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Remarkable Variation in the Socio-Spatial Organization of Sex Work and Its Implications for STD/HIV Spread

Sevgi Aral, PhD, Centers for Disease Control and Prevention, 1600 Clifton Road, Mailstop E02, Atlanta, GA 30333, (404) 639-8259, soa1@cdc.gov, Janet St. Lawrence, PhD, Behavioral Interventions Research Branch, Division of STD Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mailstop E-44, Atlanta, GA 30333, Anneli Uusküla, Dr MS, PhD, University of Tartu, Department of Public Health, Ravila 19, Tartu, 50411, Estonia, and Roman Dyatlov, The Biomedical Center, Pudozhskaya street 7, St. Petersburg, 197110, Russia.

Background: The organization of sex work in social and geographic space influences the volume and pattern of sex worker—a client contact which in turn impacts the spread of sexually transmitted infections including HIV.

Methods: Focus groups and in-depth interviews with key informants; geo-mapping, naturalistic observations and review of available literature in five sites in the Former Soviet Union.

Results: Socio-spatial organization of sex work varies greatly across sites. Key organizing principles observed in one site are not replicated in other sites. In Moscow, Russia hotel and street sex work predominate; both are highly organized with pimps, guards, drivers as distinct roles. In Saratov, brothel based sex work is predominant while in Balakovo most sex work is performed by very young, drug addicted free lancers soliciting on the streets. In St. Petersburg, sex worker – client contact is organized via the internet, cell phones, and sex service catalogues. In Tallinn, Estonia, the taxi driver emerges as the organizing principle connecting clients to sex workers in brothels. These patterns influence the interactions between sex work and law enforcement; they also affect the ability of outreach prevention workers to access sex workers. Most importantly, the socio-spatial organization of services determines the volume and pattern of client – sex worker contacts, a determent of STI spread.

Conclusion: Given the extent of its heterogeneity across sites, the socio-spatial organization of sex work should be assessed in each local area prior to initiation of any epidemiological or intervention projects.

Learning Objectives:

Presenting author's disclosure statement:

Not Answered

Handout (.pdf format, 399.6 kb)

Topics in HIV/AIDS II

The 134th Annual Meeting & Exposition (November 4-8, 2006) of APHA