In this section, the discussion moves from prevention research findings to the work and thoughts of sex work advocates and community-based outreach and prevention groups.

While many Canadian academics and researchers have found it difficult to separate the moral and occupational issues associated with sex work -- and as a result, have been slow to incorporate issues of HIV and AIDS and issues of occupational safety into their studies of male sex work -- sex work advocacy and outreach groups have been proactive and vocal about how HIV and occupational safety are linked.

There are many jobs that involve risks and require safety measures. Sex workers are well aware of the potential risks of their trade, including the potential for violence or infection. Because of this they ensure precautions for both themselves and their clients. Just as construction workers always wear helmets on a job site, sex workers use condoms.229

One of the HIV education messages put forth by Maggie's Prostitutes' Safe Sex Project is that

the risk of catching HIV is not from having sex for money, but from having risky sex with partners who we trust, love and play with -- from people and activities that are outside the parameters of sex work.230

And education by sex workers' outreach and advocacy groups has not been limited to handing out condoms and lube. Commenting on the Prostitutes' Safe Sex Project, sex worker and activist Danny Cockerline231 recalled:

When we first started doing this project, our approach was to find out what people knew about safe sex and offer them condoms. What we found was that a lot of people were really insulted because they knew about condoms and safe sex already. Even offering them a condom was an insult because they would say, "Well, I've got my own condoms." So we started a new approach where we would give them material like pamphlets to give to their customers. The whole approach was that this is material to educate your customer and it is not therefore an insult to you. That has been very successful. ... It encourages them to feel good about the fact that they are practising safe sex and promoting it with their customers. 232

Why educate sex workers and their clients?

In 1988, Canadian sex worker and activist Valerie Scott, speaking at a sex work conference in Melbourne, Australia, proposed three answers to the question, "If sex workers are already having safer sex, why bother with an AIDS education program for sex workers?" According to Scott,

1. There are still people in the business who are ill informed, usually because they have just arrived from a small town where AIDS information is not easily available, or because they are younger people for whom access to safe sex information is difficult.

2. There is more that people need to know about AIDS and STD prevention than the media usually provides. While most prostitutes know enough to use condoms, some don't know the difference between lambskin and latex, others don't know the right kind of lube to use, how to use nonoxynol-9 effectively,233 how to clean needles if they or anyone they know shoots drugs, how and why to avoid other STDs, how to assess the risks of having unsafe sex with a lover, etc. ... Gaps in knowledge are greater in small centres because there are fewer AIDS cases, and therefore less media discussion about how to avoid AIDS.

3. Prostitutes need help educating those customers and other sex partners who don't want to use condoms. Because most prostitutes have contact with hundreds of men a year, they are well situated to play the role of educators. An outreach project can provide prostitutes with the information and skills they need to do this education.234

AIDS prevention education messages for male sex workers

Many Canadian researchers have concluded that conventional HIV and AIDS prevention programs may not reach male sex workers. One reason is that provincial and national initiatives fail to focus on the potential differences between male and female sex workers.235

Another reason is that many male sex workers do not self-identify as gay, so special efforts should be made to address potential barriers to safer sex, including social, cultural, economic and sexual realities.236

Ultimately, with information on male sex workers, their clients and their experiences with HIV and AIDS as limited as it currently is, it is difficult to develop and evaluate intervention programs.237

Some sex work advocates feel that

AIDS prevention workplace messages should be delivered in the context of other workplace issues such as police harassment, violence, street and other worksite safety, daycare and other health issues. A prostitute's home life isn't much different from yours. Personal safer sex messages that work for you can work for me too.238

Community-based AIDS outreach for male sex workers

In Toronto, the Street Outreach Services (SOS) program has been working with young sex workers since 1985. The organization holds that most youth do not become involved in sex work by choice, but rather through circumstance. According to SOS, youth are pushed into sex work by such things as family problems, sexual identity issues, trouble at school, poverty or the lack of available jobs.

The anonymity of a large city like Toronto holds the appeal of apparent freedom, but in fact, relegates most of these youths to an abandonment of their original goals and ideals, replacing them with the often harsh requirements of survival.239

Among the services offered by SOS are HIV and AIDS education initiatives, peer education workshops, safer sex-toy workshops, HIV testing and counselling and condom distribution.

