The Organization of Sex Work in Low- and High-Priced Venues with a Focus on the Experiences of Ethnic Minority Women Working in These Venues

Abstract

Prior research on female sex workers (FSW) in China, and their risk for HIV and STI, neglects the nuanced experiences of ethnic minority FSW. We conducted participant observations and in-depth interviews with 33 FSW and six venue bosses to describe the experiences of FSW and management structures in high and low-priced sex work venues in Liuzhou, China. In low-priced venues, FSW had more autonomy and stronger relationships with their ethnic minority peers. Mid and high-priced venues had more formal management structures. Ethnic minority FSW working in higher priced venues experienced less support and kinship with their peers. HIV/STI prevention outreach activities occurred in all of the venues, but they were not tailored for different venue types or for ethnic minority FSW. Our findings provide guidance for tailoring public health programs that meet the needs of ethnic minority women working in different types of sex work venues.

The Role of Sex Work Pay in Moderating the Effect of Mobile Phone Solicitation on Condom Practices: An Analysis of Female Sex Workers in India

“…This is consistent with findings that economic debt and more generally, economic vulnerability, contributes to HIV risk for sex workers [1,24]. Specifically, research indicates higher paid FSWs tend to frequent more controlled condom environments, with more formalized hierarchical structures [19,21,22]. For example, highly paid Ugandan sex workers were more likely to work in environments that enforced specific policies for clients compared to their lower paid peers [19].…”

Work environments and HIV prevention: a qualitative review and meta-synthesis of sex worker narratives

“… • Support from managers/supportive establishment policies available in some informal indoor venues, but often depended on type of relationship [ 50 ] • Lack of manager supports, particularly within criminalized environments results in limited support and a lack of access to condoms, HIV/STI prevention [ 46 , 51 , 52 ] • Manager pressure to service clients quickly/satisfy clients’ needs leads to pressure for unprotected sex. [ 39 , 53 ] • Concern of manager exploitation or restriction of autonomy relates to reduced control over HIV prevention, extortion for sex [ 46 , 53 ] • In more informal settings, health protection often left to the individual worker, with a lack of managerial support [ 50 ] Sex worker/peer support • Peer support within the workplace linked to positive outcomes including role modeling, sharing of HIV/STI information, condom negotiation strategies, and support for dealing with difficult clients [ 49 , 56 , 57 ] • Workplaces that promote cooperation, rather than competition, between workers enhanced workers’ power to negotiate condom use and strengthened condom use norms at a venue level [ 37 , 39 ] • Peers support for HIV prevention also included facilitating access to HIV/STI testing and condoms (e.g., by purchasing in bulk to have available in the venue, lending condoms) [ 56 ] • Lack of social support at work or ability to work with peers related to social isolation, less exposure to advice or information on condom negotiation and sexual health, violence, and enhanced susceptibility to exploitation at work promoted workers’ vulnerability [ 41 , 46 , 58 ] Interactions with police • Access to police protections and the ability to work without criminalization fostered the creation of trusting relationships with police, ability to report violence, and ability to negotiate sexual transactions without fear of negative consequences [ 39 ] • Harassment, raids, arrest, or detention by police linked to displacement and undermines sexual negotiation [ 57 , 59 ] • Fear of police harassment, abuse, and arrest and confiscation of harm reduction equipment posed critical barriers to accessing/carrying condoms and other HIV prevention supplies [ 10 , 44 ] • Direct impacts of police harassment, abuse, and arrest included HIV/STI risks as a result of sexual violence, rape, ...…”

“…Manager W insisted that wearing a condom is regulation here and asked the client to leave politely. (Spa) [ 50 ] Last time, I put on a condom for a client. But he took it off under the table.…”

HIV infection among female sex workers in concentrated and high prevalence epidemics

“…The dynamic nature of community empowerment remains a methodological challenge for researchers and an area in need of more rigorous measurement and evaluation, in partnership with sex work communities [63]. In China, increased social cohesion between ethnic minority workers was reported in lower-paying venues, whereas moderate-to-high paying venues had more formal structures that discouraged peer network and informal support [66]. …”