Onto the Next Generation: Exploring the Impact of Mother's Experiences of Child Abuse and Commercial Sex Industry Involvement on Child Custody Outcomes

Women and girls remain substantially overrepresented in the commercial sex industry. While a number of outcomes have been linked to childhood abuse and involvement with the commercial sex industry, there exists a gap in understanding the unique impact of child abuse on child custody outcomes among adult women involved in the commercial sex industry. Drawing from data collected from 107 case files of adult women with a history of commercial sex industry involvement, the aim of the current study was to understand the link between child abuse history, commercial sex industry involvement, and child custody outcomes. Results indicated that among women who reported a history of child sex trafficking, 91.7% reported having endured child abuse. Further, 82.4% of women reported that their children were not under their custody. Dysfunctional family dynamics, substance abuse, and economic and structural barriers endured by these women are explored further, and intergenerational continuity of such traumagenic precarities is considered as a prolonged implication of such issues. Through a trauma-informed perspective, implications for prevention and intervention are discussed.

Prostitution in the shadow of life-long sexual abuse: Arab women's retrospective experiences

The present study uses the life-course and intersectionality perspectives to explore the meaning that aging Arab women attribute to their lived experiences of life-long sexual abuse in the shadow of engaging in prostitution. Interpretive phenomenological analysis was used to analyze the narratives of 10 older Arab women in Israel who were engaged in prostitution. Four themes emerged: experiencing childhood in the shadow of sexual abuse, becoming a prostitute, being entrapped in prostitution, and settling accounts with the native culture. Women aging in prostitution experience a harsh reality of abuse and loss. The present study points to multiple channels of abuse throughout the life course, from childhood until old age.

APPS-S: A Tool for Measuring the Attitudes Toward Prostitution and Women in Prostitution in the Spanish Population

This study was designed with the purpose of testing the psychometric properties of the Spanish version of the Attitudes toward Prostitution and Prostitutes Scale through three studies with different samples. The first one explores the test's dimensional structure or constructs validity through confirmatory factor analysis, as well as internal consistency and test-retest reliability. The second one focuses on discriminant and criteria validity. Finally, the third one examines the scale's convergent validity and its sensitivity to detecting changes. The results support two subscales with an optimal index of internal consistency, structural stability over time, and discriminative power between groups of participants. It is, therefore, an adequate tool for adults as well as young people and teenagers, and for detecting changes in the context of intervention or awareness workshops.

The "Reservoir" Metaphor in Anti-Venereal-Disease Campaigns in Mid-Twentieth-Century North America

Focusing on British Columbia during the mid-twentieth century, this article illuminates how North American medical, public-health, and law-enforcement professionals used the "reservoir" metaphor in efforts to control venereal disease (VD). It traces the transition from a pre-Second-World-War paradigm of VD eradication - what I call an epidemio-logic - focused on the single reservoir of female sex workers, to one concerned with several groups, including the White "male homosexual." The article also demonstrates how conceptualizing VD control in terms of human reservoirs led to analogical reasoning, improvements and setbacks to disease-control efforts, shifting understandings of infection risks, and changes to the built urban environment.

Fugitivity and marronage and the study of sex work

Campaigns against female prostitution used slavery as a rhetorical device to characterize the condition of sex workers, and sex work features prominently in contemporary campaigns against "modern slavery". In both types of campaigning, "the slave" is worked as a symbolic device to represent the abject condition of human beings objectified, controlled by violence or its threat, and stripped of agency and choice. The assumptions and generalizations about prostitution that inform this vision have been extensively critiqued. However, less attention has been paid to the fact that the analogy also rests on a very particular reading of "the slave" and a very partial appeal to histories of Atlantic World slavery. Histories of enslaved people's resistance and flight are entirely overlooked. The latter has recently prompted interest in fugitivity and marronage as analytic concepts, albeit concepts that are defined and deployed in different ways by different scholars and activists. This review asks whether and how they might potentially have theoretical purchase with regard to the contemporary experience (both positive and negative) of sex workers.

COVID-19 and the shifting organisation of sex work markets in Singapore

While past studies have sought to capture how the COVID-19 pandemic has impacted on the health and sexual lives of sex workers internationally, less attention has been paid to the reorganisation of sex markets as a result of COVID-19. We conducted a sequential exploratory mixed methods study using in-depth interviews, cyber ethnography and surveyor-administered structured surveys among sex workers. We report two key findings on how the pandemic has impacted sex markets in Singapore. First, the organisation of sex markets shifted as a result of lockdown and associated movement control measures. This shift was characterised by the out-migration of sex workers, the reduction in supply and demand for in-person sex work, and a shift towards online spaces. Second, we found that sex workers experienced greater economic hardship as a result of such changes. Given the potential shifts in sex markets as a result of the pandemic, we adopt a World Health Organisation Health Workplace Framework and Model to identify interventions to improve the occupational safety and health of sex workers in a post-COVID-19 era.

Out of the closet? Reconstructing the personal life of pioneering sex researcher Katharine Bement Davis

Katharine B. Davis was an important progressive-era figure, a pioneering professional, an innovative penologist, and an iconoclastic sexologist. Although scholars have long been aware of Davis's tolerant attitude toward same-sex relationships at the New York State Female Reformatory at Bedford Hills, where she was Superintendent from 1901 to 1913, and her open discussion of same-sex attraction in her study of "normal" women's sexuality, published in 1929, little has been known about Davis's personal life. Thus, it was a feminist biographer's dream come true to gain access to what Davis called her "autobiographical biography," the never-finished, never-published, story of her life. Or so I thought. As it turns out, my quest to understand Davis's personal life and how it informed her professional trajectory has been a bit more complicated.

