I was talking with a woman who’s interested in becoming an escort a few days ago. During the course of that conversation, she mentioned that she has Herpes, which as you no doubt know is incurable. We both agreed that full disclosure would be required. This is in congruence with my position as articulated in the post I made about providers working with STIs.
The archetype of the prostitute as the disease-ridden vector is quite commonly accepted by many people, especially those who only have the mainstream media as their source of information on the subject. There’s a common statistic floating around that suggests prostitutes are responsible for only about 3-5% of the STD transmission in this country, while teen sex is responsible for around 35% of it. The source of this is a study produced by the U.S. Department of Health and Human Services in the 1980s when HIV and AIDS were a big deal. I’m not aware of any source for current, reliable statistics on the issue, but with the huge increase in teen STD transmission rates over the past few years, I’d be surprised if the statistics aren’t much higher for them and perhaps a bit lower for prostitution’s contribution, relatively speaking. And as more and more of these infected teens move into the sex industry (as they get older), the potential for transmission is likely to rise to a certain extent.
The fact of the matter is that sex workers, prostitutes especially, rely on being healthy in order to ply their trade, and are far more cognizant and knowledgeable about and insistent on safe sex practices than the vast majority of non-sex workers. In fact, in Nevada, there’s never been a documented case of HIV transmission in the legal brothels. The overall occurrence of STDs in the brothels is far, far lower than the population at large. So the idea that professional sex providers are a huge source of STDs across the total spectrum of occurrence is a myth.
Still, there are providers out there who are infected. And, similarly, there are (potential) clients who are likewise infected.
So the thought has occurred to me in the past as to what the potential might be for providers with infections to cater to clients with infections. This could be especially appropriate for those with any incurable disease, such as Herpes or HIV. According to the UNAIDS Commission, more than 30 million people are living with an HIV infection worldwide. The CDC estimates that between 15 and 20% of Americans are infected with the Herpes virus. If one buys into the assertion that some 50% of American men will avail themselves of the services of professional sex providers at some point in their lives, there would appear to be the potential for some level of demand out there.
And though safe sex practices, such as the use of condoms (including for oral) and dental dams, can help prevent transmission of most STIs, they’re not always 100% successful. Fluids end up on other parts of the body where they can come in contact with another person. I like to lick, nibble, bite, and chew on my partners’ bodies – all over their bodies, for example. Therefore some risk remains. So it’s not enough to say that a provider will use safe sex practices, or that a client will use safe sex practices and everything would be okay.
With that in mind, what are your thoughts on infected providers advertising and marketing themselves to clients who are similarly infected? Assuming you were infected (as a client) would you feel more comfortable seeing a provider who’s similarly afflicted? If you were a provider, would you feel comfortable marketing yourself that way, and seeking clients who are similarly infected? And by “infected” I’m presuming a disease that is incurable (HIV, HPV, Herpes), not something on the order of chlamydia or others that are treatable with antibiotics.
And if your answer to those questions is “no,” why not?
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{ 11 comments… read them below or add one }
“The overall occurrence of STDs in the brothels is far, far lower than the population at large. So the idea that professional sex providers are a huge source of STDs across the total spectrum of occurrence is a myth.”
Legal brothels require frequent disease tests. Streetwalking does not. Your job does not (even though you do out of your own accord). Having seen what I’ve seen from previous jobs, I simply can’t buy into your statement that less than 3-5% of transmissions is through sex workers. Show me some research? If 15-20% of the population is infected with Herpes, wouldn’t it stand that 15-20% of sex workers are also infected?
As for the infected providing for the infected, aren’t there different strains of HIV/AIDS that can be worse than others (i.e. more aggressive; quicker to change to full-blown AIDS)? Even with the assumption that protection would still be used, would you feel comfortable taking the chance of exposing an already weakened immune system to more infection?
Streetwalking does not.
Streetwalkers comprise only about 10% of the total prostitute population.
I simply can’t buy into your statement that less than 3-5% of transmissions is through sex workers. Show me some research? If 15-20% of the population is infected with Herpes, wouldn’t it stand that 15-20% of sex workers are also infected?
I’m guessing you didn’t read the entire post?
I specifically stated that the statistics I provided came from a 1980s study, and that, insofar as I knew, there was no current reliable statistics on this issue (and that study is easily accessible through a PUBMED search if you’re that curious about it).
I also stated that sex workers are much more diligent about safe sex practices, so even if one assumes that 15-20% of sex workers are infected, the transmission rates for them as a group is going to be a lot less than you’d find in the general population. Most escorts I know get tested regularly as well as a matter of routine.
As for HIV, there are a variety of strains and subtypes, yes. The specifics of all of that are beyond me, though, so I can’t comment directly on your specific question.
“Legal brothels require frequent disease tests. Streetwalking does not”
Carrie your statement above is not entirely correct
To understand why, you have to understand what goes on in the streets when it comes to prostitution. For cities to control STD’s from street prostitutes they had to find away to have them checked for STD’s just like brothels. They do this by enforcing prostitutes’ to carry health paper/cards. And the prostitutes that run in circuits and the ones that make a living in their home towns, feeding their family’s and keep roofs over their heads are carrying health cards, because their a get out of jail free card 90% of the time.
