Sexual Risk,Behavior, and HIV Testing and Status Among Male and Transgender Women Sex Workers and Their Clients in Lima,Peru

Objectives: To determine the socio-demographics, sexual practices, and HIV prevalence of male sex workers (MSWs), transwomen sex workers (TSWs), and their male clients in Lima, Peru. Methods: Following ethnographic mapping of sex work venues, the authors revisited randomly selected venues to survey MSWs, TSWs and their clients. Results: MSWs and TSW clients are more educated than MSW clients and TSWs. Only 50% of TSW clients have received HIV testing. Self-reported HIV positivity is highest among MSW clients and TSWs. Conclusion: Notable differences exist between MSWs and TSWs and their clients that can affect the health of these groups and warrant intervention.     

Sustaining an intimate and sexually fulfilled marriage or partnership in older adulthood with a disability: Perspectives of social workers

ABSTRACT

The American portrayal of sex is often left for only the young, attractive, and able-bodied. In contrast many studies have found that older adults with disabilities in marriages and intimate partnerships have sexual desire and sexually active lives. Social workers are often burdened with balancing the sexual intimacy desires of their older adult clients with disabilities, alongside the need to protect them from sexual abuse and exploitation, particularly among those who may lack the capacity to consent due to cognitive impairment. This phenomenological study aimed to understand the lived professional experience of social workers (N = 5) in supporting married and intimately partnered couples in which at least one person was an older adult with a disability to understand the clients’ needs and common social work practice methods used to address their needs. Inductive coding was used to identify themes and subthemes. Their role included helping their clients to learn about their ability to have sex, consenting to sex, negotiating accommodations for intimacy and sex with their spouses, and counseling those who took on caregiver roles for their spouses. Social workers reported that individual diagnosis, such as dementia, should not alone determine one’s ability to consent to sex.     

Sexual Behavior,Mental Health,Substance Use,and HIV Risk Among Agency-Based Male Escorts in a Small U.S. City

Abstract

Relatively little research has examined the personal sex lives of indoor male sex workers (MSWs) or possible connections in this group between sexual behavior and factors related to HIV risk. As part of a larger project, this study collected data from 30 agency-based indoor MSWs (mean = 22.4 years) about their sexual behavior, mental health, and substance use. Few HIV risk behaviors with clients occurred. Drug use and mental health problems were relatively frequent, but not related to increased risk behavior. Instead, MSWs appeared to employ rational decision-making and harm-reduction strategies. Conceptualization of MSW sexual behavior may be required where HIV risk is not attributed to sex work per se, but to other influences such as economic and relational factors.     

An Investigation of the Incidence of Client-Perpetrated Sexual Violence Against Male Sex Workers

ABSTRACT

This article discusses exploratory research investigating the incidence and context of client-perpetrated sexual violence against male sex workers. Four different methods (Web-based surveys, tick-box questionnaires, telephone, and face-to-face interviews) were employed in this study of 50 male escorts. The qualitative data were analyzed using an adapted form of grounded theory. It was found that client-perpetrated sexual violence within male sex work appears to be uncommon. However, when sexual violence did occur the cause was a disagreement over barebacking. Escorts’ explanations for the low level of sexual violence within this sector included (1) that gay men were non-confrontational, (2) their clients led clandestine lifestyles avoiding undue attention, and (3) comparatively, female sex workers were perceived to be more vulnerable resulting in the higher level of sexual violence within the female sex work industry.     

Prevalence and Behavioral Correlates of Depression and Anxiety Among Male Sex Workers in Vietnam

ABSTRACT. Objectives: This study assessed depression and anxiety symptoms and their association with high-risk sexual and drug behaviors among male sex workers in 3 Vietnamese cities. Methods: Male sex workers ages 16 to 35 years old completed an interview that included the Center for Epidemiological Studies Depression Scale to assess depressive symptoms and the Beck Anxiety Inventory to assess anxiety symptoms, as well as questions assessing drug and sexual risk practices. Results: A majority of participants reported depressive symptomatology, although fewer reported symptoms of anxiety. Risky sexual and drug use practices predicted both types of symptoms. Conclusions: Mental distress is associated with drug and sexual risk among male sex workers.     

The Friends Thou Hast

Abstract

Most studies of male commercial sex workers (CSWs) in Thailand have been framed within a context of HIV risk and have investigated sexual behaviours and HIV knowledge. However, Mann et al. (1992) have identified health and social services and a supportive social environment as equally essential partners in an HIV-preventive triumvirate. This paper is based on extended observation and a series of in-depth interviews with forty-three male CSWs who are both organised (bar workers) and freelance as well as a number of clients (farang and Thai) and bar management. This paper examines the social environment in which male CSWs operate. It considers workplace conditions and support, the personal relationships workers have with parents, friends, clients, other bar workers and management, and how these are influenced by workers' cultural norms. A number of recommendations designed to reduce HIV-infection rates are made.     

