Sex Work and the Politics of Space: Case Studies of Sex Workers in Argentina and Ecuador

Sexually transmitted infections and factors associated with risky sexual practices among female sex workers: A cross sectional study in a large Andean city

BACKGROUND

There are limited published data on factors related to risky sexual practices (RSP) affecting sexually transmitted infections (STIs) among female sex workers (FSWs) in Ecuador.

METHODS

Cross-sectional study of FSWs presenting for a consultation in a primary health care centre during 2017. A questionnaire was administered to collect information on RSP and potential risk factors including age, membership of an FSW association, self-report of previous STI diagnosis, previous treatment for suspected STI and temporary migration for sex work. Associations between RSP and potential risk factors were estimated by logistic regression. The proportion of STI was estimated from vaginal swabs by real-time PCR for four sexually transmitted pathogens (Neisseria gonorrhoeae, Trichomonas vaginalis, Chlamydia trachomatis, and Mycoplasma genitalium).

RESULTS

Of 249 FSWs recruited, 22.5% had reported RSPs at least once during sex work. Among FSWs reporting unprotected vaginal sex in the previous three months, 25.5% had at least one other RSP type. 17.6% (95%CI 13.3-22.8) had at least one active STI. Prevalence of co-infections was 2.4% (95%CI 1.1-5.2). In multivariable analysis, RSP was associated with age (adjusted OR 1.06; 95%CI 1.02-1.10), membership of an FSWs association (aOR 3.51; 95%CI 1.60-7.72) and self-reported previous STI (aOR 3.43; 95%CI 1.28-9.17).

CONCLUSIONS

Among a population of female sex workers with high proportion of STIs, increasing age and belonging to an FSWs association was associated with a higher likelihood of engaging in RSP with clients. Engaging with FSWs organisations may reduce the burden of STI among sex workers.

Brothels as Sites of Third-Party Exploitation? Decriminalisation and Sex Workers’ Employment Rights

Decriminalisation is arguably essential to protecting the human rights of sex workers. Nonetheless, there are suggestions that decriminalisation has less influence on sex workers’ experiences of working than many assume. This paper explores management practices in brothels in the context of decriminalisation in New Zealand, focusing on sex workers’ employment status, managerial control and agency. We interviewed 14 brothel operators and 17 brothel-based sex workers in this study. The findings suggest that there remain challenges for sex workers in that brothel operators treated them as employees rather than independent contractors. Brothel operators retained control over shift times and pricing of services, and working conditions were unclear. Most sex workers understood their rights, but when operators impinged on their rights, it was often more expedient to move place of work than make an official complaint. However, decriminalisation did have a meaningful impact on the way sex workers negotiated potentially exploitative dimensions of brothel-based work. Decriminalisation has provided the context where it is possible for sex workers to experience safer and more supportive work environments than they otherwise might, where they can (and sometimes do) contest managerial control.