Safety First, Then Condoms: Commercial Sex, Risky Behavior, and the Spread of HIV/AIDS in Managua, Nicaragua

Abstract

This study analyzes the commercial sex market in Managua, Nicaragua, to understand risky behavior among sex workers. While health risks are a major concern for sex workers, the risk of violence weighs more heavily in decision making, such that they more often take risks to their health than to their immediate, physical well-being. These concerns are reflected in the lower premiums sex workers charge for unprotected sex (39 percent more for vaginal sex without a condom) compared with risks of violence, such as accompanying a client to an unknown place (a 118 percent premium). Risk behaviors reflect a rational calculation of actual risk: while only 9 percent of the sample knew anyone diagnosed with HIV, nearly 44 percent of sex workers had been assaulted. These observations indicate the need to consider sex workers' physical safety in policies to contain the spread of HIV/AIDS and other sexually transmitted diseases.Nicaragua, risky behavior, violence, HIV/AIDS, public policy, sex work, JEL Codes: A1, B54, D81,

Sex, price and preferences: accounting for unsafe sexual practices in prostitution markets

“…Not using a condom is not only inspired by price incentives but may be inspired by other motivations, for example, for fear of violent reactions by clients. This has recently been documented in a prostitution study in Managua (Nicaragua) (Willman 2008) and is supported by other research, both quantitative (Shannon et al 2009) and qualitative (Busza 2005). The evidence thus suggests the existence of a different kind of compensating differential: in some instances sex workers have the choice between getting a beating with a condom and getting out in one piece at the cost of having unprotected sex.…”

Female Sex Workers and the Social Context of Workplace Violence in Tijuana, Mexico

“…Wahab (2005) reports that 50-100 percent of those working in outdoor (street-based) settings experience violent encounters while on the job; in our study (which includes both indoor and outdoor workers) about 27 percent of our sample had experienced violence at the hands of a customer. 2 Sex workers from a range of work settings support the claim that violent encounters are shaped by the setting of the workplace, as well as other features of the social context of their work (Brents and Hausbeck 2005;Church et al 2001;Fang et al 2007;Giobbe et al 1990; Katsulis 2009;Kempadoo and Doezema 1998;Lopez-Jones 1999;Plumridge and Abel 2001;Willman 2008). Studies also show the myriad ways in which sex workers experience, manage, or attempt to avoid violent encounters while working in these settings (Bowen et al 2006;Downe 1999;Kinnell 2008;Kurtz et al 2004;Maher 2000;Otutubikey Izugbara 2005;Sanders 2004;Shannon et al 2008;Sterk and Elifson 1990;Whittaker and Hart 1996).…”

Risk attitude, risky behaviour and price determination in the sex market: A case study of Yangon, Myanmar

“…2 Other examples include Kenya (Robinson & Yeh, 2011), Mexico (de la Torre et al, 2010, Nicaragua (Willman, 2008), Congo (Ntumbanzondo et al, 2006) and Canada (Johnston et al, 2010). 3 Since 1969, Senegalese FSWs over the age of 21 years have been compelled to register with a health centre and to have routine check-ups to be tested and treated for STDs and to receive free condoms (Chersich et al, 2013).…”

“…2 2 Other examples include Kenya (Robinson & Yeh, 2011), Mexico (de la Torre et al, 2010), Nicaragua (Willman, 2008), Congo (Ntumbanzondo et al, 2006) and Canada (Johnston et al, 2010). …”