Wednesday, September 18, 2013

Sex Workers and Safety



Making Prostitution Safer?
After reading and listening to last week’s case study about the 100% Condom Program in Thailand sex workers, I began to think about an article I read recently in the news. Prostitution is legal in Switzerland and has been since 1942; however, it was not until recently that the city officials in Zurich, Switzerland have taken action in an attempt to make prostitution safer.  The city has now forbidden women to solicit in the streets and expects them to use newly constructed facilities known as “sex boxes”. 
Zurich’s hope is that these sex boxes will make prostitution not only safer for the women but also for their clients. The facility is located in the suburbs of Zurich and is surrounded by security gates manned by guards. Men (clients) will be able to drive around in their cars, select a woman and continue business in that woman’s designated drive-in sex box. In each box there is an alarm button and an emergency escape, as well as safe sex reminders (such as condom use to prevent STIs and HIV). Also onsite are social workers, full bathrooms and a kitchen for the women to use and get assistance if necessary. Regulations also require all prostitutes to buy a daily sex workers license and have health insurance. The project was paid for using tax dollars and was approved by citizens who wanted the prostitution off their streets and out of the main city.
Although the main goal of this initiative is not HIV/AIDS prevention, I can’t help but wonder if it will not only successfully make prostitution safer but also lower rates of STIs and HIV/AIDS? This may be hard to determine, since Switzerland already has a low prevalence rate (0.4%) of HIV/AIDS. However statistics show that men ages 15-24 and women ages 20-24 have the highest risk for sexual transmission, so perhaps if this is the population predominantly using the sex boxes, it very well could lower the incidence of HIV/AIDS in these age groups. 
I realize a program similar to this is not feasible for many other countries, especially if prostitution was not legal and the citizens were not willing to have their tax dollars pay for such a program. However, I think it will be interesting to see the outcomes of this project in Zurich and to look for anything that can be learned and applied elsewhere.
I drew comparisons between the case study from last week and this article for several reasons. First both countries are trying to make prostitution safer, although it is legal in Switzerland and not in Thailand; both initiatives addressed a marginalized group of people (prostitutes). Second, although the initiatives had different objectives, the overarching goal was to make prostitution safer for both the women and their clients (and therefore the general population). Thailand was successful and the verdict is still out for Switzerland. Is it time that other countries began to address issues that are typically overlooked and frowned upon in order to improve the health of many? Switzerland did it in the past by battling drug addiction and unsafe usage in the streets with needle exchanges, injection rooms and even prescriptions for the drugs with success. If Switzerland and Thailand can do it, can other countries?

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3 comments:

  1. Nice Blog Lindsey. Now, can we find some scholarly references on both campaigns? Have they been evaluated, specially the Switzerland one. I have problems there as their approach is totally located in a Power/ Control/ Quarantine Framework. Read Foucault and see how this is so problematic. It serves to dis-empower and further exploit the already marginalized population. It seems quite amusing at one level and quite a serious problem at another when I see public health officials think that they can contain a social disease by building a walled compound with surveillance with people's tax money. Wow!! such ignorance...Really can we deconstruct that "citizen's approval"? And if prostitution is legal, what is the meaning of "concerned" citizens wanting prostitution off their streets? Is it not a contradiction there? more of an irony...so there is stigma and discrimination in the swedish society...And if this is true, the strategy is faulty. it privileges some and disempowers/ exploits the other!!

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  2. I am doing some research to find out whether the campaigns have been successful or not, however, I just wanted to expose my bias to everyone. How can a nation legalize prostitution? Does the means justify the end or the end justify the means? As health worker professionals, do we have a creed (may be not the right word) like the nurses and doctors who take an oath to "do no harm?"

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  3. Very interesting post concerning sex boxes. At first, these new facilities sounded very similar to brothels. However, after doing some research, I found some interesting information on brothels and a project concerned with preventing HIV transmission in brothels. The project reviewed campaigns in various countries concerned with this health issue. According to "The Synergy Project," there is no universal definition of a brothel. The project defines a brothel as a commercial sex establishment, where managers or owners earn a fee from sexual interaction on the premises. I would assume Switzerland is not labeling these sex boxes as brothels because there is no middleman taking the money. The project concludes the most effective interventions reduce transmission through diagnosing risk causation on 4 levels- societal, institutional, community and individual.

    http://www.who.int/hiv/topics/vct/sw_toolkit/Preventing_HIV_AIDS_in_Brothels_Synergy.pdf

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