Conclusions. The "bridging effect" for HIV transmission is evident. Variables predicting condom use during commercial sex are multidimensional. Integrative programs are hence required. Methadone clinics may offer a platform for offering such services to IDU-FSWs. The performance of the TPB could be enhanced by addition of external variables; its applicability varies according to the wellbeing status of the IDU-FSWs. Future randomized control studies are warranted to design effective evidence-based programs targeting IDU-FSWs. / Introduction. Injecting drug users (IDUs) drive the HIV epidemic in China. Female injecting drug users who are sex workers (IDU-FSWs) is a strategic "bridge population" for HIV transmission from the IDU to non-IDU populations. Background characteristics, health behavioral theories (e.g. the Theory of Planned Behavior, TPB), drug dependence, economic pressure, psychological problems, social support and gender power are potential predictors of condom use during commercial sex among IDU-FSWs. Most of these associations have not been investigated in China or elsewhere, and the TPB has not been applied to HIV-vulnerable populations in China. A knowledge gap exists. / Objectives. This study validated two instruments measuring severity of drug dependence. The prevalence of inconsistent condom use among IDU-FSWs and its associations with the aforementioned variables were investigated. The hypotheses that different blocks of variables would have independent effects on condom use during commercial sex, and the effects of TPB-related variables on condom use would be moderated by some external variables (e.g. severity of drug dependence) were tested. / Results. The Opiate Addiction Severity Inventory-Revised (OASI-R) was fully validated in the Study I. Around 6.8% of IDU-FSWs were HIV positive and respectively 48% and 64% of them practiced needle sharing and unprotected commercial sex (last six months). After adjusting for significant background variables, the five TPB-related variables (AOR=0.43 to 1.92, p<0.001), severity of drug dependence (AOR=1.05, p<0.01), economic pressure (AOR=1.07, p<0.05) and all studied psychosocial variables (e.g. depression, social support and gender power; AOR=0.70 to 1.67, p<0.05) were significantly associated with condom use during commercial sex. / Subjects and methods. Two cross-sectional studies were conducted. In Study I, 178 non-institutionalized drug users were interviewed in Dazhou, Sichuan. In Study II, 281 non-institutionalized IDU-FSWs were interviewed in Dazhou, Sichuan and Hengyang, Hunan, using snowballing method and face-to-face interviews. Statistical methods such as hierarchical and interaction modeling, stratification analysis, ROC method were used in this study. / The final hierarchical model predicting condom use during commercial sex included variables coming from four blocks of independent variables, with ROC area = 94% and sensitivity/specificity = 0.84/0.91. A "Wellbeing Status Index" moderated the associations between some of the TPB-related variables and condom use during commercial sex. / Gu, Jing. / Adviser: Joseph T. F. Lau. / Source: Dissertation Abstracts International, Volume: 70-06, Section: B, page: 3462. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2008. / Includes bibliographical references (leaves 228-246). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in English and Chinese. / School code: 1307.

In this thesis, I use case study methodology to document the experiences of Latinas in sex work in Hong Kong and Macau. By investigating the identities of sex workers in these locations, I analyze risk behaviors related to each identity. I employ two theoretical frameworks; the first to examine the reasons for engaging in sex work, identities and risk behaviors; and the second to examine the women’s perception of the nature of sex work. The first framework consists of four explanatory models for analyzing sex work: a pathological model, a social dislocation and criminal subculture model, an economic position and poverty model, as well as a gender and male violence model. Of these, the economic position and poverty model seems to be a better fit with the background stories of most of the women in the study, who came from a poor socio-economic background. They took up sex work and migrated to other countries for economic reasons. However, I suggest that the agency of the women was not sufficiently taken into account by either of the models, including the economic position and poverty model. Using the second theoretical framework, I studied the women’s perception of the nature of sex work through the lenses of various feminist theories, including radical feminism, socialist feminism, Marxist feminism, liberal feminism and existentialist feminism. In looking at a systemic societal interpretation, radical, socialist and Marxist feminism views of oppression seemed justified because in most of the cases, sex work could be interpreted as a result of a patriarchal system and class conflict. At the individual level, the liberal and existentialist feminism views fit with the interviews because the women regarded sex work as empowering in view of their former poverty situations. Each of the women in the study maintained different work and private identities; and each of these identities could be associated with risk behaviors for themselves, for the clients, and for their families (especially spouses and/or boyfriends). The risks both sex workers and the local population faced as a result of the combination of criminalization of sex work and the lack of proper social services (medical, educational, and security), included violence, drug and alcohol abuse, and sexually transmitted diseases, including HIV/AIDS. In addition, sex workers were at high risks of suffering psychological trauma. The findings indicated that to avoid a culture of violence and insecurity, sex work is in need of a deeper understanding and policies that would enable better protection for sex workers, clients and the general population. / published_or_final_version / Education / Doctoral / Doctor of Philosophy

