Sex Worker Activism Research Articles

Implications of Victim Blaming Narratives for Sex Workers: Informing Social Work Practice and the Law

The purpose of the paper is to explore social works practice response to sexual violence and the impact of victim blaming narratives for sex workers. Using a feminist standpoint epistemology, in keeping with an interpretivist/feminist qualitative framework, we critically explore the oppressive structures which impact on service users′ lives. Data collection consisted of interviews with 15 female sex workers in the Republic of Ireland. In locating sex workers experiences, we set out the argument that social work practice is complicit in victim blaming narratives in response to sexual violence. Themes emerging from the data to support this claim are (1) victim blaming perspectives for sex workers (2) reporting sexual violence to authorities, and (3) impact of the Law. By using the Irish standpoint, and the 2017 Criminal Law (Sexual Offences) Act, where sex work activities remain subject to penal measures our paper provides conclusive evidence which calls into question social works response to sexual violence. We argue for a revised social work response to sexual violence which includes a critical examination of ′victim blaming′ narratives and the current legislative process which inform their practice.

Editors’ Introduction

Abstract “Troubling Terms and the Sex Trades” assembles writings from scholars, sex workers, and activists, each of whom interrogates a troubled term and its place in the history of prostitution. This introduction discusses the “keyword” tradition of historical genealogies advanced by Raymond Williams and its utility for assessing critical categories that inform historical studies and current political debates on prostitution. The essay reviews the historiography of prostitution as it has focused on troubling terms, mostly centered specifically on the categories of sex work and trafficking. The essay goes on to introduce the components of this special issue: the first section, Reflections, presents short first-person accounts by sex worker activists, advocates, and scholars regarding a critical keyword they have worked with or resisted. The second section, Features, presents longer essays that interrogate the terms sex work, demand, white slavery, red-light district, restricted area, and decriminalization. Finally, Curated Spaces explores the history of the red umbrella as a visual term that has developed as a global symbol for sex worker rights.

Criminality of Prostitution Abuse

The article is based on an empirical socio-legal analysis of criminal court case ‎files concerning prostitution abuse in Slovenia. Based on the theoretical framework developed by Petra Östergren, the authors analyse whether the Slovenian ‎regulatory system on sex work is repressive, restrictive or integrative. The paper explores how the courts define “abuse” and “exploitation” of prostitution, ‎how the participation of third parties in sex work activities is dealt with by ‎the courts, how the vulnerability of sex workers is treated, and how the existence of consent is considered before the courts. The paper examines the files ‎for moral arguments, stereotyping, and stigmatisation, as well as references to ‎occupational risks in the field of sex work and sex workers’ rights. In the conclusions the authors argue that in Slovenia the characteristics of the restrictive ‎model, with elements of both repressive and integrative, prevail.

On the paradoxes of feminist praxis

SummaryThis essay is part of a forum on Srila Roy's (2022) book, Changing the Subject. I suggest that Roy's book offers a way to sit with the paradoxes of feminist praxis by engaging with its everyday messiness and conflict. I read Roy's book through the lens of my research with sex worker activists in India, focusing on how Roy's attention to ambivalence helped me to rethink my analysis. Through ethnography, the book shows how her interlocutors strategize creatively under disempowering conditions, challenging narratives of loss and depoliticization in feminist movements. Finally, I reflect on questions the book raises about the practice of feminist research.

Reducing sex work by targeting ‘vulnerable’ sex workers: A post‐structural analysis of policies regulating Danish exit programmes directed at people involved in sex work

AbstractDespite the increased popularity of exit programmes targeting people involved in sex work, the research community has yet not critically scrutinised policies that regulate these programmes. This study aimed to start filling this research gap by studying the example of Denmark, a country that has implemented exit programmes although sex work remains partly decriminalised since 1999. In specific, this study has analysed policy documents that were formulated by the government and four Danish municipalities in relation to the government's latest grant called ‘Exit Package for People in Prostitution’, which was issued in 2019 to finance municipal exit programmes running between 2020 and 2023. The key finding indicates that the ‘problem’ of sex work is the sex work of the ‘vulnerable’ sex workers. Their sex work must be reduced because they risk being seriously harmed by their sex work activities. Implications from the findings of the study are discussed.

