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NCBI Bookshelf. In the beginning stages of the AIDS epidemic, many pgostitutes feared that female prostitutes would become widely infected and spread the AIDS virus to their male clients. The evidence instead suggests that prostitutes' risk of transmission is more closely associated with drug use than with multiple sexual clients. The evidence also indicates that the risk of transmission through sexual contact is greater in the personal relationships of female prostitutes than in their paying ones.

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That the source of infection was contaminated injection equipment rather than multiple professional customers is given further credence by the of Wolfe and colleagues Belmont, Calif. Some intervention programs advocate eliminating prostitution but neglect important economic realities.

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However, data on clients come from a limited group of studies that have relied on small, nonprobability samples, and their must be interpreted with caution. Rather, two other factors are indicated: prostitutes are more likely to become infected as a result of unprotected intercourse in the context of a personal relationship than unprotected intercourse with paying clients, and prostitutes who are IV drug users are more likely to acquire HIV infection from contaminated drug injection equipment than from work-related sexual behavior.

Instead of recruiting clients from the street or meeting them in brothels or other centralized locations, the call girl sets up her own referral system James, ; Alexander, In this study, ex-addict street outreach workers were used to identify informants among residents of buildings that served as crack houses. As noted earlier, the relationship between prostitution and drug use is unclear, but the potential for HIV transmission has been established in situations in which both factors are present.

Castro, K. When business is slow, income can often be generated by telephoning known customers and extending invitations.

New Brunswick, N. But he started paying for sex long before he met her.

THE EPIDEMIOLOGY OF AIDS AND HIV INFECTION AMONG PROSTITUTES

The woman seemed "melancholy. More extended periods of time and a wider variety of sexual techniques are generally more expensive and primarily characteristic of outcall or other off-street practitioners.

Serologic surveys capture only those women who volunteer for testing, those who seek care in public clinics for sexually transmitted diseases STDsthose involved in drug treatment programs, or those in contact with the criminal justice system. Interviews and blood specimens were obtained from men with a numbefs of sexual contact with female prostitutes and no other risk factors for infection.

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After Graham's first encounter in the red light district in Amsterdam, he was keen to recreate the experience. They are required to live in the brothel during a three-week work shift; after their shift, they are off duty for a week or more during which time they are expected to leave town. DeanH wrote:. Overs, C. Some of these young women engage in sex with men either directly for the drug or for money with which to purchase it.

Cohen [] and Carmen and Moody []. Most people think of male prostitution as dangerous, degrading and exploitative work. Stay away numbwrs the Pimps and Prostitutes. The movements of women who work in Nevada's legal brothels are severely restricted Carmen and Moody, ; Alexander, Stereotypical depictions of prostitution tend to present two ends numbeers a spectrum: the pathos associated with streetwalkers and the sophisticated elegance of prostitute girls.

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Other analyses of these data find that 84 percent of IV drug-using women reported street prostitution compared with a ificantly smaller proportion He explained how he had known Laura so long, they often meet as friends. Although the current risk of HIV infection associated with unprotected sex with a female sex worker is small, it will remain so only if both clients and prostitutes adopt safer sexual practices on a wider scale and more consistent basis.

Paris: McGraw-Hill. In these cases, transmission risks may be higher, particularly if there is a history of STDs or current infection.

CDC supports ongoing studies of female prostitutes in several cities see Table 4—1 that are investigating the sexual and social networks of prostitutes as well as strategies for outreach, treatment, and social mobilization of female sex workers. It thus becomes a wise business decision to refuse risk reduction literature Shedlin, Strategies for evaluating the risk reduction projects of community-based organizations have been laid out in Coyle, Boruch, and Turner and could prove to be useful in this arena as well.

There are certain legal benefits to this new system of services.

Other terms—such as sex workers, sex industry workers, and commercial sex workers—have also been used to describe this population in an effort to avoid the judgments that are often associated with the term prostitute. New York: Free Press. Nevertheless, for the purposes of AIDS prevention, most such organizations are difficult to identify and contact. Does it bother him that Laura sees other clients?

Finally, current and former street prostitutes may be able to deliver health messages effectively by contacting women who are currently in the industry. More than one-third In a study of 82 teenage female crack users from the San Francisco area, 24 29 percent reported exchanging sexual favors for drugs or money Fullilove et al. For women who are detained, Alexander postulates that the usual activities of the police may reinforce reliance on pimps numbfrs can arrange for bail or attend to child care needs while the women numbbers in custody, but that such activities are unlikely to be effective in reducing the prevalence of prostitution.

Although these data affirm the possibility that female prostitutes can transmit infection, questions regarding the accuracy of risk reporting may cast doubt on any conclusion regarding the extent of such transmission. In particular, the illegal nature of prostitution often forces female sex workers and their agents pimps, madams, massage parlor and outcall service operators to conceal their practices, thereby limiting educators' access to these groups and restricting support group and outreach activities.

The risk prostitutes pose to their male clients appears to be minimal, although data regarding these men are extremely limited, in part owing to the criminalization of prostitution and the reluctance of clients to be identified.

Moreover, prostitutes are at least as vulnerable as other women in their personal relationships. The committee believes such research efforts will benefit from input by women who have actually worked as prostitutes.