Entertainment Venue Visiting and Commercial Sex in China

ABSTRACT

Entertainment venues in China play an important role in the sexually transmitted disease (STD)/HIV epidemic. Most previous studies have focused on sex workers working in entertainment venues, but little is known about their clients. This study investigated the perceptions and behavior of the patrons visiting entertainment venues. Qualitative in-depth interviews were conducted with 30 male market vendors who visited entertainment venues at least once in the past 3 months in an eastern city in China. Information about their risky behavior, attitude toward commercial sex, and STD/HIV prevention approaches was collected. Saunas, karaoke bars, and massage centers are the most frequently visited entertainment venues. Seventy-three percent of study participants reported purchasing commercial sex at these entertainment venues. Participants expressed a very liberal attitude toward commercial sex. Seeking commercial sex was perceived as a characteristic of a male's nature. The perceived risks of STD/HIV infection do not deter participants from engaging in commercial sex. Commercial sex clients reported irregular condom use and a number of other misperceptions and improper practices toward preventing STD/HIV infection. Venue-based intervention is urgently needed to target the population. The sex workers themselves could potentially serve as “health educators” to communicate prevention information to their clients and encourage safer sex behavior.     

Empowering,invasive or a little bit of both? A reflection on the use of visual and narrative methods in research with migrant sex workers in South Africa

Although migration plays a critical role in the economic landscape of the world, government officials and researchers do not sufficiently include migration and/or migrants in research studies and development policies. In South Africa, many migrants – both internal and cross-border – engage in informal livelihood strategies, including sex work (see Richter et al. 2012). Currently, the bulk of research that is being conducted in South Africa in the areas of migration and sex work rely heavily on the use of traditional research approaches and focus mainly on concerns surrounding issues of public health, with increased attention to HIV (for example, see SANAC 2013; Scheibe, Drame and Shannon 2012; Scorgie et al. 2011). While this work is invaluable, there is a need for research that can counter the stigma that sex workers overwhelmingly face in light of HIV/AIDS. Participatory visual and narrative research approaches – as part of mixed method study designs – that examine the lived experiences of migrant sex workers can provide important insights that ‘move beyond the polarized and simplistic arguments that have circulated in South African about migrant sex workers’ (Nyangairi and Palmary, 2014, 132). This methodological approach makes important and necessary contributions to national and international discourses on migration and sex work (see Oliveira and Vearey 2015). In addition, these methods provide a unique platform where the normative discourses that portray migrants as a homogenous vulnerable and apolitical group of people can be contested (Palmary 2006). In this article, I present and discuss three participatory visual and narrative research projects that have been conducted with migrant men, women and transgender persons who sell sex in two Provinces of South Africa and examine the suitability of these approaches.     

Women in India: The Context and Impact of HIV/AIDS

ABSTRACT

The response to the HIV/AIDS epidemic on the Indian subcontinent has been hampered by several factors, including societal stigma, lack of educational resources, lack of economic opportunities, and the competing priorities for a nation just growing and developing an infrastructure for education, industry, and health. In particular, Indian women are silent victims in this epidemic because they do not readily have a respected voice in decision making and priority setting for the government. The epidemic is increasingly affecting and infecting Indian women (e.g., female commercial sex workers, married women, and pregnant women). The status of Indian women has placed them at extreme disadvantage because India is a country with socially progressive laws but has been slow to change its social norms. The reported HIV prevalence is low although many researchers agree a large amount of underreporting occurs. For India to address this emerging epidemic among women appropriately, it should focus on three intervention areas: (1) short-term solutions such as treatment options for those already infected with HIV to prevent further infection to sexual partners and children; (2) intermediate solutions such as education for those who are uninfected but engaging in behaviors that may put them at risk, such as injection drug use, engaging in commercial sex work, engaging in extramarital sexual relations, and having sexual partners who are not monogamous; and 3) long-term solutions such as addressing the root causes of inequality (e.g., disparities in education and employment and unwillingness to change social norms).     

West and Central Africa

This article reviews scientific and other literature during the 1990s that links migration and mobility with the spread of sexually transmitted diseases (STDs), including HIV/AIDS. The focus is on key population groups linked to the spread of HIV and STDs in West and Central Africa: migrant laborers, truck drivers, itinerant traders, commercial sex workers (CSWs), and refugees. Countries with high emigration and immigration tend to have high levels of HIV infection, with the exception of Senegal. The main destination of immigrants are Senegal, Nigeria, and Cote d'Ivoire in West Africa and Cameroon, Congo, Gabon, and Congo in Central Africa. The risk of infection and the spread of HIV is variable among migrants. There is little in the literature that substantiates hypotheses about the strong association between migration and HIV-positive status. Information is needed on the duration, frequency of return visits, living conditions, sexual activities with multiple partners, and information before departure, along the routes, at final destination, and at the time of returns. Action-based research in five West African countries (Burkina Faso, Cote d'Ivoire, Mali, Niger, and Senegal) should produce results in late 1998. Comparable studies in Central Africa are unknown. Regional studies should be complemented by local studies. Prevention would benefit from studies on the relative size of these five population groups by geographic location.     