In South Africa and many other countries worldwide, sex work is criminalised. This invariably seems to lead to back-door prostitution - an unregulated industry where sex workers are vulnerable to being exploited by pimps, brothel owners and law enforcement officers. In discussions about sex work and sex workers, two dominant views are evident: a) Sex workers freely choose to sell sex as a good way of earning an income; or b) sex workers are victims of their circumstances who are driven into the industry through direct coercion or as a result of dire poverty. Together, these views lead to an ideological trap in terms of which sex workers have to be perceived either as having agency and free will or as being helpless victims in need of rescue. My aim in this thesis was to problematise, deconstruct and reconstruct the discursive field within which sex work is embedded, in order to move beyond agency-victimhood and similar binaries, and in the hope of developing new ways of talking about prostitution that acknowledge the complexity of the sex industry rather than shoehorning it into preconceived categories. Social constructionism (epistemology), critical social theory (ontology) and discourse analysis (methodology) were interwoven in order to provide a broad, critical understanding of prostitution. Two data sources were used to gain access to and unpack the life worlds of sex workers: Semi-structured interviews with five sex workers in Johannesburg and the “Project 107” report on adult prostitution in South Africa. Foucauldian discourse analysis was used to make sense of the data, including an analysis of how concepts such as governmentality, power, confession, surveillance and technologies of the self can be applied to contemporary texts about prostitution. The “Project 107” report recommended that prostitution should not be decriminalised, and that sex work should in fact not be classified as work; instead, it proposed a ‘diversion programme’ to help sex workers exit the industry. I show how, in doing this, the report appears to hijack feminist discourses about sex workers as victims in order to further a conservative moral agenda. The sex workers I spoke to, on the other hand, demonstrated an ability to take on board, and to challenge, a variety of different discourses in order to talk about themselves as simultaneously agentic and constrained in what they can do by unjust social structures. I show how, from a Foucauldian perspective, sex workers can be seen not as pinned down at the bottom of a pyramid of power, but immersed in a network of power and knowledge, enabled and constrained by ‘technologies of the self’ to assist in policing themselves through self-discipline and self-surveillance to become suitably docile bodies within the greater public order. / Psychology / D. Litt. et Phil. (Psychology)

