Sexual safety practices of massage parlor-based sex workers and their clients

Abstract

The Outreach and Research in Community Health Initiatives and Development (ORCHID) project examines social and structural factors that contribute to HIV/AIDS risk among women working in Vancouver's indoor sex industry and their clients. From 2006 to 2009, two mixed method studies were undertaken in ORCHID: one exploring experiences of women working in the indoor sex industry, mainly in massage parlors, and the other exploring experiences of men as sex "buyers." Both studies emphasize sexual health and safety, risk and protective behaviors, and related contextual factors. No analyses examining the sexual health and safety practices of massage parlor-based sex workers and clients exist in the Canadian context. To address this gap, we analyze two survey datasets - with 118 sex workers and 116 clients. Upon comparing demographics of sex workers and clients, we discuss their condom use and sexually transmitted infections (STI) and HIV testing practices. Sex workers and clients reported high rates of condom use for vaginal/anal intercourse. While both groups reported lower rates of condom use for oral sex during sex transactions, clients did so to a greater extent (p < 0.001). Condom use with noncommercial sex partners was reported to be less consistent by both groups. STI testing was higher among sex workers than clients (p < 0.001). Initiatives targeting clients of massage parlor-based sex workers for STI education and testing are needed. Future research should investigate how different types of relationships between sex workers and clients impact their sexual safety practices.

A Content Analysis of Health and Safety Communications Among Internet-Based Sex Work Advertisements: Important Information for Public Health

“…The study findings build on nascent empirical understandings of the content of Web-based advertisements [19,22,23,27,41]. This research also contributes particular topics for consideration in public health and eHealth programming among the growing population of sex workers who use the Internet as their primary means to communicate, at least initially, occupational health and safety details to potential clients.…”

“…Condom use was regularly communicated for anal or vaginal intercourse, yet less than half of the advertisements communicated that a condom was required for oral-genital sex. Although there is growing evidence that many sex workers may experience STI infection rates similar to or less than the general population [12,46,47], the lack of condom requirement for oral-genital sex may still pose a significant health threat for them [41,48,49]. For example, STIs such as syphilis, gonorrhea, and chlamydia can be transmitted via oral-genital contact and can be asymptomatic [50].…”

“I’m Not Looking for Mr. Right, Just Mr. Right Now”: Men Clients of Men Escorts

“…The participants in this study employed a number of different strategies to mitigate the risk of contracting HIV and other STIs. First and foremost, and consistent with the findings of Minichiello et al (2000), participants reported using condoms consistently for anal sex, although no participants reported using condoms for the, markedly less risky, oral sex 27 (see also Kolar, Atchison, and Bungay 2014). Some participants were preoccupied with ensuring that the escort they hired consistently engaged in safer anal sex practices.…”

“…The second position approaches sex work as work and asserts that sex workers' vulnerability to violence, exploitation, and poor labour practices is the result of social conditions (i.e. criminalization and stigma) (Atchison, Vukmirovich, and Burnett 2015, Kolar, Atchison, and Bungay 2014, Jones 2013, Gysin and Gysin 2013, Joseph and Black 2012, Milrod and Weitzer 2012, Pettinger 2011, Pruitt and Krull 2011, Atchison 2010, Sanders 2008a, Bernstein 2007, Earle and Sharp 2007, Lowman and Atchison 2006, Pitts et al 2004, Bernstein 2001, Jordan 1997, Plumridge et al 1997, Armstrong 1978. These scholars argue that through the decriminalization of sex work and challenging the stigma associated with the sex industry, sex workers can work in safety and in dignity.…”

“…Research from this perspective has historically been limited to studies that interviewed sex workers about their clients (rather than speaking with clients themselves) (Boyle 1994, Armstrong 1978. Over the last two decades or so, a small body of literature has emerged in which data is gathered from clients directly through interviews (Jones 2013, Gysin and Gysin 2013, Sanders 2008a, Bernstein 2007, Bernstein 2001, Jordan 1997, Plumridge et al 1997) and intervieweradministered or self-administered surveys (Kolar, Atchison, and Bungay 2014, Atchison, Vukmirovich, and Burnett 2015, Joseph and Black 2012, Atchison 2010, Lowman and Atchison 2006, Pitts et al 2004. The advent of the Internet facilitated the emergence of review boards where sex workers advertise, clients review sex workers, and both sides of the exchange discuss various aspects of the sex industry.…”