In Montreal, Projet Prostitution Masculine is a community-based initiative that takes HIV prevention to the streets. Initiated in 1996 and coordinated by the AIDS service organization Séro-Zéro, this project delivers condoms, lubricants and a needle exchange service to male sex workers in the downtown core.240

In Winnipeg, the Village Clinic's Street Outreach Project allowed male sex workers "to define their own needs and identify strategies to meet those needs, instead of service being delivered based on assumptions of employees and volunteers of the community clinic."241 This project delivered basic health services including condom distribution, health information and service referrals to male sex workers. It also collected behavioural data on the male sex work populations that it served.242

In Vancouver, Andrew Sorfleet coordinates the Sex Workers Alliance of Vancouver (SWAV). Through the award-winning SWAV website, which has been on-line since August 1995, sex workers and their clients can access information on issues affecting sex workers, including information on HIV and AIDS.243

Also in Vancouver, the Downtown South Community Health Clinic operates Boys R Us, a drop-in centre for male sex workers which provides a safe place, meals, health-related services and links to HIV and AIDS counselling and testing. The centre also serves as a point of recruitment for the Vanguard Study. The drop-in is operated in cooperation with a number of the city's other community-based organizations, including AIDS Vancouver.

These are some examples of community-based organizations providing AIDS outreach for male sex workers in Canada.

Footnotes

229. STELLA, Some Myths About Sex Work, educational pamphlet, Montreal, 1996. [back]

231. For information about Danny Cockerline, see: http://www.walnet.org/97_walnut/danny_cockerline/.

232. Danny Cockerline, quoted in Brock, D., "Prostitutes are Scapegoats in the AIDS Panic," Resources for Feminist Research, 1985, 18, 2, p. 16.

233. Currently, the effectiveness of nonoxynol-9 in reducing the risk of HIV transmission is unclear. See Cook, R. L. and Rosenberg, M. J., "Do Spermicides Containing Nonoxynol-9 Prevent Sexually Transmitted Infections? A Meta-Analysis," Sexually Transmitted Diseases, 1998, 25, 3, pp. 144-50.

234. Scott, V., The Role of Sex Worker Representative Organisations, paper presented to the First National Sex Industry Conference, Melbourne, Australia, October 1988, p. 89.

235. Godin, R., Mathews, F. and Meston, J., Does Anybody Care: Proceedings of the Follow-Up Consultation on Juvenile (Adolescent) Prostitution, Halifax, Children's Aid Society, 1990.

236. Miller, M. L., Strathdee, S. A., Martindale, S. L., Cornelisse, P. G. A., Hogg, R. S., Cook, D., Montaner, J. S. G., O'Shaughnessy, M. V. and Schechter, M. T., Characteristics of Male Sex Trade Workers Enrolled in a Prospective Study of HIV Incidence, paper presented to the Tenth Annual B.C. AIDS Conference, Vancouver, October 1997b.

237. Shaver, F. and Newmeyer, T., Men Who Have Sex With Men: A Comparison of the Sexual Practices and Risk-Taking Behaviour of Gay and Bisexual Men and Male Prostitutes, paper presented to Sida, jeunesse et prévention. Au-delà du discours, des actions!, at the 64th conference of ACFAS, Montreal, May 1996.

238. Highcrest, A. and Maki, K., Prostitutes: AIDS Prevention in Their Private Lives, alternately titled When Love is Illegal: AIDS Prevention in the Context of the Private Sex Lives of Prostitutes, paper presented to the VIIIth International Conference on AIDS, Amsterdam, Netherlands, July 1992, p. 5.

239. Street Outreach Services, Submission by Street Outreach Services (SOS) to the Board of Health, Toronto, Street Outreach Services, June 14, 1995, p. 1.

240. Séro-Zéro, Projet Prostitution Masculine Action Séro-Zéro 1997-1998, Montreal, Séro-Zéro, 1998.

241. Linnebach, K. and Schellenberg, J., "Street Outreach with MSM Sex Trade Workers Allows Clients to Define their Needs," Canadian AIDS News, Canadian Public Health Association,1996, 9, 2, p. 11.

242. Village Clinic, Street Outreach Project Needs Assessment: Final Report, Winnipeg, Village Clinic, 1997.

243. http://www.walnet.org/swav/.