Thesis (MPhil)--University of Stellenbosch, 2003. / ENGLISH ABSTRACT: This paper looks critically at particularly two harmful sexual practices most prevalent among the Zulu people in Kwazulu-Natal; virginity testing for girls, and the practice 'dry sex.' It is mostly the ripple effects of these practices, regarding the spread of mV/AIDS that is most alarming to medical science, leaving them no option other than to condemn this behaviour. This treatise however endeavours throughout to proffer understanding for the needs of a culture as diverse and unique as the Zulu people. Further, this paper often looks from an overarching African perspective, since despite African peoples' differences in terms of linguistics, geography, religiosity and general differences in daily run of the mill activities, there is a dominant socioreligious philosophy shared by all Africans. The, a, band c of virginity testing, and the resulting moral issues revolving around this practice are addressed. The main issues regarding the repercussions of virginity testing are discussed as well as the medical controversy involved in these issues. This will prove the limited effectiveness of this practice and the potential, yet serious and harmful ramifications it has for girls who are tested. In stark contrast to these girls, stands the girl who starts at a very tender age with the practice of 'dry sex', often encouraged and taught to her by female elders in order 'to please men'. This practice serves as a very powerful tool for commercial sex workers, venturing the streets and the truck driver stops, as it lures men into making her the preferred choice. So desperate are her socio-economic and cultural circumstances that she risks infection, and ultimate death, in order to comply with his need for unprotected and 'dry sex.' Numerous studies alert us to the fact that the drying agents used lead to lacerations of the vaginal walls, causing SID's, which in tum, exacerbate the spread of the disease. Zulu traditions and customs regarding sexuality and sexual relationships proffer essential insight into the Zulu people's sexual behaviour. In order to strike a balance between two diverse cultural groups, the West and African, a critical assessment of the West's own sexual history guides us to understand the West's 'sober' practice of monogamy is no less 'permissive' and 'promiscuous' than the African's practice of polygamy. The paper also investigates the corresponding differences in relation to indigenous knowledge systems versus science. African people discern the body's physiology and anatomy metaphorically and symbolically. We cannot simply gloss over these perceptions, enforcing scientific-based knowledge in our educational programmes, without consideration and accommodation for a very unique way of interpreting one's daily experiences and one's unique self. It is not only our biased discernment of indigenous knowledge that complicates the Aids pandemic considerably, but it is also enhanced by the burden of stereotyped gender-roles. Not only is a paradigm shift regarding the imbalance of power very much needed, we also need to understand that the inculcated anger some men in the Zulu culture fosters is a force to be reckoned with, as it displays psychological underpinnings of damage, signalling very clearly the need for therapeutic measures of healing. Conversely, the female in the Zulu culture has started to empower herself, but not always in terms of a beneficial end in itself. Similarly, it must alert us to the fine line separating the virgin-whore dichotomy, fuelled by her poverty-stricken and maledominated existence. It would appear that what we are fighting for is more than the preservation of life whilst engulfed by AIDS's scourge, but a global vision where the individual, or a whole community, with regard to mVIAIDS, is "self-reproducing, pragmatically selfsustainable and logically self-contained." (Bauman 1994: 188) / AFRIKAANSE OPSOMMING: In die Zoeloe kultuur figureer daar veral twee tradisionele seksuele gedragspraktyke wat kommer wek by sommige Westerlinge, hier ter plaatse sowel as in die buiteland. Alhoewel hierdie praktyke as natuurlik, eksklusief en algemeen beskou word, is daar huidiglik stemme van protes wat waarsku dat die twee praktyke potentiele gevaar inhou vir die mens se gesondheid en geesteswelsyn. Die praktyke behels dat jong en weerlose meisies vanaf die ouderdom van ses jaar gereeld onderwerp word aan 'n vaginale toets om vas te stelofhulle nog 'n maagd is, en, die voorkeur van sommige mans om omgang te he met 'n vrou wat haar vagina op 'n 'onnatuurlike' wyse droog, hard en styf hou met die oog op 'n meer bevredigende seksuele ervaring vir die man. Baie vroue geniet ook hierdie ervaring. Die mediese wetenskap is veral bekommerd oor die moontlike verband tussen die nadelige repurkussies van die twee praktyke en die vinnige verspreiding van MIVMGS en pleit derhalwe dat daarmee weggedoen word. Die praktiseerders van eersgenoemde praktyk word byvoorbeeld gewaarsku dat dit mag lei tot gevalle van verkragting, anale seks asook kindermishandeling, terwyl laasgenoemde praktyk veral twee hoe risiko-groepe ten opsigte van die VIGSpandemie ten prooi val; die kommersiele sekswerkers in Kwazulu-Natal wat die praktyk gebruik as wapentoerusting, en die land se vragmotorbestuurders wat hierdeur verlei en aangemoedig word. Hierdie vorm van seksuele omgang ondermyn egter nie net kondoomgebruik nie. Studies het bewys dat die gebruik van 'n vaginale uitdrogingsmiddel daartoe kan lei dat die wande van die vagina mag skeur. Beide groepe loop derhalwe nie alleenlik die risiko om 'n seksueeloordraagbare siekte op te doen nie, maar om ook 'n VIGS-slagoffer te word. Terwyl die beperkte effektiwiteit van die twee praktyke deurkam word, poog die verhandeling om deurgaans 'n duidelike ingeboude begrip te handhaaf vir die unieke en eiesoortige karakter van die Zoeloe kultuur. Dit redeneer dat beide groepe, Afrikaboorlinge en Westerlinge, moet probeer verhoed om te polariseer en illustreer dat diverse kultuurgroepe almal, vanuit 'n kultuurhistories perspektief, meerdere of mindere tekens van promiskuiteit en permissiwiteit ten opsigte van seksualiteit toon. Dit spreek vanself dat die twee praktyke ondersoek moet word teen die agtergrond van die Zoeloe's se inheemse kennis met inbegrip van die wyse waarop die menslike fisiologie en anatomie metafories en simbolies verklaar word. Die digotomie wat bestaan tussen inheemse kennis en wetenskap vra dat ons boodskappe gekommunikeer moet word op 'n wyse wat beide gesigspunte konsolideer. Uiteraard kompliseer die stereotipering van geslagsrolle in die Zoeloe bevolking die VIGS-pandemie aansienlik. Dit dra in 'n groot mate daartoe by dat die VIGSpandemie nie suiwer as 'n biomediese probleem manifesteer nie, maar dat ander psigo-sosiale faktore in berekening gebring moet word. Dit werk byvoorbeeld 'n ongebalanseerde magsposisie in die hand wat sommige Zoeloe mans se sielkundige worsteling met hul diepgewortelde, polities geinspireerde woede belig en dui op sommige kontemporere Zoeloe vrouens se toenemende geneigdheid om seks aan te bied in ruil vir geld. Sy doen dit om sodoende haarself van die juk van die Zoeloe man se mag oor haar en haar neerdrukkende sosio-ekonomiese omstandighede te bevry. Die verhandeling beweeg dikwels buite sy grense en fokus nie net bloot op die gedrag van die Zoeloe bevolking nie, maar boorlinge van Afrika in die algemeen. Hierdie oorhoofse Afrika-perspektief vind regverdigingsgronde in die lig van die feit dat boorlinge van Afrika saamgesnoer word deur 'n oorheersende sosio-religieuse filosofie, desnieteenstaande die feit dat daar merkbare verskille voorkom ten opsigte van linguistiek, geografie, religieusheid en ander wat betref hul daaglikse gebruike en omgang.

