win for some sex workers as an acknowledgment, recognition and judicial validation of experiences by legal institutions of sex workers, a sub-group of women – migrant and immigrant sex workers – remain in the shadows. This article examines how law excludes migrant and immigrant sex workers; it is a starting point for research on how migrant and immigrant sex workers may participate in future legal reform. (shrink)

A growing and substantial body of research suggests that female sex workers play a disproportionately large role in the transmission of HIV in many parts of the world, and they are often referred to as core groups by epidemiologists, mathematical modellers, clinicians and policymakers. Male sex workers, by contrast, have received little attention and it is not known whether it is helpful to conceptualize them as a core group. This paper draws upon ethnographic research documenting social and sexual networks in (...) London and looks at the position of five male sex workers within a network comprising 193 men and seven women (as well as 1378 anonymous sexual contacts and 780 commercial contacts). In so doing, it suggests that there is no evidence to show that male sex workers are more or less likely to acquire or transmit HIV in the course of commercial sex compared with other types of sexual relationships. In addition, men engaging in non-commercial sex all reported having unprotected sex in a variety of contexts and relationships and there is no evidence to suggest that men who are not sex workers play less of a role in the transmission of HIV. In short, these data suggest that it would be inappropriate to conceptualize male sex workers as a core group. This is not to suggest that public policy should continue to overlook male sex workers. New and inventive approaches are required to reach out to a vulnerable but diverse group of men, selling sex for a variety of reasons; even if these men are no more vulnerable to acquiring and/or transmitting HIV than other men and women that form part of their network. (shrink)

Law enforcement’s troubled interactions (characterised by unusually harsh, arbitrary, unjust, and racist interactions and attitudes) with minority and marginalised populations in Canada and other western countries are well documented. Against the backdrop of such scholarship, this paper attempts to make sense of alternative perceptions held by some sex workers of colour about police officers’ attitudes or behaviours towards minority and marginalised communities. Using qualitative interview data, this paper explains how some sex workers of colour in Canada actively interpret the character (...) of law and legality to negotiate power imbalances when interacting with police officers. The main aim here is to show how research participants produce a counter-narrative and a polarised image (instead of a fixed one) of police officers as simultaneously ‘compassionate’ and ‘prejudiced’ social control agents, bringing out the symbiotic tensions between such dichotomous characteristics. (shrink)

While analysis of what takes people into prostitution has been widely documented, this article explores the way adult ‘30 something’ prostitutes consider their futures and the ideas they have about leaving or staying in prostitution. Drawing on contested notions of prostitution as ‘work’ and the broader context of life-history research with sex workers, it explores the experiences that frame prostitutes’ own narratives about their working lives and futures. An illustrative range of five life-history accounts from British sex workers are analysed (...) as ‘imagined’ curriculum vitae, listing emergent categories of: aliases, education, interests, thoughts on retirement, financial planning, getting older, hopes and ambitions and fantasy futures. These ‘stories’ are analysed looking at ways they inform on-going feminist debates about the realities of (voluntary adult) sex workers’ concerns. They point again to the relevance for sex workers and feminists of understanding sex work as ‘a job’. (shrink)

Legal protections and remedies for sex workers are important mechanisms for redressing discrimination. This paper proposes a strategic approach at Queensland and national levels using industrial and anti-discrimination laws and institutions to effect change in legal processes and regimes and increase uptake of individual remedies. It provides a strategic approach that could be considered by other organisations advocating with, and for, members of other marginalised groups to effect systemic change.

In this article, the authors take up the historical figure of Dr Betty Paërl, who has surprisingly turned up in very different kinds of specialised archives. The white mathematics professor was located in IHLIA LGBT+ Heritage, the largest queer heritage collection in Europe, as a notable SM sexpert and spokesperson on transgender politics, and also found during archival research into the anti-(neo)colonial struggles of Suriname against the Dutch. Upon closer inspection of the materials, the authors find the recurrent image/item of (...) the whip that presses them to carefully think through how the archive of Dr Paërl casts light on a history that Katherine McKittrick calls being ‘in the shadow of the whip’. The article aims to combine an analysis of these versions of the whip in different visual and discursive registers to detect the liberatory politics underlying her activisms. To do so, the authors develop the intersectional model of the kaleidoscope employed by Dutch Black, migrant and refugee (BMR) feminist theorists to grasp the shifting patterns of power that Paërl battled and embodied as an activist of the anticolonial struggle, for sex workers’ rights, for kinky sex and for transgender people. This is all the more important in the historical study of transgender visual materials that most often arrive in archives via medical and police photography or pornographic materials. The historical researcher, the article argues, should be wary of (re)producing a static vision that would reduce transgender figures to sex and gender politics, or eclipse a vision of trans politics that dilates beyond sexuality. (shrink)