Pleasure and protagonism: An interview with Maria de Jesus Almeida Costa, a Black sex worker activist from Brazil's Northeast region

Pleasure and protagonism are two words that define Maria de Jesus Almeida Costa, or Dijé, as friends call her. She was just an adolescent when she first arrived in the São Luiz red light district and began to fight against the violence and injustice she witnessed. Today, she is 62 years old and the leader of the sex worker movement in the Brazilian state of Maranhão, in the Northeast region of the country. She is widely recognised for her tireless fight for the preservation of the historical centre of São Luiz where the red light district remains to this day, and where Jesus also raised her children and lives to this day. In this interview, Jesus talks about the pleasures and dangers of prostitution, her fight against racism and sex work stigma, her relationship with the academy and researchers, the alliances and partnerships she mobilised during the Covid-19 pandemic and the challenges that she is facing in Brazil's current conservative, far-right government.

Why Men (Don't) Buy Sex: Purity Moralization and Perceived Harm as Constraints on Prostitution Offending

This study explores the moralization of purity and perceptions of harm as constraints on sex buying among men. Purchasing sex has long been considered an offense against public morality. While personal morality provides a powerful constraint on offending, and people may vary in the extent to which they experience moral intuitions about bodily and spiritual purity, research has so far neglected the role of purity moralization in understanding sex buying behavior. We hypothesize specifically that moral intuitions about purity constrain sex buying by leading people to perceive it as inherently wrong and by eliciting perceptions that sex buying is harmful to prostitutes. We test these hypotheses in a nationally representative survey of U.S. men (N = 2,525). Results indicate that purity moralization is associated with reduced sex buying, and that this relationship is mediated fully by perceptions of sex buying as harming prostitutes.

Life story, prostitution and activism: Challenges and possibilities of research in co-creation

This article discusses the process of writing, which I refer to here as 'co-creation', of the life story of Lourdes Barreto, co-founder of the Brazilian Movement of Prostitutes. I intertwine public history and oral history methodologies with a decolonising feminist epistemology. This theoretical framework made it possible to situate Lourdes' narratives of prostitution in the North and Northeast of Brazil within the conceptual fields of agency and resistance. Lourdes guided the fieldwork and helped me redefine how I incorporated my presence into her daily life. In dialogue with her, I sought to conduct a participatory research project, in which authorities on distinct knowledges were also shared. I refer to the intersection of subjectivities and positionalities between investigator and collaborator as part of an intense process of co-creation, participation, and negotiation. Co-creation stimulated reflections on ethical and political issues throughout the research process with Lourdes; as the narrator, she was a participant in the process as opposed to an object to be analysed. Similarly, throughout the process of researching prostitution, as a researcher, I became an active member of the movement. The essay includes photographs of the process, alongside reflections on the challenges and particularities around the relationship between researcher and narrator.

Towards action research with trans women sex workers: Policy, space and social challenges

Trans women face multiple social, economic and health inequalities and the impact of gender oppression and violence is even more profoundly experienced by trans women sex workers, although in culturally specific ways. This paper presents a pilot study conducted to explore and engage with the context of trans women sex workers in Lido Tre Archi, Italy. In line with the community psychology values of social justice, social change and participation, we outline our engagement process and key challenges observed when attempting action research with such a highly marginalised group. Data were collected in the form of ethnographic notes from informal consultations with different stakeholders and participant observations, and of documents (newspaper articles, picture captions) and were analysed using thematic analysis. Findings are organised in three themes relating to the social, policy and physical context in Lido Tre Archi demonstrating evidence of the contextual challenges and how they intertwine to generate a spiral of marginalisation and social exclusion for the participants. We take a collaborative and reflexive stance in our work and conclude with recommended steps and potential limitations to initiate an action research project.

Correlates of Exchanging Sex for Drugs or Money for Adolescent Males: A Hidden Population

Research from prostitution, sex trafficking, and commercial sexual exploitation (CSE) literature have found risk factors that can lead to both male and female youth becoming involved in this sex trade. These behaviors have been clearly defined and institutions have begun to address known risk factors. Youth who have reported involvement in trading/exchanging sex still remain hidden with limited information known about this group. The exchanging/trading sex literature has failed to explore correlates of involvement for adolescent males. This study explores factors found in prior research related to prostitution, sex tracking, and CSE to begin to understand adolescent males who exchanged sex for drugs or money. A secondary data analysis was used to examine the exchange of sex for male youth aged 12 to 18 in the United States. Results reveal that sexual activities were significant in predicting exchanging sex indicating a need for a more in-depth analysis of current and potential correlates for males.

A survey of condom use among female sex workers in Northern Sydney; declining condom use for fellatio

Condom use among female sex workers (FSWs) is dynamic. We conducted a survey, by anonymous questionnaire, of condom use among FSWs routinely attending our clinical service in Northern Sydney. Logistic regression models determined associations with inconsistent condom use. All 201 women approached completed a questionnaire. Chinese-born women comprised 67% of participants. The median age was 35 years. Clients requesting unprotected fellatio was reported by 95% of participants, and approximately two-thirds felt pressure to have unprotected fellatio and vaginal sex (VSI). Inconsistent condom use at work was reported by 74% for fellatio and by 24% for VSI. The strongest adjusted association with inconsistent condom use for fellatio was monetary inducement by clients (aOR = 40.7, 95% CI 4.87-340, p = 0.001). The only other significant adjusted association was age ≥ 30 years (p = 0.02). The strongest adjusted association with inconsistent condom use for VSI was also monetary inducement by clients (aOR = 56.1, 95% CI 9.26-340, p < 0.001). Other significant adjusted associations were Chinese-speaking participants (p = 0.03) and clients requesting unprotected VSI (p = 0.02). We report high levels of inconsistent condom use. Health promotion should assist FSWs, particularly those of Chinese ethnicity, develop skills in dealing with pressure for unprotected sex, particularly fellatio.

The Criminalized Victim: Evaluating Public Perceptions of Sex Trafficked Individuals

Individuals who have been sex trafficked are continuously being targeted for prostitution and other related offenses instead of being recognized for their victimization. This may occur due to a fundamental lack of understanding of the sex-trafficked experience, allowing for misperceptions to form unhindered. Individuals with these misperceptions then go on to form laws and services intended to aid victims, but instead leave them vulnerable and criminalized. This study assessed whether an educational intervention on the experience of a sex-trafficked individual could influence public perceptions of free will doubt and criminal culpability. This study used a non-equivalent groups posttest-only design to administer an article on the sex trafficking experience, including the trauma and coercion a victim faces, or a neutral article on optical illusions, to then assess sex trafficking knowledge, free will doubt, and culpability beliefs. Participants (N = 445) were recruited from the general public through Amazon Mechanical Turk and were reimbursed for their involvement. Results suggest that even when individuals display a basic understanding of the sex trafficking experience, they do not fully comprehend the complexities of how free will can be compromised by trauma and coercion, ultimately affecting perceptions of personal culpability for criminal activity.