Existential social work and the quest for existential meaning and well-being: A conceptual framework

ABSTRACT

The aim of this article is to conceptualize “existential social work.” A greater understanding of what existential social work means may enable social workers and those studying social work to see how its practice can reveal “the truth” about human existence and how they, as professionals, can enhance existential meaning and existential well-being among their clients. In such work, existential social workers have at their disposal tools such as the Frankl therapeutic approach to existential analysis (i.e., logotherapy) as well as spiritual-sensitive modalities (prayer and mindfulness). To interpret and understand apparent phenomena in the therapy is the ultimate goal with existential social work practices, thus providing clients with the opportunity to discover the meaning that exists in themselves. In addition, these practices pave the way for existential well-being.     

Rehearsing Gender and Sexuality in Modern Thailand

Abstract

In this paper I draw on a series of interviews with gay-identified Thai men, and with male bar workers and their clients in order to chart the traditions, discourses, and institutional contexts contributing to the construction of gender and sexual identity in Thailand. I argue against the uncritical application of Western paradigms to the study of Thai sexuality and present a view of gender and sexuality that is “fluid and pragmatic.” I consider difficulties associated with sexual choice and levels of acceptance and toleration, and look at examples of how sex work has been socially constructed. Finally, I discuss the attachment of Thai male bar workers to the “gay” community.     

Investigating the Timing of First Sexual Intercourse Among Youth in EDO State,Nigeria in the Context of the Aids Epidemic

ABSTRACT

Objectives: This study examined the timing of sexual debut among youth in Edo state, Nigeria given the role that sexual abstinence plays in HIV prevention in sub-Saharan Africa. Methods: Survey data were collected from rural youth aged 11 to 17 years old enrolled in Junior Secondary Schools in Edo State, Nigeria. Discrete-time hazard techniques were used to examine the effects of theoretically relevant covariates on the timing of sexual debut among youth in Edo State. Results: Results indicate strong, significant relationships between psychosocial predictors and age at first sex for boys and girls. Youth with higher levels of knowledge about HIV as well as those who rejected common myths about HIV transmission delayed first sexual intercourse. Early sexual intercourse was strongly associated with experiencing pressure to engage in sex, while delay was associated with greater confidence that one could decline to participate in sex. On the other hand, youth with higher condom use self-efficacy engaged in first sexual intercourse at an earlier age. Conclusions: These results support the relevance of programs such as Nigeria's Family Life and HIV Education to contribute to delaying sexual intercourse focusing precisely on the forms of knowledge, myth rejection, motivation, and behavioral self-efficacy measured here. They provide policymakers with concrete evidence to increase support for such programming as a means to combat the spread of HIV among youth.     

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.     

Agency Practices Affecting Social Workers Who Treat Substance-Abusing Clients

Abstract

This study interviewed 115 MSWs with substance abuse training working in general social service agencies to determine if they viewed their settings as facilitating or hindering their work with substance-abusing clients. This study builds on the work of Lightfoot and Orford (1986) who found that social workers were more hindered than helped by their agencies' practices regarding substance-abusing clients.

Results: A majority of workers viewed their agencies as facilitating substance abuse-related work through support from supervisors and administrators, availability of substance abuse training, workers' freedom to choose clients, and opportunities to supervise others on substance abuse-related issues. Supervisor data corroborated these findings. This is a hopeful sign for the profession contrasting with considerable social work literature documenting the profession's historic ambivalence toward substance-abusing clients.     

Culturally responsive social work practice with D/deaf clients

ABSTRACT

D/deaf individuals are often marginalized in our society. A lack of cultural understanding among social workers serving this population, coupled with communication barriers, inconsistent access to interpreters, or misperceptions of culture, adds to the potential for further marginalization. D/deaf individuals seeking mental health and social services live in a unique cultural context with which social workers may not be familiar and experience persistent issues surrounding access to mental health and social services. This article reviews some useful best practices, cultural points to be aware of, and suggests some strategies for providing culturally responsive social work when working D/deaf clients.     

Between Money,Morality and Masculinity

Abstract

This paper focuses on the supply-side of Chiang Mai's gay bars, that is, the male sex workers called dek bar or “bar boys”¹ in Thai. I formulate some explanations why these young men -more than half of whom do not consider themselves to be “homosexual” -take on a job as a male sex worker. In this analysis I focus on certain notions in traditional Thai society, trends in contemporary urban Thai society, the economics of work in a gay bar, as well as the sexual behaviour of male sex workers and the concepts they use to describe their work.     