Borrowing the notion of “metropole” and applying it to global HIV/AIDS policy, I describe how a global AIDS metropole generates, maintains, and diffuses specific identities related to the HIV pandemic throughout the world, concentrating on the prostitute and sex worker identities. I first describe the dominant, and increasingly polarized, Western discourses that have shaped these identities over time. I then specifically address the inappropriate application of the sex worker and prostitute identities to women who practice three different forms (...) of sexual exchange in Antananarivo, Madagascar. Through an ethnography of women engaged in the sexual economy, I explore the disconnect between the discourse and assumptions underlying policies issuing from the global AIDS metropole, as compared to the realities of women’s lives. I discuss potential negative health consequences of the inappropriate application of these labels, both for women participating in the sexual economy and for the population in Antananarivo at large. Finally, I consider the role that relational feminist theory could play in contributing toward a paradigmatic shift in how the global AIDS metropole approaches core-groups such as sex workers or prostitutes. (shrink)

In public health and the social sciences, there is growing recognition of the role that social context plays in determining health. Frequently, social relations of inequality are among the most important features of social context identified in this work, and emphasis is placed on identifying and addressing these inequalities in order to improve health. Within the field of HIV/AIDS prevention as well, researchers have begun to look beyond individuals for an understanding of the structural causes of HIV-related risk. This research (...) demands that greater attention be paid to the social mechanisms and contextual factors that lead to HIV risk. Among these factors are law and social policy, which form a part of the context in which risk-taking occurs and which can promote both HIV transmission and prevention. On the one hand, laws limiting access to sterile injection equipment have contributed to HIV-related risk behavioxs among injection drug users. (shrink)

In public health and the social sciences, there is growing recognition of the role that social context plays in determining health. Frequently, social relations of inequality are among the most important features of social context identified in this work, and emphasis is placed on identifying and addressing these inequalities in order to improve health. Within the field of HIV/AIDS prevention as well, researchers have begun to look beyond individuals for an understanding of the structural causes of HIV-related risk. This research (...) demands that greater attention be paid to the social mechanisms and contextual factors that lead to HIV risk. Among these factors are law and social policy, which form a part of the context in which risk-taking occurs and which can promote both HIV transmission and prevention. On the one hand, laws limiting access to sterile injection equipment have contributed to HIV-related risk behavioxs among injection drug users. (shrink)

Le bâtiment Z3 du quartier du Céramique à Athènes offre un bon exemple des questions que se posent aujourd’hui les spécialistes concernant le travail des femmes au ive siècle avant J.-C. (hors du domaine privé de la maison). L’agencement des pièces et le mobilier trouvé sur place attestent la fonction du bâtiment : une fabrique de textile qui pourrait, en plus, avoir tenu lieu de lieu de prostitution. Le document, sans apporter de réponse certaine sur l’organisation du travail dans le (...) quartier des artisans d’Athènes, permet de souligner des traits spécifiques : le caractère systématique du travail imposé aux esclaves, l’absence de distinction entre habitat et lieu de travail, la polyvalence des tâches imposées, y compris les services sexuels. (shrink)

Criminalization is a form of social marginalization that is little appreciated as a determinant of poor health. Criminalization can be understood in at least two ways — in the narrow sense as the imposition of criminal penalties for a certain behavior, and more broadly as the conferral of a criminalized status on all individuals in the population, whether proven guilty of a specific offense or not. Both criminal penalties and criminalized status threaten the mental and physical health of these populations (...) in many ways. Incarceration, abandonment by families and communities, social disdain, physical abuse, discrimination, and relentless fear undermine their ability to enjoy their right to the highest attainable standard of health goods and services. Understanding the social determinants of health in these populations and formulating programs to address them have rarely been high priorities in national or international policy. (shrink)