This purpose of this study is to incorporate women into the history of homelessness. Women's experience is missing from the narrative of industrial era homelessness, which causes researchers to make a distinction between the modem day homeless population and its predecessors. This distinction prevents researchers from examining the long term structural causes of homelessness and analyzing the role homelessness plays in U.S. society. This study explores the population characteristics and living conditions of three groups of women who were considered homeless during the early decades of the twentieth century in Portland. These groups include single working women who lived away from their family, prostitutes, and single mothers. This study also traces the development of charitable institutions and social welfare programs that arose to meet the needs of homeless women during this era and examines the relationships between homeless women and the reformers and charities that took up their cause. The inclusion of women's experience into the history of early twentieth century homelessness necessitates a broadened definition of the homeless phenomenon. Women's homelessness during this era was both defined and determined by their family situation. Women who lived outside of the patriarchal family were considered homeless and suffered economic hardship because of their non-traditional living arrangements. Incorporating an analysis of home back into homelessness will result in non-gendered policy implications. Labor market remedies and affordable housing solutions are still needed, but changes to the structure of the household economy are also called for. The unpaid labor women traditionally perform must be socially and economically valued and the sexual division of labor within the home needs to be challenged.

Sex work is a highly debatable subject in the field of psychology but little has been said about sex work and resilience. Challenges associated with criminalisation of sex work are rife but sex work continues to exist. This study explored the ability of heterosexual street based female sex workers (FSW) to ‘bounce back’ from challenges they face. The study employed qualitative paradigm and a transcendental phenomenological design was used. Snowballing sampling was used to select twelve FSW who participated in semi structured interview. Thematic analysis was used to extract recurrent themes across participants. Participants reported being victimised and physically and verbally abused by clients and the public. FSW showed their resilience by rationalising their role with having a purpose in working as FSW, obligation as bread winners and regarding sex work as legitimate work. They adopted psychological survival techniques and used various safety techniques to cope. The results emphasised importance of employing resilience and strength based approaches in researching and developing training and psychological programmes for sex workers. / Psychology / M.A. (Psychology)

Former studies show that the break-up from prostitution can be seen as a process with several stages which the person has to go through and that there are several factors which can affect the break-up. The aim of this study is to create an understanding for and illustrate how a break-up from prostitution can look like. We have interviewed three ex-prostitutes about their own break-up and three social workers who work with helping individuals to exit prostitution. We have analyzed the material through the theory of exit process by Helen Fuch Ebaugh (1988) and through former studies. All the ex-prostitutes and the social workers in our study described the break-up from prostitution as a process. All our respondents agreed on that there are several different factors affecting a break-up from prostitution, whereof close relationships and the own motivation to make a change are the most significant ones. Formal support from professionals is also considered having an impact on the exit process as well as during the period after the break-up. In summary, the break-up process from prostitution is very complex, can be emotionally exhausting and may vary to a great extent between individuals.