The Connections of Mental Health Problems,Violent Life Experiences,and the Social Milieu of the “Stroll” with the HIV Risk Behaviors of Female Street Sex Workers

Abstract

This paper examines the connections of mental health, victimization, and sexual risk behaviors among a sample of 278 street-based female sex workers in Miami. Using targeted sampling strategies, drug-using sex workers were recruited into an HIV prevention research program. Data were collected by trained interviewers, and focused on drug use and sexual risk for HIV, childhood abuse, recent victimization, and mental health. More than half of the participants reported histories of physical (51.1%) or sexual (53.1%) abuse as children, 37.4% were classified with moderate or severe anxiety symptoms, and 52.9% had symptoms of moderate or severe depression. Logistic regression analyses demonstrated significant associations between mental health issues and engagement in recent unprotected vaginal and oral sex. The program development and policy implications of these findings are discussed.     

Lesbian,Gay Male,Bisexual and Transgendered Elders: Elder Abuse and Neglect Issues

ABSTRACT

Unfortunately, due In large measure to our society's still-pervasive social prejudice against and ignorance about sexual orientation and gender minorities, there have been few studies of this population of elders, and virtually no one has examined how this population's culture affects its experience with elder abuse. Based on the author's knowledge of this community and discussions with social workers and domestic violence specialists who serve it, these clients are likely to be more resistant than other clients to accepting services. Greater awareness of the existence and circumstances of lesbian, gay male, and transgendered elders should help protective services staff in building rapport with these clients and in getting them the services and assistance that they need.     

Psychosocial Correlates of Premarital Sex Among College Students in Hunan Province,China

ABSTRACT

A cross-sectional study was conducted to examine the psychological and sociocultural factors associated with premarital sexual behavior among a sample of 1,875 Chinese college students in Hunan Province. Chi-square tests, t-tests, and logistic regression were used to determine any variations in the variables between those who had initiated sex and those who had no sexual experience. Students who were impulsive decision makers were more likely to have had premarital sexual intercourse. Those participants who perceived that their parents/friends would approve of their having sex and those who were more exposed to sexual media programs were more likely to have premarital sexual intercourse. Male students were almost 2 times more likely than female students to have had premarital sex. The findings provide insights for developing reproductive and sexual health education programs for Chinese young adults.     

Sexual Problems and Distress among Men and Women with Same-Sex and Opposite-Sex Sexual Partners: An Analysis of a Nationally Representative Sample of Adults in Great Britain

Abstract

Objective: This study aimed to examine differences in reporting sexual problems and distress among men and women with same-sex and opposite-sex sexual partners.

Methods: Multinomial regression was undertaken on risk of reporting sexual problems and/or distress using data from the third National Survey of Sexual Attitudes and Lifestyles.

Results: Differences were detected between men of different sexual behavior groups when considering the problems “lack of enjoyment in sex,” “felt anxious during sex,” “felt no excitement or arousal during sex,” “lack of interest in sex,” “did not reach/took a long time to reach climax,” and “getting or keeping an erection.” Fewer differences were detected among women.

Conclusions: Women reporting same sex sexual partners, and to a greater extent men reporting same sex sexual partners , have different sexual health needs and report sexual health problems and distress to a different extent than is the case for individuals who only have opposite-sex sexual partners     

Family Network,Workplace Network,and Their Influence on Condom Use: A Qualitative Study Among Older Female Sex Workers in China

The objective of this study was to qualitatively explore the components of social networks and their influence on condom use among female sex workers (FSWs) aged 35 years and older in China. In-depth interviews with 63 older FSWs and 6 focus group interviews with pimps and owners of roadside salons and hotels were conducted in 3 Chinese cities. The mean age of participants was 42.6 years old (SD = 6.9 years) and the mean age of starting sex work was 38.6 years old (SD = 6.6 years). Two types of networks that influenced condom use were identified: family networks (relationship with children and husbands) and workplace networks (relationship with peers, clients, pimps, and owners). Relationships between older FSWs and their children negatively influenced condom use. Low levels of network support and norms regarding condom use were observed in the relationship between older FSWs and their clients, whereas positive social support and norms were prevalent among older FSWs who had frequent contact with peers. Norms for condom use existed among pimps and owners but were counterbalanced by monetary gains. Future human immunodeficiency virus (HIV) interventions for older FSWs should take the different features of social network components into consideration.     

Multiple sex partners among college women and men: Sexual behaviors and sexual satisfaction revisited

The purpose of this investigation was to examine the effects of number of lifetime sex partners on sexual behaviors, sexual attitudes, and sexual satisfaction for never‐married college women and men. An anonymous questionnaire was administered in select classes at a midwestern state university. One‐partner group (one sex partner) women, in comparison to few‐partner (two to five sex partners) and many‐partner (six or more sex partners) group women, were more likely to have been older at first intercourse and to report psychological sexual satisfaction, mastur‐batory guilt, and commitment and love as conditions for sexual intercourse. For men, one‐partner group respondents were also more likely than few‐partner and many‐partner group respondents to report older age at first intercourse, masturbatory guilt, and commitment and love as conditions for sexual intercourse. In an era in which early sexual fulfillment clashes with concerns over unsafe sexual practices, these data provide insights into the influence of multiple partner experience on the sexual behavior patterns of young adults.