Treponema pallidum in female sex workers from the Brazilian Marajó Archipelago: prevalence, risk factors, drug-resistant mutations and coinfections

BACKGROUND

Female sex workers (FSWs) are an especially vulnerable group for syphilis and other sexually transmitted infection (STIs). This study determined the prevalence of syphilis in FSWs and factors associated with this disease in the Marajó Archipelago (northern Brazil), as well as the frequency of point mutations (A2058G and A2059G) in the 23S rRNA gene of Treponema pallidum and coinfections with hepatitis B virus (HBV), hepatitis C virus (HCV) and hepatitis D virus (HDV).

METHODS

FSWs were diagnosed using a rapid qualitative test and the isolates were evaluated for the presence of point mutations by real-time PCR. Blood samples with T. pallidum were tested for the presence of HBV, HCV and HDV by ELISA and confirmed by real-time PCR. The factors associated with syphilis were identified using Poisson regression models.

RESULTS

Overall, 41.1% FSWs tested positive for syphilis and 23.5% were infected with strains having A2058G/A2059G point mutations. HBV (23.0%) and HCV (8.1%) were detected among FSWs with syphilis. Six factors were associated with syphilis: low levels of education, reduced income, drug use, unprotected sex, a lengthy career in prostitution and a lack of regular medical check-ups.

CONCLUSIONS

These findings indicate an urgent need for implementation of effective strategies to diagnose, prevent and treat syphilis, as well as other STIs, in this Brazilian region.

Examining hopes, aspirations, and future plans of women in non-brothel-based sex work in Kolkata, India

Sex work can offer a quick way of making money and is the only profession in which women may earn more in fewer hours when compared to other available jobs. However, most studies with sex workers in India are based on socially biased assumptions about sex work; that is, women are either coerced or trafficked into sex work. Limited attention has been paid to the voices of non-brothel-based sex workers in India. Drawing data from a larger ethnographic study conducted between December 2009 and July 2010, this paper analyses how women sex workers operating from non-brothel-based sex work settings in Kolkata, India, foresee their future. Unlike the popular 'victim imagery' of women sex workers in the Global South, this study found that women are not passive recipients of the trade; instead, they employ agency - sometimes transgressing the normative boundaries and at times reinscribing these boundaries to secure a future for themselves and their families. Therefore, to promote HIV preventive behaviour programmes reaching out to sex workers, non-governmental organisations (NGOs) must proactively inquire about women's future plans and assist them in materialising their future goals, which are mostly concerned with their children's future, a life free of stigma/shame, and financial security in old age.

"Back to Where They Were": The Socio-Discursive Representation of Transgender Sex Workers and Urban Space in a Television News Report

Despite significant advances in recent years, Argentina's transgender community still faces structural social exclusion. For a vast majority of transvestites and transgender women, early expulsion from the family home and the educational system results in having to resort to prostitution as their only option for surviving. Police edicts and other similar devices are used to penalize prostitution and persecute transgender people in public places, showing that prejudice and violence against their identities also manifest in the control of urban space. Here I present the results of an in-depth qualitative linguistic analysis of a 2018 television news report about the temporary relocation of the transgender sex workers from their usual location in the Bosques de Palermo, the biggest public park in the City of Buenos Aires. The theoretical frame is Critical Discourse Analysis and the methodology is inductive and qualitative. The analysis centers on the linguistic resources that define the socio-discursive representation about the transgender sex workers in relation with urban space and the city's government. The bases of the analysis are the Synchronic-Diachronic Method for the Linguistic Analysis of Texts and the Method of Converging Linguistic Approaches. These methods revealed, in the first place, that the transvestites and transgender women are represented as mere occupants of public space through their close association with the discursive category of Space. In the second place, they are represented as fundamentally passive in relation to the Government of the City of Buenos Aires; while, at the same time, the government's responsibility for their displacement is systematically mitigated. Finally, the lack of work alternatives to prostitution for the transgender community is naturalized through the persistent association of the discursive categories connected with transgender people, prostitution and urban space. If we compare these results with those of previous research, we can see that these discursive features-none of which challenge the status quo-remain one of the basic components of the socio-discursive representation of transgender people elaborated by the mainstream media.

Students in the Sex Industry: Motivations, Feelings, Risks, and Judgments

Student sex work is a current phenomenon all over the world, increasingly reported by the media in recent years. However, student sex work remains under-researched in Germany and is lacking direct first-hand reports from the people involved. Further, sex work remains stigmatized, and therefore, students practicing it could be at risk of social isolation and emotional or physical danger. Therefore, this study examines students working in the sex industry focusing on their personal experiences and attitudes toward them. An online questionnaire was completed by 4386 students from Berlin universities. Students who identified themselves as sex workers (n = 227) were questioned with respect to their motivations to enter the sex industry, characteristics of their job, feelings after the intercourse, and perceived risks. Student non-sex workers (n = 2998) were questioned regarding knowledge of and attitudes toward student sex workers. Most student sex workers reported that they entered the sex industry due to financial reasons (35.7%). The majority reported offering services involving direct sexual intercourse. Disclosing their job to friends, family, or others was associated with less problems with social isolation and in romantic relationships. With a total of 22.9%, student non-sex workers reported never having heard about students working in the sex industry. The most frequent emotions mentioned by them with regard to student sex workers were compassion and dismay (48.9%). There was no difference in happiness between student sex workers and non-sex working students. Through this research, it becomes evident that there are similarities between the student’s motivations to enter the sex industry, their feelings, and the problems they have to face. Moreover, prejudices still prevail about the life of student sex workers. Increasing understanding of student sex work might help those sex workers to live a less stigmatized life and thereby to make use of support from others. The universities as institutions could form the basis for this, e.g., by openly supporting student sex workers. This could help to encourage the rights of student sex workers and to gain perspective with respect to the sex industry.