Participation as a Health Communication Strategy in HIV/AIDS Intervention Projects: an Examination of a Project Targeting Commercial Sex Workers in India

This article examines how participation frames health communication strategies in the Sonagachi Project. The current research, which involves a study of 37 commercial female sex workers in a red-light district of India, investigates how the participation of target audiences in the enunciation of health problems in HIV/AIDS intervention projects engenders change. The study analyzed how a participatory framework in an HIV/sexually transmitted infection intervention project among sex workers addresses sociostructural constraints that affect the lives of the sex workers. The article aims to investigate how participation engages the sex workers in roles of power and decision-making within a health intervention program directed toward curbing sexually transmitted infections.     

How Does a “Risk Group” Perceive Risk?

Abstract

Throughout the HIV/AIDS epidemic, female sex workers have been identified as a “risk group” and interventions developed to reduce their behavioral risk-taking. Both individual and structural level programs continue to target “risks” such as multiple partners and lack of condom use. Sex workers themselves, however, are likely to view their experiences more holistically, perceiving a range of risks within their work. This paper presents qualitative data from a participatory study conducted with brothel-based migrant Vietnamese sex workers in Cambodia, illuminating one community's perceptions of the sex industry. It argues that design and implementation of effective HIV prevention activities must be based on sex workers' own interpretations and responses to risk, using them as a realistic entry point for effecting change. Actively engaging with sex workers through participatory research and projects offers the first step in shifting the current epidemiological focus toward identifying feasible, context-specific risk-reduction strategies.     

Gendered Economic,Social, and Cultural Challenges to HIV/AIDS Prevention and Intervention for Chinese Women

ABSTRACT

China is experiencing the most rapidly expanding HIV prevalence in the world, with the percentage of Chinese women living with HIV/AIDS also increasing significantly. Chinese women's risk of HIV infection is heavily influenced by patriarchal cultural beliefs, Confucian doctrines, and rapid social and economic changes in China. Chinese women generally have a low level of awareness of HIV/AIDS. With inherent inferior social status and economic disadvantage, their vulnerability to HIV infection is heightened by adverse impacts of massive rural-to-urban migration, explosion of the commercial sex industry, and prevalence of gender-based violence. In order to target HIV/AIDS prevention and treatment programs for Chinese women, their specific needs and gendered obstacles must be addressed and tackled. These include strategies that aim to fight against poverty, improve education, enhance HIV/AIDS awareness, facilitate new life-skills acquisition and behavior change, make available woman-centered services for testing and treatment of HIV, and eradicate gender-based discrimination and violence. There is also an urgent need to further develop various public health infrastructure in China, especially in remote and rural areas. The pool of gender experts in China should also be expanded to conduct a thorough gender analysis and design a national response to address the evolving HIV/AIDS epidemic in Chinese women.     

城郊社区外来工文化生活状况的调查研究——以浙江绍兴城郊社区为例

关注城市农民工生活现状，保障他们的合法权益，使他们在异乡能安居乐业，更好地为当地经济建设和社会发展服务，深受各级政府组织关注。本调查的关注点是城郊社区外来工的文化生活状况。调查显示，该市城郊社区外来工收入相对较高，但影响外来工文化生活质量的主、客观因素依然存在，仍迫切需要政府、社会和用工单位的关心帮助和积极引导。     

Prevalence of Sexually Transmitted Diseases and Risk Behaviors from the NIMH Collaborative HIV/STD Prevention Trial