Molecular epidemiology of HIV-1 among adult female sex workers at the Guatemala-Mexico border

ABSTRACT Sex workers have been demonstrated to have increased vulnerabilities to HIV and a high population prevalence of the disease. Despite their increased risk, sex workers have been underrepresented in molecular epidemiology studies assessing HIV in Mesoamerica. This study aims to describe the sociodemographic characteristics and phylogenetic profile of HIV-1 within a cohort of HIV-positive female sex workers (FSW) situated at the Guatemala-Mexico border. HIV viral sequences were collected from a cohort of FSW ≥18 years of age from San Marcos, Guatemala (n = 6) and compared to viral sequences collected as part of the Mesoamerican Drug Resistance Monitoring Programme to assess HIV viral diversity in Mexico and Guatemala (n = 3956). All of the FSW sampled were determined to have genetically unrelated HIV infections, suggesting multiple introductions of the virus and/or the potential existence of populations not captured by current surveillance efforts. Many reported numerous vulnerabilities that may have heightened their risk of acquiring and transmitting HIV through sex work activities. Our phylogenetic analysis indicated that national surveillance programmes may not fully capture the viral diversity among FSW and their clients within this region. Additional research is needed to fully capture HIV diversity and transmission in Mesoamerica, especially in the Guatemala-Mexico border region.

The Syndemic of Substance Use, High-Risk Sexual Behavior, and Violence: A Qualitative Exploration of the Intersections and Implications for HIV/STI Prevention Among Key Populations in Lagos, Nigeria

BackgroundKey populations (KP) are defined groups with an increased risk of HIV due to specific higher risk behaviours. KP who use substances engage in risky behaviors that may play a co-active role in HIV transmission and acquisition in Nigeria. This qualitative study explored the 'syndemics' of substance use, sexual risk behavior, violence and HIV infection among KP who use substances.MethodsNineteen sexually active men who have sex with men [MSM] and 18 female sex workers [FSW] aged 16 years and older who use substances were purposively selected to participate in sixteen in-depth interviews and two focus groups. We utilized a syndemic framework to explore the interaction of socio-economic factors, substance use and high-risk sexual practices. The interviews were audio-recorded, transcribed, organized in NVIVO 11 and analyzed using thematic analysis.ResultsMajority (95%) were non-injection substance users (primarily alcohol and marijuana); a few KP also used cocaine and heroin. Sixty percent of participants were between 16-24 years. Substance use utilities and trajectories were heavily influenced by KP social networks. They used substances as a coping strategy for both physical and emotional issues as well as to enhance sex work and sexual activities. Key HIV/STI risk drivers in the settings of substance use during sexual intercourse that emerged from this study include multiple sexual partnerships, condom-less sex, transactional sex, intergenerational sex, double penetration, rimming, and sexual violence. Poverty and adverse socio-economic conditions were identified as drivers of high-risk sexual practices as higher sexual risks attracted higher financial rewards.Conclusions and RecommendationsFindings indicate that KP were more inclined to engage in high-risk sexual practices after the use of substances, potentially increasing HIV risk. The syndemic of substance use, high-risk sexual behavior, adverse socio-economic situations, and violence intersect to limit HIV prevention efforts among KP. The behavioural disinhibition effects of substances as well as social and structural drivers should be considered in the design of targeted KP HIV prevention programs. HIV intervention programs in Nigeria may yield better outcomes if they address the nexus of sexual risk behavior and substance use as well as knowledge and appropriate use of HIV prophylaxis.

When the Law Fails to Protect: Stigma, Violence and Sex Workers’ Multi-Layered Responses in the Kenyan Cities of Nairobi, Mombasa, Kisii and Meru

In Kenya, criminal laws on sex work and same-sex activities, combined with stigma on sex work and homosexuality, shape sex workers’ vulnerability to violence. This paper explores sex workers’ responses to violence at various levels of social and legal organisation. Drawing from a community-based participatory research (CBPR) approach including qualitative interviews and focus group data, the paper illustrates a close and mutually reinforcing nexus between criminalisation, sex work stigma and homophobia as well as a resulting climate of impunity for perpetrators. By understanding sex workers as agentic actors, it demonstrates how sex workers respond to, rework and resist this repressive landscape of violence. It argues that sex workers mitigate the risk of experiencing violence by ‘getting by’ and ‘getting ahead’, while sex worker organisations support them to engage in collective resistance. The paper demonstrates a need to reform sex work-related laws and argues that action should extend beyond legal reform to include efforts to mediate the social processes that undercut sex workers’ access to rights and social justice.