The Dark Tetrad and Male Clients of Female Sex Work

Many scholars have investigated the attitudes, beliefs, motives, and behavior of male clients of female sex workers. However, few have examined individual differences in major dimensions of personality expressed by men who purchase prostitution compared to those who do not. Although several evolutionary psychologists have studied prostitution and those involved in sex work, to our knowledge, none have explicitly considered the utility of an evolutionary personality perspective in trying to understand why particular men pay for sex. In the current mini-review, following other researchers, prostitution is described principally as a form of short-term mating sought primarily by men. We argue that the socially aversive traits embodying the Dark Tetrad (narcissism, Machiavellianism, psychopathy, and sadism) may characterize certain male clients of female sex workers, particularly those consumers expressing the motives of desiring exciting and novel sex with women who are treated with contempt, perceiving prostitution in a business-like manner with little emotional involvement, and seeking to dominate and control sex workers who are viewed as vulnerable and subservient. The traits of the tetrad may also be more prevalent among men who purchase sex from female sex workers in outdoor (e.g., street prostitution) in comparison to indoor settings (e.g., escort agencies).

Sex trafficking, prostitution, and increased HIV risk among women during and after the 2015 Nepal earthquake

Women might be at increased risk of HIV infection after a disaster situation due to several interlinked environmental and social factors, such as increased sex trafficking and prostitution, in resource-limited settings. However, this information has not been clearly understood. Based on the review of available gray and peer-reviewed evidence, the present debate paper summarizes potential factors for increasing women's HIV risk during/after two earthquakes that hit Nepal in 2015. Poverty and socio-economic crisis, displacement and reduced social capital, increased rate of sex trafficking and prostitution, and poor access to health care seem to be the factors to increase women's HIV risk in the earthquake-affected areas of Nepal. There is a lack of essential empirical evidence on environmental and social factors (e.g. increased sex trafficking and prostitution) that are linked with women's HIV risk in the post-disaster phase. Therefore, the factors and interactions discussed should be further studied potentially in disaster-affected areas so that locally and culturally salient and sustainable relief and reconstruction strategies, which include strategies for preventing HIV risk in post-disaster situations, can be developed.

Pre-exposure HIV prophylaxis (PrEP) among transgender women: 3 years of follow-up in a university hospital in Paris

OBJECTIVES

The principal outcome was to describe clinical characteristics of a transgender male-to-female (TGW) cohort followed for pre-exposure HIV prophylaxis (PrEP).

INTRODUCTION

Few efforts and preventive interventions have targeted transgender population, despite them being at great risk of HIV infection.

METHODS

This was a retrospective transgender male-to-female (TGW) cohort followed for PrEP at Bichat Hospital Sexual Health Clinic between February 2016 and January 2019.The principal outcome was to describe clinical characteristics of this TGW population: modalities of PrEP uptake, treatment adherence and tolerance, sanitary system retention, hormonal therapy and STIs.Data about age, ethnicity, language, sex work and sanitary healthcare insurance coverage were also collected.

RESULTS

Forty-nine TGW were included, with a median age of 33 years; 43/49 (87.7%) were from South America and 43/49 (87.7%) were sex workers. Forty-four 44/49 TGW (89.7%) had no regular healthcare insurance coverage. Nineteen out of 49 (38.7%) had a history of STI in the last 12 months. Hormone intake was reported in 16/49 (32.60%). PrEP with oral TDF/FTC was prescribed on a daily basis for 45/49 TG (91.8%). Two TGW discontinued PrEP for gastrointestinal intolerance. No case of renal toxicity or HIV seroconversion has been reported. Retention rate was high (71.4%), but average follow-up was 9 months.

CONCLUSIONS

Our data showed a very vulnerable population, with a high proportion of migrants, sex workers and with a low healthcare insurance coverage. Retention rate was high (71.4%). Further multi-component interventions are needed to improve global sex health approach, PreP follow-up and sanitary system retention among TGW population.

Popular repugnance contrasts with legal bans on controversial markets

We study popular attitudes in Germany, Spain, the Philippines, and the United States toward three controversial markets-prostitution, surrogacy, and global kidney exchange (GKE). Of those markets, only prostitution is banned in the United States and the Philippines, and only prostitution is allowed in Germany and Spain. Unlike prostitution, majorities support legalization of surrogacy and GKE in all four countries. So, there is not a simple relation between public support for markets, or bans, and their legal and regulatory status. Because both markets and bans on markets require social support to work well, this sheds light on the prospects for effective regulation of controversial markets.

Court-Affiliated Diversion Programs for Prostitution-Related Crimes: A Comprehensive Review of Program Components and Impact

OBJECTIVE

Court diversion programs offer alternative treatment interventions in lieu of punitive sanctions. Programs have recently been developed for women arrested for prostitution, with a recognition that many of these individuals frequently experience multiple forms of violence and experience multiple barriers to exiting sex work. This review aims to (a) examine programmatic components used across programs, and (b) identify the diversionary programs' impact on participants.

METHODS

Studies were identified by entering key search words into three electronic databases and by conducting a citation search.

RESULTS

Nine articles were included in the review. Although programs varied in structure, services, and length of time, studies indicated a range of positive outcomes for participants.

CONCLUSIONS

Results help to illuminate future directions for criminal justice practice, policy, and research.

Victim or Prostitute? The Classification of Commercial Sex Events Involving Minors in the National Incident-Based Reporting System

Sex trafficking is recognized as a national problem that inflicts serious harm on its victims, yet, legislative responses to trafficking vary depending on jurisdiction. Federal legislation considers youths who engage in commercial sex acts as trafficking victims. States, however, vary in the evidence required to prove a juvenile is a victim of sex trafficking, as opposed to an offender of prostitution. Using four years of data from the National Incident-Based Reporting System, we compared details of commercial sex incidents involving youths who were identified as trafficking victims or arrested as prostitutes. Beyond legislative differences, comparisons between cases are discussed to illuminate how state law enforcement officials legally classify these events involving adolescents (i.e., as victims or prostitutes). Further, we consider the policy implications of the findings.

