Usage of the Terms Prostitution, Sex Work, Transactional Sex, and Survival Sex: Their Utility in HIV Prevention Research

Abstract

This article considers the terms prostitution, sex work, transactional sex, and survival sex, the logic of their deployment and utility to research concerned with people who are paid for sex, and HIV. The various names for paid sex in HIV research are invested in strategically differentiated positionings of people who receive payment and emphasize varying degrees of choice. The terminologies that seek to distinguish a range of economically motivated paid sex practices from sex work are characterized by an emphasis on the local and the particular, efforts to evade the stigma attached to the labels sex worker and prostitute, and an analytic prioritizing of culture. This works to bestow cultural legitimacy on some locally specific forms of paid sex and positions those practices as artifacts of culture rather than economy. This article contends that, in HIV research in particular, it is necessary to be cognizant of ways the deployment of alternative paid sex categories relocates and reinscribes stigma elsewhere. While local identity categories may be appropriate for program implementation, a global category is necessary for planning and funding purposes and offers a purview beyond that of isolated local phenomena. We argue that "sex work" is the most useful global term for use in research into economically motivated paid sex and HIV, primarily because it positions paid sex as a matter of labor, not culture or morality.

The “Sociological Equation”: Intersections Between Street Sex Workers’ Agency and Their Theories about Their Customers

“…As McMillan et al (2018) pointed out in their discussion of the links between sex work language choices and HIV transmission, "[a]gency is always circumscribed in some manner", leading them to argue for a "framework in which choice is conceptualized as a matter of contextual complexity and not imbued in notions of victimhood and culpability" (p. 1524). While clearly constrained within a coercive and stratified context, the workers we interviewed engaged or attempted to engage in many of the agentic activities documented by other researchers.…”

Women Who Trade Sexual Services from Men: A Systematic Mapping Review

“…For example, individuals may occasionally and opportunistically exact a fee or gift for a sexual service without perceiving themselves as someone who trades sex (Carael et al, 2006;Dennis, 2008;Harcourt & Donovan, 2005;Stoebenau et al, 2016). (For a discussion of various terms used for selling sex, see e.g., McMillan, Worth, & Rawstorne, 2018). Carael et al's (2006) estimates of commercial sex, based on 78 national representative household surveys and nine city based surveys, found that between 1% and 14% of men had paid for sex in the last 12 months, with large discrepancies between regions.…”

Work2Prevent, an Employment Intervention Program as HIV Prevention for Young Men Who Have Sex With Men and Transgender Youth of Color (Phase 3): Protocol for a Single-Arm Community-Based Trial to Assess Feasibility and Acceptability in a Real-World Setting

“…Additionally, economic marginalization may increase potential for HIV exposure and infection by contributing to reliance on survival sex work, or exchanging sex for money, food, shelter, drugs, or other commodities [ 25 - 27 ]. Survival sex work has also been associated with coping-related substance use [ 12 , 13 , 17 , 20 , 21 ].…”