ABSTRACT

This cross-sectional study describes the baseline prevalence and correlates of common bacterial and viral sexually transmitted diseases (STDs) and risk behaviors among individuals at high risk for HIV recruited in five low- and middle-income countries. Correlations of risk behaviors and demographic factors with prevalent STDs and the association of STDs with HIV prevalence are examined. Between 2,212 and 5,543 participants were recruited in each of five countries (China, India, Peru, Russia, and Zimbabwe). Standard protocols were used to collect behavioral risk information and biological samples for STD testing. Risk factors for HIV/STD prevalence were evaluated using logistic regression models. STD prevalence was significantly higher for women than men in all countries, and the most prevalent STD was Herpes simplex virus-type 2 (HSV-2). HIV prevalence was generally low (below 5%) except in Zimbabwe (30% among women, 11.7% among men). Prevalence of bacterial STDs was generally low (below 5% for gonorrhea and under 7% for syphilis in all sites), with the exception of syphilis among female sex workers in India. Behavioral and demographic risks for STDs varied widely across the five study sites. Common risks for STDs included female gender, increasing number of recent sex partners, and in some sites, older age, particularly for chronic STDs (i.e., HSV-2 and HIV). Prevalence of HIV was not associated with STDs except in Zimbabwe, which showed a modest correlation between HIV and HSV-2 prevalence (Pearson coefficient = .55). These findings underscore the heterogeneity of global STD and HIV epidemics and suggest that local, focused interventions are needed to achieve significant declines in these infections.     

HIV Infections Among Older Male Clients of Low-Cost Commercial Sex Venues in Southern China

This study aimed to identify the association of unsafe sex behaviors with HIV infection among the male clients who purchase commercial sex in low-cost sex venues. A cross-sectional study was conduct in a southern province of China among male, low-cost commercial sex clients, who were over 50 years old. Participants were interviewed using a structured questionnaire and had completed HIV testing. Among the 3,485 participants, the prevalence of HIV was 2.96% (95% confidence interval: 2.40–3.52%). The associated risk factors studied for HIV infection included (1) not currently married; (2) use of counterfeit TCMs with sildenafil; (3) noncondom use during commercial purchased sex; and (4) recent engagement of commercial sex within past week. Given the high prevalence of HIV infection among the study group, more political policy intervention and health education should be considered for the identified subpopulation (over 50-year-old men in low-cost commercial venues, counterfeit TCMs with sildenafil and noncondom use).     

Young Clients of Hotel-Based Sex Workers in Bangladesh: Vulnerability to HIV,Risk Perceptions,and Expressed Needs for Interventions

ABSTRACT

A qualitative study was conducted among key informants and 53 young clients (15 to 24 years of age) of commercial sex workers from nine hotels in Dhaka, Bangladesh. Respondents reported first sexual encounter before 18 years of age, and reasons for purchasing sex were to prove masculinity or to reduce wet dreams and masturbation, thought to be detrimental to health. Limited knowledge of HIV and sexually transmitted infections was linked to high-risk sexual practices. Condom use was related to perceptions of cleanliness, status, and trust in the sex worker.

A hotel-based, confidential intervention program promoting safe sex practices among clients of sex workers is warranted.     

Prostitution and the Politics of HIV Prevention in Cambodia: A Historical Case Study

Cambodia received international attention in the early 1990s when it emerged from civil war with the highest HIV rate in Asia, in which up to 60% of sex workers were infected. A massive influx of financial, human, and material resources ensued, and debates over “best practices” for HIV prevention were played out. Over time, the politics of AIDS shifted, mirroring changes in the politics of the largest player in global health, the United States. This sparked acrimonious polarization within international health policy, with direct implications for the lives of sex workers. This article traces those debates over sex work and HIV, highlighting the example of one brothel district in Cambodia where Medecins Sans Frontieres provided services to over 300 migrant Vietnamese sex workers. Using literature and program documentation from the time, this article highlights how countries such as Cambodia can become vulnerable to manipulation and used to serve wider political agendas.     

Improving the contribution of migrant remittances to development: the experience of Asian labour-exporting countries

"The purpose of this paper is to review policy initiatives [concerning migrant remittances] in six major labour-exporting countries in Asia--Bangladesh, India, Korea, the Philippines, Pakistan, Sri Lanka, and Thailand. Where relevant, the experience of these countries will be compared and contrasted with those of labour-exporting countries in other parts of the world....[The author concludes that] the imposition of mandatory remittance requirements on migrant workers is unlikely to enhance remittance inflows unless the government of the labour-exporting country effectively controls the migration process." (SUMMARY IN FRE AND SPA)     

Battling for Survival, Battling for Moral Clarity: "Illegality" and Illness in the Everyday Struggles of Undocumented HIV+ Women Migrant Workers in Tel Aviv

