Sex workers worldwide have unique and exclusive access to men that may never actively seek information about HIV or STIs. Clients generally view sex workers as "sexperts" and as a result, they may ask questions that they would never dare broach with a health professional, making sex workers a valuable resource in HIV education work.

In Australia, sex workers continue to demonstrate high levels of sexual health of which we can be proud. In over 20 years of HIV in Australia, no cases have been recorded of transmission of HIV between a sex worker and a client or vice versa 1. Sex workers also have consistently lower rates of sexually transmitted infections (STIs) than the general community.

However, the maintenance of good sexual health among Australian sex workers has occurred despite less than optimum conditions. In most States and Territories, some sex work contexts are still criminalised. Sex workers have shown much skill in continuing such high levels of safer sex practices in what is a far from an enabling environment.

Female workers in particular – the largest and most researched group in the sex industry - use condoms for oral, vaginal and anal sex. The reasons for Australian sex workers having been so successful at implementing wide scale condom usage in commercial transactions are complex, ranging from the obvious prevention of transmission to the creation of a psychological barrier between worker and client during penetrative sex. Female sex workers were using condoms prior to the emergence of HIV in Australia to avoid other STIs such as gonorrhoea, however HIV increased the support of sex industry management for safer sex and also reduced client resistance to condoms. Sex workers have been linked with disease in our culture since the days of syphilis epidemics in Europe, and sex workers use this stereotype strategically with clients - alluding to the fact that the client needs to protect himself 2 against the worker to reinforce the expectation of safer sex.

For male sex workers, HIV/AIDS education often involves expelling some of their client’s myths of transmission. For instance, men visiting male and pre-operative transgender workers may try to encourage the sex worker to have sex without a condom with comments like, “I’m married. I’m clean. I/you don’t need to use a condom” or “I’m not gay so I don’t have HIV.” The worker’s insistence of condom usage may go some way towards educating their clients on not only the risk of HIV, but STIs.

Sex work skills

Sex workers use a range of skills within commercial sexual services that increase the comfort levels of clients around safer sex. A good example is the application of condoms using the mouth. This technique is great preparation for safer oral sex and eroticises condom use, so that putting on the condom is less intrusive to the flow of the exchange, ensuring that the client is less likely to lose an erection. Also, some sex workers will open the condoms and have them close by before the sex begins, further reducing interruption.

One of the gifts that sex workers offer their clients is to broaden their sexual horizons. Often, one of the messages our culture promotes is that sex revolves around penetration. Heterosexual men in particular can be focused around penetrative sex almost to the exclusion of other forms of erotic play. For female sex workers on the job learning, informal peer education between co-workers in sex industry workplaces and formalised peer education through sex worker organisations; has developed a broad repertoire of erotic touch. This can include body slides (a sexy form of body contact massage); tit-fucking (known as Spanish within the sex industry) and nipple play on a client. These techniques minimise the length of time spent performing penetrative sex – thereby reducing condom breakages and wear and tear on the body. An additional benefit of these non-penetrative activities can be introducing clients to unfamiliar erogenous zones and lower risk sex play.

Unfortunately, sex workers are not immune to negative messages about sex in our culture. Female sex workers in particular can be affected by stigma attached to sexually active women. However, even when sex workers are not embraced by sex positivity and pride, usually they can talk about sex in a frank and comfortable way. This comfort is developed due to a feature of commercial sex as one of the most heavily negotiated sexual exchanges. The professional framework around sex work has created conditions for explicit conversations about sexual boundaries and desires. The role of sex workers who can talk with ease and knowledge about sex cannot be underestimated in creating an environment for learning about sexuality. This openness allows for non-judgemental exploration of sex, hopefully increasing the chances of clients approaching pleasure in a healthy, joyous and less risky fashion.

Link to the original article in HIV Australia, Vol 3. #1 Sep - Nov 2003

References

1. Harcout, C, 1994, "Prostitution and Public Health in the Era of AIDS." In Sex Work and Sex Workers in Australia, edited by R. Perkins, G. Prestage, R. Sharp and F. Lovejoy, University of NSW Press, Sydney: 218-219.
2. The overwhelming majority of clients of sex workers are male, and for the purpose of this article, the focus is on male clients.