Stigma Consciousness Concerns Related to Drug Use and Sexuality in a Sample of Street-Based Male Sex Workers

Abstract

Measurement of, and response to, three different stigmas and their exposure (homosexual behavior, sex work, and drug use) were studied a group of 90 key-informant recruited male sex workers in Houston, Texas who were over 18 and had exchanged sex for money in the previous 7 days. Respondents reported on self-identified sexual orientation and were interviewed, including providing responses on a measure of perceived stigma relating to sexual behavior and drug use. Two thirds were white, almost all had used drugs (many in the past week), and half had ever injected. A fifth identified as heterosexual, with the remainder split between gay and bisexually-identified men. There was a high level of homelessness and contact with the criminal justice system for drug and property offences. Consciousness about drug-related stigma was moderately associated with concerns about drug-related exposure and sensitivity to rejection as a drug user, but not to exposure as homosexual or as a sex worker. Drug-using status is related to greater concern about exposure as a sex worker. Data suggest that stigma is domain-specific and that there are different patterns of response to different stigmata in the same individual. Measurement of stigmata and concern about exposure and rejection need to be specific to stigmatized behaviors, and not generalized to other stigmatized behaviors since the data suggest that they are minimally related.     

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.     

Risk and Protective Factors Associated with Personal Mastery Among Sexual Minority African-American Female Sex Workers

Research among sexual minorities has traditionally examined problems such as substance use, HIV risk, mental health problems, and victimization. Among sexual minority street-based female sex workers, these vulnerabilities can be magnified. Grounded in theories of resilience, this study examines risk and protective factors associated with a high level of personal mastery among a vulnerable population of women. Data are drawn from baseline interviews from street-based African-American female sex workers enrolled in a randomized intervention trial in Miami, Florida. We compare sexual minority (N = 197) and heterosexual (N = 365) women on measures of risk and protective factors; among sexual minority women we present logistic regression analyses which reveal that severe mental distress and HIV transmission risk are associated with low levels of personal mastery, while protective factors of transportation access and social support are associated with high levels of personal mastery. These findings suggest that these protective factors may potentially facilitate the development of personal mastery and represent beneficial avenues for intervention efforts.     

Students Who Strip: The Benefits of Alternate Identities for Managing Stigma

We apply interactionist theories that highlight the contextual nature of stigma and the relational quality of stigmatization to the case of college students who work as topless dancers. We explore how the “toll of stripping” might be mediated by having an alternate, positive identity like “student.” Our analysis demonstrates that students who strip are distinctive from other strippers in important ways that stem from their salient, positive identity as students. Although they often feel as if they live a “double life” because they hide their occupation from family and friends, they benefit from sharing their student goals and ambitions with club customers. “Student” is a socially acceptable identity to share in routine social interactions and helps student strippers frame dancing as a transient occupation, offering them an opportunity to maintain a positive sense of self while buffering them from some of the negative effects of stripping.     

Predicting the Job Satisfaction of Female Sex Workers in Queensland,Australia

ABSTRACT. This study used a cross-sectional survey to examine job satisfaction and its correlates among 247 female sex workers working as private service providers, in licensed brothels, and in illegal sectors of the industry (mainly street-based workers). Overall, most sex workers reported positive job satisfaction. Satisfaction was higher in women working legally and was comparable with women from the general population. Multivariate analyses revealed that job satisfaction was significantly linked to women's reasons for initially entering the industry. Sex workers’ age, education, marital status, length of time in the industry, and current working conditions were apparently less important for satisfaction.     

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.     

Childhood Sexual Abuse as a Risk Factor for Subsequent Involvement in Sex Work

Abstract

The following paper is a review of research studies examining the relationship between childhood sexual abuse (CSA) and subsequent involvement in sex work. The vast majority of research studies in this area are conducted on primarily female street-based prostitutes; however, there has been a recent emergence of studies focused on male, predominantly gay/bisexual, participants. Also, more studies have begun to include mixed gender samples and non-sex worker comparison groups. Highlights of the paper include a critique of studies reporting a prevalence of CSA, the intervening effects of family environment, runaway behavior, and abuse characteristics, and a brief overview of research on other sex worker populations. Limitations as well as contributions of current studies are underscored and directions for future research are indicated.     

