‘Moonlight sex:' Female sex workers' narratives of intimacy and pleasure, with implications for harm reduction strategies

Background: Harm reduction strategies erroneously discount the significance of intimacy and pleasure in sex workers' lives. Research documents the association between perceived intimacy and lower rates of condom use among female sex workers (FSWs). Several studies describe sex workers' subjective experience with condoms across a range of partners. The giving and taking of sexual pleasure as an aspect of intimacy is not sufficiently understood, but could illuminate pathways to safer sex strategies that value, rather than disregard, intimacy and pleasure.

Objective: To understand FSWs' perspectives on sexual power, pleasure, pain and shame so that harm reduction strategies effectively reflect and respond to their lived experience of gender and sexuality.

Methods: Data are derived from qualitative research conducted through CARE's SAKSHAM project in Andhra Pradesh, comprising narrative histories of 24 women, participatory research sessions with 22 women on (hetero)sexual subjectivity and sexual hierarchies, and in-depth interviews with 22 women on stigma and violence.

Results: Women described in detail how to pleasure men, explained how men experience sexual pleasure and how to wield sexual power over men. In their intimate relationships, women placed men's pleasure ahead of their own – seeking possibly to secure a relationship. The women ranked favored sexual acts, ranging from peno-vaginal sex to ‘moonlight sex' to ‘ice fruit.' Images of intimacy permeate the data.

Conclusions: The process of researching sexual subjectivity built trust among staff and the FSWs. In light of the findings, on-going harm reduction interventions have been subsequently modified, and new activities designed jointly with the women.