Evidence of male sex work has a history as long as female sex work. There is century old evidence of male Sumarians and Greeks selling sex to other men. Men are today still selling sex to other men. This study showed that the elimination of sex work is practically impossible, and could only be accomplished by the gross denial of basic human rights. Male sex workers have not received the same attention from researchers as have their female counterparts. This is so despite the large numbers of male sex workers in cities all over the world who potentially contribute to the worldwide sexually transmitted infection rates. It is known that wherever indiscriminate sexual activities take place, the risk of transmission of infections are greater. The activities between the male sex worker and his client(s) determine the health problems they are exposed to. The purpose of this research was to determine what transpires between male sex workers and their client(s) in order to provide the sex workers with knowledge to better take care of their own health as well as the health of their clients. A qualitative research design was used to collect data by means of in-depth interviews and participant observation sessions. Research strategies that were also used included: description, ethnography, phenomenology, and the biographic methods of qualitative research. The research revealed that men who have sex with men (MSM) were exposed to forty-nine different preventable sexually transmitted infections including HIV/AIDS, trauma, violence, and alcohol and drug abuse. All these conditions relate to the lifestyle and activities of male sex workers. Recommendations were made regarding the removal of factors that hinder the delivery of programmes on safer sex to MSM. A booklet on safer sex for MSM was compiled by the researcher and distributed to all informants upon completion of the research. The neglected topic of male sex work was highlighted and health practitioners and other decision makers can now use the information in this thesis to make a contribution towards the better management of male sex work in South Africa in the interest of public health. / Health Studies / D.Litt et Phil. (Health Studies)

In this study semi-structured, in-depth individual interviews were conducted with sixteen female street children aged 15 to 18, who were engaged in commercial sex work. These children were conveniently selected to explore the social dislocation of and social support for female street children engaged in commercial sex work. In addition, two focus group discussions consisting of nine female street children each, as well as seven key informant individual interviews, were conducted. This study found that female children engaged in commercial sex work experienced a high degree of social dislocation and that the children who participated in this study tended to create their own communities and isolated themselves from the broader community in which they lived. This study further found that different support programmes had been introduced to alleviate the problems experienced by these children and that a number of organisations delivered support services to address their needs. / Sociology / M. A. (Sociology)

Given the lack of effective vaccine or medicine, changing an individual's risk behaviours has been crucial in preventing the spread of HIV. Consistent and correct condom use has been considered as the most effective form of HIV prevention among female sex workers. Despite coordinated national level interventions over the last decade, a consistent decline in condom use among female sex workers has been evidenced in the Ethiopian context, particularly with non-paying partners. Thus far, no study has been produced that has illustrated major determinants of consistent condom use among female sex workers which would help in developing effective intervention strategies for the prevention of HIV spread in the country. In other countries, the Information, Motivation and Behaviour (IMB) model has been used to identify individual level determents of condom use. However, the researcher postulated that behaviour emanating from the personality structure of individuals could be the fundamental individual level determents of adherence to condom use and chose to investigate this using the Enneagram theory of personality, which was acknowledged for its heuristic value in explaining and enhancing self-development of at-risk individuals. This cross-sectional study was conducted in Addis Ababa. With the Without Finite Population Correction of the Sample Size Estimation Formula, the sample size of 350 was set and participants were recruited using Respondent-Driven Sampling (RDS). Using trained female sex workers, the Essential Enneagram Test (EET) and an Information-Motivation-Behaviour (IMB) questionnaire were administered to collect data. General Linear Modeling (GLM) Multivariate analysis was carried out to assess the correlation between personality style and consistent condom use among participants in the last seven days before the interview. The finding of this study revealed that personality type, measured by the Essential Enneagram Test (EET), is able to predict adherence to condom use among female sex workers and provided a new dimension for policy makers and practitioners in behavioural intervention programmes, such as Information-Education-Communication, peer-to-peer approaches, as well as health and rehabilitation services by using the Enneagram principles and universal growth process. / Psychology / D. Litt. et Phil. (Psychology)