Group Work Practice with Transgendered Male to Female Sex Workers

Abstract

Group work is frequently the method of choice for working with adolescents. This paper focuses on group work with transgend-ered youth who engage in sex work. Utilizing case examples, this paper provides an overview of the role that sex work plays in the lives of some transgendered youth and offers guidance for those interested in utilizing group work approaches with transgendered adolescents.     

Gender Stereotypes and the Reshaping of Stigma in Rehabilitative Eldercare

Rehabilitation policies are becoming increasingly popular in eldercare as a means to ensure dignity and reduce costs. This paper examines the implications of rehabilitation within Danish homecare work, a type of work that is often stigmatized due to its associations with low‐status ‘dirty’ body work in old people's homes. The paper combines two research traditions: studies of dirty work and studies of body work. It draws on observations and focus groups in Denmark to explore how the introduction of rehabilitation changes the work of care workers, and how such changes are associated with a potential reshaping of stigma. In contrast to previous research, this paper shows that although rehabilitation was partly introduced to reduce stigma of this type of work, the practice of rehabilitation paradoxically reinforces the stigma that it attempts to manage. Thus, the analysis helps to improve our understanding of the ambiguous and varying ways rehabilitative eldercare reshapes and reinforces stigma and gender stereotypes among women who do ‘dirty’ body work.     

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.     

Vice Careers: The Changing Contours of Sex Work in New York City

In the mid-1990s, changes to law enforcement strategies in New York City pushed many women working in the sex trade off of the streets and into the indoors. Increasing numbers of women began advertising sexual services in bars, over the Internet, and in print media, and conducting their work in their homes, hotels, and brothels. This study uses in-depth interviews and participant observation to examine the impact of this change on the life and work of women working in New York’s indoor sex trade. A critical finding is that as women move their work indoors, they begin to conceive of sex work as a profession and a career, rather than just a short-term means of employment. This “professional and careerist orientation” may have significant implications for the length of women’s tenure in sex work and ultimately, for their ability to exit the trade completely.

From Exploitation to Industry: Definitions,Risks, and Consequences of Domestic Sexual Exploitation and Sex Work Among Women and Girls

In the last 15 years, terms such as prostitution, sex trafficking, sexual exploitation, modern-day slavery, and sex work have elicited much confusion and debate as to their definitions. Consequently several challenges have emerged for both law enforcement in the prosecution of criminals and practitioners in service provision. This article reviews the state of the literature with regard to domestic, sexual exploitation among women and girls in the United States and seeks to (1) provide definitions and describe the complexity of all terms relating to domestic sexual exploitation of women and girls in the United States, (2) explore available national prevalence data according to the definitions provided, and (3) review the evidence of mental health, social, and structural risk factors at the micro-, mezzo-, and macrolevels.     

‘It's Just Acting’: Sex Workers’ Strategies for Capitalizing on Sexuality

This article reports on an ethnographic study of female sex workers in Britain who work in the indoor prostitution markets. The empirical findings contribute to the sex‐as‐labour debate and add to the sociological literature regarding the gendered and sexualized nature of employment, particularly the aesthetic and emotional labour of service work. Grounding the empirical findings in the theory of identity management and emotional labour and work, the article reviews some of the existing examples of how sex workers create emotion management strategies and describes an additional strategy, that of the ‘manufactured identity’. I argue that sex workers create a manufactured identity specifically for the workplace as a self‐protection mechanism to manage the stresses of selling sex as well as crafting the work image as a business strategy to attract and maintain clientele. Drawing on comparisons between sex work and other feminized service occupations, I argue that sex workers who are involved in prostitution under certain conditions are able to capitalize on their own sexuality through the construction of a manufactured identity. The process of conforming to heterosexualized images in prostitution is conceptualized as not simply accepting dominant discourses but as a calculated response made by sex workers to manipulate the erotic expectations and the cultural ideals of the male client.     

Sex Work,Office Work: Women Working Behind the Scenes in the US Adult Film Industry

Women currently working behind the scenes in the adult film industry both inform considerations of the contemporary experiences of sex work in the USA and shed some light on differential experiences of gendered workplace organizations. Based on ethnographic observations and informal interviews conducted at a typical adult film production company and on examining the industry's historical development, I have found that a diverse range of occupations and occupational opportunities are available for women in the adult film industry and women workers in the US adult film industry experience their gendered workplace in unique ways. I suggest that this is due in part to the adult film industry's wider social network, which has itself been shaped by the historical development of the adult film industry and the stigma of sex work.     