The Influence of Legal Brothels on Illegal Sexual Service Purchasing Habits: The U.S. Context

In this study, we use a survey of sex workers' clients to examine the relationship between having paid for services in legal brothels in Nevada and paying for criminalized sexual services among male clients. Using ordinary least squares (OLS) and generalized ordered logistic regression models, the use of legal brothels is found to be negatively related to reported purchasing of criminalized sexual services, regardless of criminal history, income, and most other demographic factors. When tested by criminalized purchase context, purchases made using the Internet, from public, outdoor contacts (such as the street) and indoor, public contacts (like bars), were less likely to occur with brothel experience. This study addresses a critical gap in scholarship on sex workers' clients purchasing choices with consideration to both market choice and frequency of purchase when having been exposed to a legal replacement for an illegal transaction. Implications and areas of further study are discussed.

Examining Recidivism in a Prostitution Diversion Program

Street-based sex work is criminalized throughout much of the U.S. Diversion programs have shown mixed results. This study examined the effect a quasi-experimental intervention (prostitution diversion program, n = 149) had on prostitution rearrest compared with a waitlist control group (n = 77) among N = 226 individuals arrested for prostitution in Baltimore. In both groups, n = 64 (28.32%) were rearrested for prostitution over 30 months. Tests of differences compared groups with a significant difference in gender only. A Cox proportional hazard model examined differences in survival time (to recidivist prostitution arrest) between individuals in the control and intervention groups at 6, 12, 18, 24, and 30 months. Results indicate that participation in the intervention did not have a significant effect on decreasing prostitution arrests over time. History of prior prostitution arrest was a significant predictor (hazard ration [HR] = 1.12, p = .02) of rearrest.Lack of program success suggests that barriers to exiting prostitution are substantial, despite availability of supportive services, and that diversion programs may not be the best intervention strategy for all sex workers. Future research should identify motivators for exiting and how to reduce exiting barriers.

Sex Work and the Karmic Wheel: How Buddhism Influences Sex Work in China

As prostitution is widely condemned as a form of criminality in China, there is a need to examine how Buddhism functions not as a form of therapy for the purposes of rehabilitating or deterring prostitution but as a force that encourages participation in prostitution. In this work, we argue that rural-urban migrant sex workers who are Buddhists appropriate the religion's teachings of compassion, mindfulness, and karma to find a renewed sense of meaning and purpose in their livelihoods. We illustrate how Buddhism allows sex workers to cultivate the affective labor required for the purposes of servicing male clients in conjunction with finding positive purpose in their lives. In doing so, their bodies gain affirmative value in the form of helping their heterosexual male clients address deficits in their masculinities.

Risk Factors for Domestic Child Sex Trafficking in the United States

Despite increased effort to respond to human trafficking at national and state levels, very little empirical research has been conducted on domestic child sex trafficking. This study retrospectively examines associations between multiple risk factors and domestic child sex trafficking (i.e., entry into the commercial sex industry under the age of 18) in a sample of individuals aged 16 and older currently involved in the commercial sex industry ( N = 273). Two primary research questions are addressed: (1) What set of risk factors, prior to entering the commercial sex industry, are associated with domestic child sex trafficking and (2) what group differences, if any, exist in risk factors between current or former domestic child sex-trafficking victims and non-trafficked adults engaged in the commercial sex industry? A cross-sectional survey was administered using Respondent-Driven Sampling (RDS) in five cities in one Midwestern state. Overall, 115 participants (48.3%) were identified as current or former domestic child sex-trafficking victims. Bivariate results suggest that childhood emotional and sexual abuse, rape, ever running away from home, having family members in sex work, and having friends who purchased sex were significantly associated with domestic child sex trafficking. Multivariate results indicate that domestic child sex trafficking victims were significantly more likely to have ever run away and to be a racial/ethnic minority than non-trafficked adults engaged in the commercial sex industry. Findings can inform state-level policies on human trafficking and assist child protection and juvenile justice agencies in developing prevention and intervention responses to commercial sexual exploitation.

Risky sexual behavior and sexually transmitted infections among men who have sex with men and purchase sex attending an Israeli sexually transmitted infection clinic

Men who have sex with men (MSM) and purchase sex (MPS) are a sub-group potentially at high risk for acquiring and transmitting sexually transmitted infections (STIs). This is a hard-to-reach population resulting in a scarcity of studies covering the issue. This cross-sectional study aimed to assess the association between purchasing sex and high-risk behaviors related to HIV/STI transmission and appraise the STI prevalence among MSM. All MSM who attended the STI clinic in Tel Aviv between 2003 and 2010 were included. Demographics, behavioral, clinical, and laboratory data were compared between MPS and non-MPS to identify high-risk sexual behaviors and STI prevalence associated with purchasing sex. Of the first visits of 2694 MSM who attended the STI clinic during the study period, 151 (5.6%) paid for sex. MPS were more commonly older and married than non-MPS. MPS were more likely to engage in behaviors associated with high risk for HIV/STI transmission, including infrequent condom use during anal sex, substance use during sex, and selling sex themselves. MPS had a higher STI prevalence than non-MPS, although this was not statistically significant ( p = 0.05). These findings highlight the need to establish culturally tailored interventions for MPS addressing the potential risks associated with purchasing sex.

Culturally Competent Health Care for Sex Workers: An Examination of Myths That Stigmatize Sex-Work and Hinder Access to Care

Sex workers are individuals who offer sexual services in exchange for compensation (i.e., money, goods, or other services). Within the United States the full-service sex work (FSSW) industry generates 14 billion dollars annually there are estimated to be 1-2 million FSSWers, though experts believe this number to be an underestimate. Many FSSWers face the possibility of violence, legal involvement, and social stigmatization. As a result, this population experiences increased risk for mental health disorders. Given these risks and vulnerabilities, FSSWers stand to benefit from receiving mental health care however a constellation of individual, organizational, and systemic barriers limit care utilization. Destigmatization of FSSW and offering of culturally competent mental health care can help empower this traditionally marginalized population. The objective of the current review is to (1) educate clinicians on sex work and describe the unique struggles faced by FSSW and vulnerability factors clinicians must consider, (2) address 5 common myths about FSSW that perpetuate stigma, and (3) advance a research and culturally competent clinical training agenda that can optimize mental health care engagement and utilization within the sex work community.