‘No More on Our Streets and Not in Our Neighbourhoods’: Exploring Community Activism Against Sex Work

Sex work within the Nigerian context is generally regarded as a crime and shameful behaviour commonly perpetrated by women and/or girls who exchange sexual services with different people usually men for monetary or other benefits. This present study investigates an approach initiated by some communities in Ilorin metropolis of Kwara, Nigeria to eradicate sex work activities. The study adopted a qualitative research method. Three hundred and seven residents from 5 communities where brothel-based and street-based sex workers are predominant participated in the study. A range of sampling methods including criterion, convenience and venue-based sampling methods were used; in-depth interview was the instrument employed in data collection, and data analysis was done using thematic analysis. Results indicate that while the approach is effective in controlling sex workers’ activities, it inspires violence and normalises human rights abuses of sex workers in Ilorin metropolis. The paper suggests a need for a public campaign aimed at sensitising members of the communities about the fundamental rights of their fellow citizens which they are obliged to venerate as Nigerians.

Prevalence and Correlates of Active Amphetamine-Type Stimulant Use Among Female Sex Workers in Malaysia.

The use of amphetamine-type stimulants (ATS) has been associated with increased sexual risk behaviors and HIV transmission, among other adverse health outcomes. However, ATS use among female sex workers (FSWs) in Malaysia has not yet been characterized. We examined the prevalence and correlates associated with ATS use among Malaysian FSW. Between February and December 2016, 492 FSWs, including cisgender (n = 299) and transgender (n = 193) women, were recruited using respondent-driven sampling in Greater Kuala Lumpur, Malaysia. A structured questionnaire was used to collect demographic characteristics, sexual behaviors, ATS and other substance use, behavioral health issues, involvement in criminal justice, and experience of physical and sexual trauma. Logistic regression analyses were conducted to determine factors associated with active ATS use, defined as ATS use in the last 30 days. Nearly one-third (32.3%) of participants reported active ATS use. In the multivariable model, ATS use was associated with drug use during sex work (aOR = 17.10; 8.32–35.15), having moderate to severe level of substance use disorder (aOR = 3.38; 1.48–7.70), and engaging in sex work with multiple clients per day (two clients: aOR = 3.39; 1.36–8.46; three clients: aOR = 5.06; 1.81–14.10). A high prevalence of ATS use was documented in our sample. The presence of moderate to severe substance use disorder, the use of drugs during sex work activity, and having multiple sex work clients per day were significantly associated with active ATS use. Given these findings, prevention and harm reduction strategies need to be tailored to address the increasing ATS use and the associated adverse health consequences among FSWs in Malaysia.

Managing the toll of sex work with bounded agency: Perspectives of ex-sex workers

The present study builds upon qualitative narratives of ex-sex workers to explore if these women felt they had maintained a positive sense of self during involvement in sex work and, if so, how. Specific objectives were to identify strategies they used to protect their self-concept and better understand the challenges they faced in their efforts to keep sex work within their comfort zone. Fourteen participants were recruited in six different cities from the province of Quebec (Canada) and interviewed twice in 2016. Findings suggest that women were very aware of the effects sex work could have on their self-concept because of the stigma surrounding it, but also because of ambivalent experiences with clients and pimps. As a result, they used various strategies to protect their sense of self, the main one being the making and following of rules that govern sex work activities. Yet, our findings show that the protective quality of these self-concept protection strategies is limited, as women observed that they compromised with personal boundaries at various occasions during their pathways. They made strong associations between these compromises and a progressive fragilization of their sense of self.

The white-painters of Cabbagetown: Neighborhood policing and sex worker resistance in Toronto, 1986-1987.

Toronto in the 1980s was embroiled in intense debates about the place of sex work in society. The passing of new legislation in 1985 criminalizing communication for the purposes of prostitution led to increased police harassment of outdoor sex workers. Within a gentrifying urban neighborhood, homeowners created a neighborhood organization, the South of Carlton Association, with the express purpose of collaborating with Metro Police and City Council to remove sex workers from the downtown stroll. In turn, sex worker activists in the Canadian Organization for the Rights of Prostitutes practiced a range of strategies to challenge this oppression—including archiving their resistance.