Correlates of Homophobia and Use of Gay Affirmative Practice Among Social Workers

ABSTRACT

Research on social work practice with gay and lesbian clients has historically focused on examining social workers' attitudes towards gay and lesbian individuals, however, no studies have examined the relationship between attitudes and practice using validated measures to assess practice. The focus of this study was therefore to examine the relationship between attitudes and practice with gays and lesbians using the recently developed and validated Gay Affirmative Practice Scale (GAP). Significant relationships were found with the GAP and two measures of homophobia as well as with measures that assessed feelings about lesbians and gay men, contact with gays and lesbians, attendance at workshops that focused on gay and lesbian issues, relationship status, sexual orientation, political party, and primary area of practice. Relationships with measures of attitudes were also examined. Implications for social work practice, education, and research are discussed.     

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).     

The Second Closet: A Qualitative Study of HIV Stigma Among Seropositive Gay Men in a Southern U.S. City

ABSTRACT

Objectives: Stigma connected with HIV/AIDS has decreased considerably since the early epidemic yet affects those living with HIV in many ways. Little research, particularly qualitative research, concerning HIV stigma from the perspective of gay men has emerged. The present qualitative study aimed to fill this evidence gap by examining how HIV stigma is perceived and experienced by gay men who have become HIV-infected and how they respond to this stigma. Methods: Thematic analysis of 19 gay men's narratives identified six main themes. Results: Encountering HIV stigmatization was common and was linked to the physical stigmata identifying respondents as HIV-positive. Overwhelmingly, they found stigmatization to be most intensely felt within gay communities. One profound theme was internalized HIV stigma, referring to respondents’ internalized negative feelings about their HIV status. A related theme was the closeted nature of HIV. Lastly, regarding how the men dealt with the HIV diagnosis and experiences of HIV stigma, a theme of adaptation became clear. Conclusions: Although exploratory, the results can serve as a beginning framework for understanding and assisting seropositive gay men who experience HIV stigma. The findings are important because it is realistic to expect that in a climate in which HIV has become increasingly invisible and closeted and in which infections are on the rise, gay and bisexual men will be increasingly affected and infected by HIV.     

Transactional Sex: Supply and Demand Among European Men Who have Sex with Men (MSM) in the Context of Local Laws

Objectives: Transactional sex (TS) is generally defined as the trading of sex for material goods. Cast within the broader context of prostitution laws, we examined variations in the sociodemographic profile of men who have sex with men engaging in TS by payment direction (buying/selling). Methods: The data were collected as part of the 38-country European Men who have sex with men Internet Survey project, conducted in 2010. Results: About 12% of respondents reported engaging in TS in the past year. TS was associated with laws, age, education, employment, and residence. Conclusions: The striking sociodemographic differences in TS by payment direction suggest a power differential and a leading role of socioeconomic factors in TS.     

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.     

Conceptions of Immigrant Integration and Racism Among Social Workers in Sweden

Drawing on 22 qualitative interviews with social workers in Sweden, this article analyzes how social workers conceive immigrant integration and racism and tackle racism within their institutions and the wider Swedish society. The majority of the white social workers framed integration in relation to cultural differences and denied or minimized the role of racism in structuring their services and the ethnic relations in Sweden. In contrast, social workers with immigrant backgrounds were less compromising in discussing racism and assumed it as a problem both for themselves as institutional actors and as immigrants in everyday life and institutional settings. Social institutions in Sweden have been important actors in endorsing equality and accommodating differences. However, it is of paramount importance for social justice-minded social workers to identify and unsettle those structures and discourses that enable racist and discriminatory policies and practices against those groups who are not viewed as “core” members of the Swedish society. The absence of anti-racist social work within Swedish social work is primarily related to the idea of color-blind welfare universalism that is assumed to transcend the particularity of the needs, experiences, and perspectives of different groups in Sweden. While integration is envisioned and framed as a political project of inclusion of non-white immigrants, it tends to become a political device through which hierarchies of belonging are constructed. Following such conception of integration, cultural/religious differences and equality are framed as conflicting where cultural conformity underpinned by assimilationist discourses becomes a requirement for political, social, and economic equality.