Stigma as a Barrier to Mental Health Service Use Among Female Sex Workers in Switzerland

Background: Many sex workers suffer from mental health problems, but do not seek help. Aim: To examine stigma-related and non stigma-related barriers to care and perceived need for treatment among female sex workers in Switzerland. Methods: Mental health service use, barriers to care, perceived need and presence of illness, symptoms, and psychiatric diagnoses were assessed among 60 female sex workers in Zürich, Switzerland. Outcomes: Mental health service use was defined as use of psychiatric medication, psychotherapy, or substance use services for at least 1 month during the past 6 months. Results: Adjusting for symptom levels, mental health service use was predicted by lower stigma-related, not by structural, barriers as well as by more perceived need for treatment and higher age. Clinical Implications: Sex workers with mental health problems would benefit from non-stigmatizing mental health care as well as from interventions to reduce public and self-stigma associated with mental illness and sex work. Strengths and Limitations: Limitations are the cross-sectional data, limited sample size, and recruitment from an information center for sex workers. Conclusion: Interventions that aim to increase mental health service use among sex workers should take stigma variables into account.

Despite Being "Known, Highly Promiscuous and Active": Presumed Heterosexuality in the USPHS's STD Inoculation Study, 1946-48

The Sexually Transmitted Disease Inoculation Study of the United States Public Health Service (USPHS) was a short-term deliberate exposure experiment into the prevention of venereal diseases. Between 1946 and 1948, over 1,300 Guatemalan prisoners, psychiatric patients, soldiers, and sex workers were exposed to syphilis, gonorrhoea, and chancroid. USPHS researchers initially proposed hiring sex workers to "naturally" transmit venereal diseases to male subjects who would then be given various prophylaxes. The researchers were interested in studying the effectiveness of new preventative measures. In other words, the USPHS study was designed to transmit venereal diseases heterosexually from an "infected" female body to the men who, it was assumed, were sexually isolated subjects. However, the researchers did record instances of male-to-male disease transmission among their subject populations, instances that challenged the presumption of heterosexuality on which the study was based.

Is Paid Surrogacy a Form of Reproductive Prostitution? A Kantian Perspective

This article reexamines the "prostitution objection" to paid surrogacy, and argues that rebuttals to this objection fail to focus on surrogates as embodied persons. This failure is based on the false distinction between "selling one's reproductive services" and "selling one's body." To ground the analysis of humans as embodied persons, this article uses Kant's late ethical theory, which develops the conceptual framework for understanding human beings as embodied selves. Literature on surrogacy commonly emphasizes that all Kantian duties heed to the categorical prohibition to treat persons as mere means. What this literature leaves out is that this imperative commands us more specifically to engage ourselves and others as embodied persons. This article aims to relate this point to a specific issue in assisted reproduction. It argues that a Kantian account of human beings as embodied persons prohibits paid surrogacy on exactly the same grounds as it prohibits prostitution.

Migration, Agency, and the Sex Industry: Practitioners' Perspectives on Foreign Sex Workers in Turkey

The article presents the political, economic, and sociocultural factors that make Turkey an attractive destination for foreign sex workers, and reviews trends in official statistics of arrested traffickers, rescued victims, and deportation of migrant illegal sex workers. In-depth interviews of 20 law enforcement and nongovernmental organizations staff members, who in the course of their work come into close contact with foreign sex workers, shed light on the statistics. The interview data provide insights into the structure of the Turkish sex market, the factors that bring foreign women to work in this market, and the impact of legal reforms on the circumstances of foreign sex workers. The article concludes with the implications of the findings for public policy.

Challenges Facing Asian Sex Workers in Western Australia: Implications for Health Promotion and Support Services

Introduction: Asian sex workers are a significant part of the Australian sex industry. Criminal laws, racism, isolation, poor English language skills and stigma and discrimination combine to increase the vulnerability of Asian sex workers in Australia. To inform service delivery and potential legislative reform, we undertook a study of sex worker health and safety in Western Australia with a focus on Asian sex workers.

Methods: This was a mixed methods study in which peer researchers played an essential role. We undertook a survey (available online and in paper form and translated into three languages other than English), semi-structured interviews with sex workers, and interviews with key advisors.

Results: In our study, Asian sex workers were older, had lower levels of education, more likely to have sex work as their main source of income, work longer hours and work exclusively in a shop-front massage parlor compared to their non-Asian counterparts. The vast majority of Asian sex workers in our study said they had poor English language skills and the greatest proportion spoke Chinese languages. Sex work had a positive impact on the well-being of many respondents, and their level of psychological distress was similar to the general Australian population. Stress and “bad clients” were common negative impacts of sex work. Asian study participants were less likely than their non-Asian counterparts to smoke, undertake risky drinking or use illicit drugs. A similar proportion of Asian sex workers reported being assaulted compared to their non-Asian counterparts.

Discussion/Conclusion: The major challenges facing Asian sex workers in WA seem to be stigma and discrimination, stress, social isolation, and confusion about their legal standing leading to a fear of authorities, particularly the police. Our findings support the need for enhanced targeted peer-based health promotion outreach services for Asian sex workers, increased Asian language services in sexual health clinics and decriminalization of sex work.

Indigenous Australian women's colonial sexual intimacies: positioning indigenous women's agency

Colonialist views of Indigenous bodies and sexualities continue to affect Indigenous peoples worldwide. For Indigenous Australians, this burden has resulted in repression and oppression of power, sex and desire. Focusing on the sexual intimacies of Indigenous Australian women, this paper provides an account of the dominant Australian historical discourses, finding that Indigenous women were viewed as exotic, erotic, something to be desired, yet simultaneously something to be feared. Our sexualities were described as savage, promiscuous and primitive and we were often viewed as prostitutes with our voices and views constrained by patriarchal and imperial regimes of power. But within this context, Indigenous women fought back through both individual and collective acts of agency. This paper demonstrates how Indigenous Australian women's agency not as a new phenomenon but rather as a position that disrupts the popular discourses of exploitation and victimhood that have been persistently perpetrated against Indigenous women.

