When Sex Work Becomes Your Everything

Abstract

In Peru, there are few studies on male sex workers (MSWs) and existing studies explore limited sub-groups or offer limited information about MSWs’ perspectives. This study provides in-depth perspectives from 40 MSWs who work in downtown Lima (Cercado) and in surrounding urban neighborhoods (non-Cercado) through interviews on their identities, lives and HIV/STI risks and vulnerabilities. Findings are that entry into sex work links economy and affection, particularly among Cercado MSWs. Continued sex work cements this link, making it difficult to exit sex work and establish goals. Ties between economics and affections influence MSWs’ perceived HIV/STI risks, vulnerabilities and prevention practices. Although Cercado MSWs report higher HIV/STI risks and vulnerabilities than non-Cercado peers, they report fewer prevention practices given inability to buy condoms and acceptance of client offers of higher payment, especially clients they feel affection for. MSWs need support to strengthen their self-perceptions and define and pursue their goals in order to improve their HIV/STI prevention practices, health and well-being.

Is Intimate Partner and Client Violence Associated with Condomless Anal Intercourse and HIV Among Male Sex Workers in Lima, Peru?

“…(6) Globally, MSWs have been shown to have numerous (7) and diverse sexual contacts, (8) high rates of sex without a condom, high prevalence of STIs, (5) and high rates of substance abuse. (9) In Peru, existing research shows additional factors that place MSM and MSWs at high risk of HIV acquisition, including work location, (10) sexual role, (11) and high risk sexual networks. (12)…”

HIV and syphilis testing behaviors among heterosexual male and female sex workers in Uganda

“…Limited data are available on HMSW, perhaps because HMSW are usually less visible than FSW [ 18 ] and the assumption that sex work by heterosexual men constitutes a small proportion of male commercial sex [ 19 , 20 ]. Additionally, risk of HIV acquisition through insertive penile-vaginal intercourse is lower than that for insertive or receptive anal intercourse among HMSW who have sex with women [ 21 ].…”

Sexual Risk, Behavior, and HIV Testing and Status Among Male and Transgender Women Sex Workers and Their Clients in Lima, Peru

“…These behaviours place male sex workers (MSWs) and transgender women sex workers (TSWs), groups known to engage in such risky behaviours, at an increased risk of HIV and other sexually transmitted infections (STIs) (Baral et al, 2015; Nureña et al, 2011; Operario, Nemoto, Iwamoto, & Moore, 2011; Poteat et al, 2015; Silva-Santisteban et al, 2011). Bayer et al showed that the transactional nature of sex left low-income MSWs in Lima feeling more at risk for HIV due to their inability to afford condoms, their clients’ requests that they not use condoms and their inability to negotiate condom use (Bayer, Garvich, Díaz, Sánchez, et al, 2014). Studies in different contexts have shown that these risks and vulnerabilities increase since low-income or street-based MSWs tend to be younger, less educated, and more dependent on sex work to survive (Bayer, Garvich, Diaz, Sanchez, et al, 2014; Bayer, Garvich, Díaz, García, & Coates, 2014; Infante, Sosa-Rubi, & Cuadra, 2009; Mariño, Minichiello, & Disogra, 2003).…”

“…Bayer et al showed that the transactional nature of sex left low-income MSWs in Lima feeling more at risk for HIV due to their inability to afford condoms, their clients’ requests that they not use condoms and their inability to negotiate condom use (Bayer, Garvich, Díaz, Sánchez, et al, 2014). Studies in different contexts have shown that these risks and vulnerabilities increase since low-income or street-based MSWs tend to be younger, less educated, and more dependent on sex work to survive (Bayer, Garvich, Diaz, Sanchez, et al, 2014; Bayer, Garvich, Díaz, García, & Coates, 2014; Infante, Sosa-Rubi, & Cuadra, 2009; Mariño, Minichiello, & Disogra, 2003). In Lima, only 38–50% of MSWs surveyed reported always using a condom during sex with recent male or TW partners and only 23–53% reported during so with female partners, with lower condom use for low-income versus higher-income MSWs (Bayer, Garvich, Diaz, Garcia, et al, 2014).…”

“…Studies in Peru, Argentina, and Mexico with MSWs have also shown inconsistent condom use (Bayer, Garvich, Díaz, García, et al, 2014; Infante et al, 2009; Mariño et al, 2003). There are few health and social services available to MSW and TSW populations in Latin America (Baral et al, 2015; Bayer, Garvich, Díaz, Sánchez, et al, 2014; Infante et al, 2009), and many sex workers are homeless or face considerable social stigma (Baral et al, 2015; Bayer, Garvich, Díaz, Sanchez, et al, 2014; Bayer, Garvich, Díaz, García, et al, 2014; Infante et al, 2009; Mariño et al, 2003).…”