Income generation and the patterning of substance use: A gender-based analysis

BackgroundPrevious research has demonstrated how income-generating activities among marginalized people who use drugs (PWUD)–including employment, income assistance, street-based activities, sex work, and illegal activities–can provide both benefit (e.g., additional income) and harm (e.g., violence, criminalization). However, little is known about gender differences in factors such as drug use patterns that are associated with income-generating activities among PWUD. MethodsUsing data from prospective cohorts of HIV-positive and HIV-negative PWUD in Vancouver, Canada, we conducted exploratory gender-stratified analyses of associations between substance use patterns and income-generating activities, using generalized linear mixed-models. ResultsParticipants reported income sources as employment (23.4 %), income assistance (88.1 %), street-based activities (24.9 %), sex work (15.2 %), drug dealing (31.5 %), or other illegal activities (13.9 %). GLMM results showed gendered patterns of engagement in specific income-generating activities and some diverging patterns of substance use. For instance, men receiving income assistance were less likely to use opioids (Adjusted odds ratio(AOR) = 0.64; 95 % confidence interval(CI) = 0.50–0.82) and women engaged in sex work were more likely to use crack-cocaine (AOR = 2.74, 95 % CI = 2.22–3.37). However, results reflected primarily converging patterns of substance use between women and men across income-generating activities, particularly for drug dealing and other illegal activities. ConclusionsOur results suggest that substance use patterns may be more closely associated with income generation context than gender. Given potential harms associated with some income generation activities, results highlight the need for further investigation of the social and structural context of income generation, its intersections with gender and substance use, and the expansion of low-threshold work opportunities.

‘Voiceless Victims’: Children Living in the Red-Light Areas of Ibadan, Nigeria

Much research work on victims of sex work, including studies employing feminist perspectives, focuses on sex work as either being a ‘victimless crime’, or women as victims, leaving the victimization of children as direct and proximate victims relatively unexplored. The practice of commercial sex work in Nigeria is illegal; however, sex business thrives in most urban centres with considerable prevalence of red-light districts. Brothels, strip clubs and other sex-oriented businesses that constitute red-light districts are usually located in neighbourhoods where people that have no business with sex work live with their families. This present study, therefore, moves to expose the risks and vulnerabilities of children living in red-light areas. Drawing on social disorganization and learning theories, an analytical cross-sectional survey of residents of neighbourhoods where commercial sex work thrives within the city of Ibadan was conducted. Fifty-seven family men and women living in red-light areas with their children were purposively selected to provide data for the qualitative study. The rate of children’s engagement in premarital sex, consumption of illicit drugs, alcoholic intake, stealing, street fighting, and school dropout was found to be a factor of their intimacy with sex work and workers in red-light areas. The study concludes that children who grow up in red-light areas are more vulnerable to being physically, emotionally, sexually abused and exploited than children who do not live in such areas. Regulation of sex work activities and prioritizing of child protection issues were suggested.

Social service responses to human trafficking: the making of a public health problem

Human trafficking has received considerable attention from policymakers, researchers and service providers globally, with resulting interventions often positioning trafficking as something that simply exists. Drawing on Bacchi’s ‘What’s the Problem Represented to be?’ approach, this article proposes that trafficking is continually made through efforts designed to eradicate it. We conducted 22 interviews with representatives from social service organisations funded by the government of Ontario, Canada, for anti-trafficking programming. These interviews provide insight into how trafficking is being represented and with what effects. Our findings suggest that organisational initiatives often rely on individualised health-related interventions, such as trauma-informed counselling and other mental health support, to address trafficking. In the process, various sex work activities are deemed ‘symptoms’ of trafficking, and perceived pathways to engaging in sex work (such as drug use/dependence, a history of trauma and low self-esteem) are produced as ‘causes’ or ‘risk factors’. We contend that by pathologising sex work and sex workers, organisations are employing a contradictory neoliberal paternalism to advance a public health representation of human trafficking that simultaneously responsibilises and disenfranchises purported victims.

Sex Work Is Associated With Increased Vaginal Microbiome Diversity in Young Women From Mombasa, Kenya

Although nonoptimal vaginal bacteria and inflammation have been associated with increased HIV risk, the upstream drivers of these phenotypes are poorly defined in young African women. Mombasa, Kenya. We characterized vaginal microbiome and cytokine profiles of sexually active young women aged 14-24 years (n = 168) in 3 study groups: those engaging in formal sex work, in transactional sex, and nonsex workers. Vaginal secretions were collected using self-inserted SoftCup, and assayed for cytokines and vaginal microbiome through multiplex ELISA and 16S rRNA sequencing, respectively. Epidemiological data were captured using a validated questionnaire. The median age of participants was 20 years (interquartile range: 18-22 years). Approximately two-thirds of young women (105/168) had vaginal microbial communities characterized by Gardnerella and/or Prevotella spp. dominance; a further 29% (49/168) were predominantly Lactobacillus iners. Microbiome clustering explained a large proportion of cytokine variation (>50% by the first 2 principal components). Age was not associated with vaginal microbial profiles in bivariable or multivariable analyses. Women self-identifying as sex workers had increased alpha (intraindividual) diversity, independent of age, recent sexual activity, HIV, and other sexually transmitted infections (beta = 0.47, 95% confidence interval: 0.05 to 0.90, P = 0.03). Recent sex (number of partners or sex acts last week, time since last vaginal sex) correlated with increased alpha diversity, particularly in participants who were not involved in sex work. Nonoptimal vaginal microbiomes were common in young Kenyan women and associated with sex work and recent sexual activity, but independent of age. Restoring optimal vaginal microflora may represent a useful HIV prevention strategy.