Undocumented migrant workers living with HIV/AIDS in Israel, like their counterparts elsewhere, are doubly abject due to their lack of legal status on one hand and their ill health on the other. Unlike Israeli citizens living with HIV/AIDS, who can access an array of state funded treatments and support services, undocumented migrant workers living with HIV/AIDS are marginalized both by the state's exclusive immigration regime and by its efforts to shake off responsibility for their health needs. At the same time, HIV treatment and care are generally unavailable in migrants' countries of origin. Despite the state's exclusionary orientation and in contradiction of official policies, certain forms of HIV treatment are available to undocumented migrants through the day‐to‐day efforts of a small array of activist Israeli NGOs, (state‐employed) doctors, and state officials. The tension between these simultaneous, oppositional processes of exclusion and inclusion generate a “gray area”— a zone of competing values, claims and interests‐ in which undocumented migrants living with HIV/AIDS and these other stakeholders search for new options and possibilities while continually taking pains to protect their own varied, and often competing, interests. Actors thus constantly bargain with laws, health policies, and one another in a collective battle not only over migrants' chances of survival, but also over the rationality and the morality underlying the state's “and their own” decisions and choices. Anchored within this complex, indeterminate zone, the present article draws upon ethnographic field research conducted among undocumented HIV+ migrant women in Tel Aviv to explore some of the stakes, mechanisms, and outcomes of these complicated, high stakes negotiation processes.     

新生代农民工教育需求探析

对新生代农民工来说,教育是提高自身人力资本、实现经济地位和社会地位转变的最主要途径。总体来看,新生代农民工对教育需求强烈,偏好学历教育,学习内容上体现了明显的市场经济导向,在教育机构的选择上存在一定的差异性。因此,技能与学历相结合的教育是最适合于新生代农民工的教育,可以通过深化成人教育和职业教育改革、规范培训机构、加强政府扶持力度和强化企业责任等途径以满足新生代农民工群体的特殊需要。     

Global HIV and AIDS: Calling all Social Work Educators

As the HIV/AIDS global pandemic continues to grow through a third decade, the need for social work educators to prepare social workers in distinct fields of practice with skills to assist those infected with and affected by HIV is of paramount importance. HIV/AIDS holds multi-level and multi-system effects for vulnerable populations. This article features global HIV and AIDS teaching resources beginning with common global practice challenges. Next, five teaching units focus on practice needs and challenges of divergent vulnerable populations including men who have sex with men, women, injecting drug users (IDU), commercial sex workers, and children orphaned by AIDS. Discussion questions, selected readings and electronic resources accompany each unit. The authors close the article with suggested recommendations for content integration into social work courses, and next steps for the profession.     

Evaluation of HIV/AIDS prevention through peer education, counselling, health care, training and urban refuges in Ghana

Since 1996, Ireland Aid has supported UNICEF Ghana in the implementation of five activities that promote behaviour change to limit the spread of HIV/AIDS and STIs. The interventions are run by different local organisations, and have provided over 75,000 in and out-of-school youth and commercial sex workers with preventive education. People retained the information given, are knowledgeable about how HIV is transmitted, and can name key preventive methods. They pass on the information to their friends. Commercial sex workers were empowered to support one another in negotiating for safer sex. The programme was supported by community members, leading to demand for condoms and for education on HIV/AIDS/STIs. One project gave support to pregnant girls, including health care and vocational training. A drawback in the programme has been the occasional delays in the supply of the educational materials to the peer educators.     

从农民工进城住房入手改革户籍制度

现阶段城市户籍实际代表了三项公共服务:以城市最低生活保障为主的社会救助服务,以经济适用房和廉租房实物或租金补贴为主的政府补贴性住房安排,以及迁移人口子女在城市公立学校平等就学的机会。户籍制度改革的关键,就在于如何通过有效的政策改革方案,为外来人口提供可支付的住房,以及为其子女教育建立有效的融资机制,从而使外来务工人员主要是农民工可以在城市定居下来。土地制度改革可以作为突破口,通过城中村政府和村民有效的公私合作,充分利用市场机制为外来人口提供可支付住房,辅以相关财税体制改革,同时可以有效解决外来务工人员子女的教育问题。在通过土地制度改革和相关财税体制改革有效解决了外来人口住房问题和子女教育问题后,户籍制度改革也就完成了实质性突破。     

Invisibility and Temporary Residence Status of Filipino Workers in South Korea

This study concerns a group of Filipino immigrant workers–mostly trainees or undocumented workers–in Korea. It deals with the influence of immigration on family members and their relations. The stories of sending babies to the Philippines and talking on the phone show how the concept of transnational motherhood can be applied to immigrant workers in Korea. This study also discusses the meaning of invisibility and temporary residency as a two‐control mechanism of immigrant workers in Korea. Korean society keeps immigrant workers invisible and prevents their becoming members of society in many ways. Therefore, Filipino migrant workers do not belong to either their home country or Korea.