Comparing Sex Buyers With Men Who Do Not Buy Sex: New Data on Prostitution and Trafficking

We investigated attitudes and behaviors associated with prostitution and sexual aggression among 101 men who buy sex and 101 age-, education-, and ethnicity-matched men who did not buy sex. Both groups tended to accept rape myths, be aware of harms of prostitution and trafficking, express ambivalence about the nature of prostitution, and believe that jail time and public exposure are the most effective deterrents to buying sex. Sex buyers were more likely than men who did not buy sex to report sexual aggression and likelihood to rape. Men who bought sex scored higher on measures of impersonal sex and hostile masculinity and had less empathy for prostituted women, viewing them as intrinsically different from other women. When compared with non-sex-buyers, these findings indicate that men who buy sex share certain key characteristics with men at risk of committing sexual aggression as documented by research based on the leading scientific model of the characteristics of non-criminal sexually aggressive men, the Confluence Model of sexual aggression.

Psychosocial Stress, Course of Pregnancy and Pregnancy Outcomes in the Context of the Provision of Sexual Services

Introduction There has been very little medical research into pregnancies which occur in the context of prostitution, even though the associated health risks for mother and child, e.g. violence or maternal drug abuse, are well known. The aim of this study was to compile and summarize what is known (inter-)nationally about this topic and identify key points of support as part of a uniform standard of healthcare in pregnancy. Material and Methods A selective search of the literature was done in Pubmed and Livivo/Medpilot and in the databases NIH, Cochrane, DARE, NHSEED and HTA on the factors influencing preterm delivery. Results There are no systematic studies on pregnancy risks in the context of sexual services. But there is data available on specific risk factors, for example the increased risk of prematurity associated with sexual/physical violence (OR = 1.28-4.7). The Prostitute Protection Act provides only limited protection for affected women, and statutory maternity protection regulations also have little impact as they require a formal contract of employment which rarely exists even in the context of legal prostitution. Conclusion Approximately 400 000 women are currently working as prostitutes in the Federal Republic of Germany. The number of unreported cases is high. Nevertheless, there is little concrete data available on the probable health risks if these women become pregnant. The existing laws that should offer protection fall short of the mark. There is a need for more research into the future implementation of the Prostitute Protection Act which should focus on health counselling, health promotion and additional protective legislation. Low-threshold healthcare services offered in the context of prenatal care could be an opportunity to improve care.

Childhood Maltreatment and Child Protective Services Involvement Among the Commercially Sexually Exploited: A Comparison of Women Who Enter as Juveniles or as Adults

A risk for commercial sexual exploitation is childhood maltreatment. It's unknown whether juveniles in commercial sexual exploitation experience more childhood maltreatment than adults or how involved child protective services is in investigating maltreatment, a focus of this study. Women (N = 96) who sold sex commercially completed a cross-sectional questionnaire. Descriptive statistics, t tests, chi-squares, and odds ratios were used to examine differences in background, childhood maltreatment, and child protective services involvement by juvenile or adult entry. Although 93% of participants experienced child maltreatment, juveniles had increased odds of parent/caregiver sexual abuse, being left alone, being kicked out, and running away from a parent/caregiver. There were no differences in cumulative childhood maltreatment resulting in an investigation or removal, indicating that juveniles not investigated or removed by child protective services had as much childhood maltreatment as juveniles who were investigated or removed by child protective services. Results highlight the need for child welfare staff to recognize childhood maltreatment as risks for commercial sexual exploitation.

Hunter-Prey Discourse: A Critical Discourse Analysis of the Online Posts of Men Who Buy Sex

BACKGROUND

The Internet has emerged as a major expediter of the commercial sex (CS) industry. While use of web-based CS industry sites is brisk, the full extent of their impact remains unclear particularly how they influence users' views of the CS industry.

OBJECTIVE

This research study sought to uncover the nuances of buyers' interactions on an online CS website.

DESIGN

Six hundred sixty-six online posts from 363 unique members were collected and analyzed using critical discourse analysis.

RESULTS

Via the use of language and dialogue, particular ways of thinking about and talking about buying sex are normalized and reinforced. Evident within these discursive patterns are mechanisms by which assumptions are forwarded, perceptions shaped, and authority established.

CONCLUSIONS

Information about how CS industry websites establish beliefs, relationships, and practices among its users may increase understanding of how the CS industry seeks to gain acceptance in the American culture and normalize its activities.

Regulating sex work: subjectivity and stigma in Senegal

Senegal provides a unique example of a sub-Saharan African country with a legal framework for the regulation of commercial sex work. While registering as a legal sex worker affords women access to valuable social and medical resources, sex work is condemned by Senegalese society. Women who engage in sex work occupy a socially marginal status and confront a variety of stigmatising discourses and practices that legitimate their marginality. This paper examines two institutions that provide social and medical services to registered sex workers in Dakar: a medical clinic and a non-governmental organisation. It highlights the discourses about sex work that women encounter within these institutions and in their everyday lives. Women's accounts reveal a variety of strategies for managing stigma, from discretion and deception to asserting self-worth. As registered sex workers negotiate their precarious social position, their strategies both reproduce and challenge stigmatising representations of sex work. Their experiences demonstrate the contradictory outcomes of the Senegalese approach to regulating sex work.

Introduction to the Culture, Health & Sexuality Virtual Special Issue on sex, sexuality and sex work

This article provides an editorial introduction to a virtual special issue on sex work and prostitution. It offers a brief history of sex work studies as published in the journal Culture, Health & Sexuality; reflects on the breadth and scope of papers the journal has published; considers the contribution of the journal's papers to the wellbeing and sexuality of people who sell sex; and envisions future areas of inquiry for sex work studies. As authors, we identify major themes within the journal's archive, including activism, agency, context, discourse, hazard, health, legalisation, love, place, power, race, relationships, stigma and vulnerabilities. In particular, we reflect on how HIV has created an environment in which issues of culture, health and sexuality have come to be disentangled from the moral agendas of earlier years. As a venue for the dissemination of a reinvigorated scholarship, Culture, Health & Sexuality provides a platform for a community of often like-minded, rigorous thinkers, to provide new and established perspectives, methods and voices and to present important developments in studies of sex, sexuality and sex work.