Police Crackdowns, Human Rights Abuses, and Sex Work Industry in Nigeria: Evidence From an Empirical Investigation

This study undertook a qualitative investigation into police crackdowns as a form of operational control mechanism employed to suppress sex workers and sex work industry in Ilorin Emirate, Kwara State, Nigeria. The study employed a qualitative research method. One hundred and six female commercial sex workers (41 at street hot spots and 65 in brothels) participated. They were aged between 19 and 47 and selected through a variety of sampling methods including purposive, referral, and venue-based sampling methods. In-depth interview was the instrument used in data collection, and thematic data analysis was employed in analyzing the data. Results indicate that police crackdown is usually experienced by sex workers at street hot spots and in brothels and are often associated with brutality, human rights abuses, and extortion, which have negative impacts on the livelihoods and general well-being of sex workers. Sex workers devised some strategies to escape and avoid police arrests and abuses. Thus, crackdowns merely displace sex workers during intense restrictions but do not reduce sex work activities. Therefore, the study suggests a change in suppressive approach to an inclusive nonviolent method in reducing commercial sex work activities.

Sex workers are returning to work and require enhanced support in the face of COVID-19: results from a longitudinal analysis of online sex work activity and a content analysis of safer sex work guidelines.

Sex workers confront unique challenges in the face of COVID-19. Data from an international sex work website popular with cisgender men and transgender men and women suggest that, after a period of physical distancing, many sex workers are returning to in-person work: from May to August 2020, active sex work profiles increased 9.4% (P < 0.001) and newly created profiles increased by 35.6% (P < 0.001). Analysis of sex work and COVID-19 guidelines published by five community-based organisations found that they focused on altering sexual practices, enhancing hygiene and pivoting to virtual work. To capitalise on these guidelines, funding and research for implementation and evaluation are needed to support COVID-19 risk reduction strategies for sex workers.

The 1975 French sex workers’ revolt: A narrative of influence

The 1975 French sex workers’ strike is widely acknowledged by sex workers’ movement activists as the spark that ignited the contemporary European sex workers’ rights movement. Yet, significant scholarly research has judged the strike a failure because it neither achieved law reform, nor was it able to sustain a lasting presence. How then should we understand the disparity between how sex worker activists see the occupation and the judgment of academic researchers? This research extends the analytical frame of the 1975 movement’s influence beyond the disappointment of specific policy outcomes and instead addresses the role that the movement played in challenging attitudes towards sex workers, and building a new collective identity that fed into the emerging global sex workers’ rights movement. It argues that by defining and amplifying a set of shared grievances recognisable across borders the strike was a significant cultural achievement for the sex workers’ movement and this in turn established a narrative of influence.

Housing and income effects on HIV-related health outcomes in the San Francisco Bay Area – findings from the SPNS transwomen of color initiative

ABSTRACTTranswomen of color are disproportionately impacted by HIV and may have worse health outcomes than other populations. This analysis was conducted to examine structural factors associated with poor health outcomes among transwomen of color living with HIV in the San Francisco Bay Area (N = 159). Univariate and multivariable analyses were conducted to determine if structural factors were associated with poor HIV-related health outcomes. A majority of participants were Black or African American (110/159, 69.2%), 32 (20.1%) identified their primary race/ethnicity as Hispanic or Latino/a or Spanish, and 17 (10.7%) identified as another race/ethnicity. Transwomen of color in our sample faced extreme structural barriers, including residential transience, extreme low income, high prevalence of running out of money in the last six months, high rates of food insecurity, high prevalence of income via entitlement programs, engagement in sex work and other illicit activities for income. Unstable housing was the structural factor most consistently associated with poor health outcomes along the HIV care continuum and may explain engagement in other sources of income generation. Interventions are needed that go beyond the individual and health care-level to address needs for housing and economic opportunities to improve HIV care outcomes among transwomen of color living with HIV in the San Francisco Bay Area.