Social inequalities, sexual tourism and HIV in Cartagena, Colombia: an ethnographic study

Abstract

Background: Cartagena, Colombia's main port on the Caribbean Coast, reported an HIV incidence of 7.5 per 100, 000 inhabitants in 2007 with 90.0% transmission by heterosexual contact and 70 identified as women with a stable partner. Studies across Colombia illustrate that HIV infection relates to social inequalities; most people with HIV live in poverty and have minimal access to health care, education, and secure jobs. The purpose of this article is to analyse the relationship between social inequalities, sexual tourism and HIV infection in Cartagena, Colombia. Methods: Data come from a five-year participatory ethnography of HIV in Cartagena in the period 2004-2009, in which 96 citizens (30 of whom were living with HIV) participated in different data collection phases. Techniques included participant observation, in-depth interviews and thematic life histories. Out of this material, we selected three life histories of two women and a man living with HIV that are representative of the ways in which participants expressed how social inequalities make it virtually impossible to engage in safe sex practices. Results: At stake is the exchange of condomless sex for goods within the widespread sexual tourism networks that promote an idealisation of dark-skinned men and women as better sexual performers. Our results illustrate the complex interplay of social inequalities based on class, skin colour, gender and sexual orientation. Furthermore, they suggest a synergistic effect between poverty, racialization, and gender inequalities in the historical maintenance of social dynamics for a fruitful growth of a sexual tourism industry that in turn increases vulnerability to HIV infection. Conclusions: Although the convergence of social inequalities has been thoroughly reported in the literature on social studies of HIV vulnerability; distinctive dynamics are occurring in Cartagena, including a clear link between the contemporary globalised sexual tourism industries and a racialised social structure-both having historical roots in the colonial past- .

The HIV epidemic in Colombia: spatial and temporal trends analysis

“…Most of Colombian PLWHA are poor, have low educational attainment and have minimal access to health care and secure jobs. Social inequities have led people to work in the sexual tourism industry to sustain themselves and their families [ 31 ]. The HIV prevalence among sex workers in Colombia is also moderately high at 1.2% due not only to societal stigma but also to political and structural factors [ 32 ].…”

The Hiv Epidemic in Colombia: Spatial and Temporal Trends Analysis

“…Social inequities have led people to work in the sexual tourism industry to sustain themselves and their families. [15] The HIV prevalence among sex workers in Colombia is also moderately high at 1.2% due not only to societal stigma but also to political and structural factors. [32] Preventing HIV in sex workers is essential to decrease HIV overall in Colombia.…”

“…The majority of people live in poverty without secure jobs, having low educational attainment and poor access to healthcare services. (14)(15) Colombia has one of the highest sexual tourism rates compared to other countries worldwide [14] , with the Caribbean and 'coffee belt' regions being the main tourist destinations. The 'coffee belt' comprises the states of Risaralda, Caldas and Quindio.…”

Pragmatic approaches to control inbound sex tourism and prostitution in Thailand and Cambodia: the examination of relevant policy gaps and suggestion of multifaceted policy development

“…Given the tremendous human rights concerns, sexual exploitation against children and women, and its relationship with sex tourism are explored in this essay. Sex tourism is defined as individuals travelling for the enjoyment of sex (Quevedo-Gomez et al ., 2020). The 2012 Report on Trafficking in Persons indicates that sexual exploitation for sexual purposes is the most common kind of human trafficking, representing some 79% of all forms of human trafficking per se .…”