Womb Rentals and Baby-Selling: Does Surrogacy Undermine the Human Dignity and Rights of the Surrogate Mother and Child?

The question of surrogacy has dominated much of the European human rights agenda over the last two years, at the time writing, the Parliamentary Assembly of the Council of Europe hopes to adopt a resolution on surrogacy in the coming months. There is, however, danger in taking action at a supranational level to address the European 'surrogacy problem', without first honestly answering the question: does surrogacy undermine the human dignity and rights of the surrogate mother and child? This paper presents the case that surrogacy, by its nature, necessarily undermines the human dignity of both the woman and child born through such arrangements, and thus neither commercial nor altruistic surrogacy can ever be justified.

Entrapment and Enmeshment Schemes Used by Sex Traffickers

Emerging research suggests that sex traffickers/pimps control the majority of trafficked girls in the United States. The youthfulness of these victims and their lack of psychosocial maturity severely diminish their ability to detect exploitative motives or withstand manipulation of traffickers. A review of 43 cases of sexually exploited girls involving non-relative traffickers and 10 semi-structured interviews with social service providers revealed numerous scripts and schemes used by sex traffickers to entrap and entangle victims including boyfriend/lover scripts, ruses involving debt bondage, friendship or faux-family scripts, threats of forced abortion or to take away children, and coerced co-offending. These findings inform potential prevention efforts and highlight the need for multi-systemic, victim-centered approaches to intervention.

Tackling Trafficking by Targeting Sex Buyers: Can It Work?

The European legal instruments on human trafficking encourage states to tackle the demand for services of trafficked persons, for example, by making the use of services of a trafficked person a criminal offense. In Finland, buying sex from a trafficked person is a criminal offense. This article reports the results of an evaluation of the Finnish law and shows that the implementation has been inefficient. The authors argue that with an amendment of the law, the implementation could be improved but a truly efficient policy would require a total ban of sex purchase along the lines of the Swedish model.

Gendered contexts: Psychopathy and drug use in relation to sex work and exchange

Few scholars have examined psychopathology correlates of sex work. It has been suggested that sex work may reflect manifestations of impulsive-antisocial psychopathic traits (e.g., reckless disregard, delinquency) in women more than men. The current work examined relative contributions of drug dependence and distinct psychopathic features in relation to traditional forms of sex work (i.e., prostitution) in women, along with gender differences in psychopathy relationships with casual forms of sex exchange (i.e., trading sex for necessities). Study 1 included 171 community-dwelling women offenders, and Study 2 included 319 participants (42.3% women) with histories of drug use and/or violence. Participants completed the Psychopathy Checklist: Screening Version, prostitution was measured as self-report and/or public record data across studies, and sex exchange in Study 2 was assessed using a questionnaire based on prior research on sexual risk-taking. Findings across both studies demonstrated that although psychopathic traits, particularly impulsive-antisocial features, were associated with prostitution in women above the use of drugs, drug dependence did not moderate the relationship between psychopathic traits and prostitution in women. Analyses of Study 2 data revealed that impulsive-antisocial traits were associated with sex exchange at low, but not high, levels of interpersonal-affective traits across participants. As well, interpersonal-affective traits were significantly positively related to sex exchange in men and not significantly (and negatively) related in women. In sum, impulsive-antisocial traits related to prostitution among women, suggesting that women may manifest these traits within intimate contexts. Moreover, findings indicated gender differences in the manifestation of interpersonal-affective traits within sexual exchange contexts. (PsycINFO Database Record

Women Exiting Street-Based Sex Work: Correlations between Ethno-Racial Identity, Number of Children, and Violent Experiences

Through this article the authors examine data collected from 126 women seeking services at a transitional housing facility, primarily for women leaving street-based prostitution. Descriptive statistics on the women's ethno-racial identity, numbers of children, and experiences with violence are presented and analyzed to determine correlations and implications for social service providers working with this unique population of women. Nearly half of respondents are women of color, a majority have given birth to at least one child, and more than half are in a non-commercial intimate partnership, with a significant number reporting extensive experiences with violent trauma and abuse. Results indicate statistically significant differences in women's ethno-racial self-identification and their experiences of sex work and violence, as well as their marital status. Most notably, African-American and Hispanic women face the greatest and most diverse forms of intimate partner violence and negative sex industry experiences, with African-Americans more likely to engage in sex work as minors, be sexually abused as children, work for a pimp, and face physical assault and instances of sex trafficking. Results also support existing research showing correlations between traumatic childhood events and adult substance abuse, sexual assault, and other negative outcomes.

Psychological health and HIV transmission among female sex workers: a systematic review and meta-analysis

Current HIV prevention interventions for female sex workers (FSWs) have tended to target the cognitive factors in changing their behaviors, yet little attention has been paid to the psychological factors that influence the behavior of women in sex work. This review aimed to explore the associations between the psychological health of FSWs and HIV risk. A total of eight studies published in English before July 2013 were identified and reviewed. FSWs had reported psychological issues, including depression, suicidal thoughts as well as lower quality of life, and the pooled prevalence of probable depression was as high as 62.4%. The majority of studies showed that higher scores in psychological health problems were associated with increased HIV risk behavior, in particular inconsistent condom use, or sexually transmitted infections. Among the five studies which measured symptoms of depression, four documented that higher depression scores were significantly associated with inconsistent condom use among FSWs with their clients and/or partners. Meta-analysis using a fixed-effects model was performed to examine the association between depression and inconsistent condom use and found that higher scores in depression were significantly associated with inconsistent condom use (odds ratio = 2.57, p < .001). This review contends that future HIV preventive interventions should take psychological health of FSWs into consideration.