Have you ever wondered why street prostitutes can work right in from of the police, and nothing happens? The reason is exactly what I explained – control.
When the police stop a prostitute, health papers or card is the first thing they ask for, and after running the prostitute for warrants, if she has none, she is free to go “Only” if she provided those papers – If she didn’t she is told to go home and if she is seen again she goes to jail. So a large percent of street prostitutes carry them. Which cuts down on STD’s. Because its simple; f you don’t have them you go to jail. If you have a STD and are working you go to jail. and these are first time 60 day jail sentences, even longer if you keep repeating it.
If the cities can’t control prostitution they can somewhat control the STD’s and crime rates by letting street prostitutes work under the rules provided that they carry proof that their clean – and this is nothing new it has been going on for a very long time.
And most smart Escorts play by these rule too. They will have to provide them in court anyhow.
I feel like it could be a market that a woman could address for sure, esp if she is working in a larger city where she would be more likely to possibly encounter said client base. But I feel like this woman would potentially be offering herself up for much scrutiny and abuse from men writing/calling to her about services. Its an interesting situation to ponder though because I would assume there are men out there who may be infected but still would like to experience/enjoy an escort.
It sounds like a creative solution to a difficult problem. If I was a client with an STI and wanted to do the ethical thing and disclose it, I would feel more comfortable disclosing it to a provider who I knew already had that STI. From a provider point of view, it would save them having to field enquiries from clients that may lose interest once the provider’s STIs were subsequently disclosed.
I remember reading about a dating site exclusively for people with Herpes. With the percentage of people infected with herpes that live normal lives and want to be ethical about their dating it’s a great idea.
My problem with escorts advertising specific STDs is that while it does make sense to keep the virus/disease contained there are some dangerous “bug chaser” fetishes out there. Purposely getting infected and then trying to transmit it…
So, unless there was some kind of screening (or perhaps referral from a doctor) to guarantee both the client and provider have herpes or HIV I’d be hesitant about advertising such forms of prostitution in the free market.
In a broader sense, it’s an interesting debate how far you can erode human rights in the name of containing a disease.
I think this would be a great angle in larger metropolises. I know if I were infected with an STI I would never procure the services of escort that was clean. You’re talking about ruining the livelihood of a woman and possibly her family. Knowingly sleeping with any woman without full disclosure is horrific enough, but to add on the extra level of ruining her job as well is just unthinkable in my book. The two times I’ve delved into the world of paying for the company of a woman I fully disclosed that I had no history of STIs and she did as well with me before we went anywhere with the evening. Granted, she could have lied, but I tend to believe the majority of people are not going to do such in that profession.
If I WERE infected with an STI I would definitely prefer finding an escort with the same rather than sleeping with random women. I wouldn’t have infecting others on my conscious, even WITH full disclosure, and I’d be supporting someone’s livelihood in difficult economic times. It may be faux pas to some, but I believe those with an STI would appreciate the option to have peace of mind when going out for some fun.
I’ll join the list of thinking that is a great idea and solution. There are dating sites already catering to those with such STI’s – providers should have the same kind of network. As others said, this would be a relief on both sides… Neither having to hide the issue, and both still being able to enjoy pleasure and such.
Gee, now if we could just get such common sense legalized in this Puritan nation…
As heartened as I am to see how many men would not visit an escort when they themselves had an STI, the number of people I have to knock back, for rampant and obvious cases of genital warts for instance, would suggest that this view is not as prevalent in the general populace. Friends who work in brothels have an even higher level of incidence. It’s only anecdotal evidence, but if many infected men don’t care or prefer infected escorts…. business might not be that great.
I think it would be fantastic if prostitutes who had STIs of whatever variety went out there and did their thing with a warning. I’m sure there are a lot of people out there who want some sort of gratification but cannot (through screening or own conscience) have sex with someone because of the infection. If they knew the other person was at a similar standing they could fully enjoy themselves with no worries of hurting the other person involved. It might also help reduce the continued spread of infection. Maybe not by any large margin, but it could help.
I think you really should stop grouping HIV and herpes together. They are not even in the same ballpark. While technically herpes is an incurable “disease” it’s roughly like saying that acne is an incurable disease. For the overwhelming majority of outbreaks they are about as consequential as getting a nasty zit. And a lot of people don’t get infected from sexual activity.
I’ve had cold sores for as long as I can remember – the first documentation I have of it is my grade 1 school photo. I sure as hell wasn’t doing anything sexual at that age. So I don’t even think of it as an STI and I’ve never felt any need to sit someone down and put on my serious face to make full dislosure before we… have sex? kiss? sample each others drinks? And I’ve never disclosed it to a provider, nor would I expect a provider to disclose it to me. And any disclosure would be met with my puzzled “so what?” face.
Now, current sore is another story. But I’m assuming you want disclosure even from someone who hasn’t had an outbreak in years? And I’m also assuming you would include HSV1 and HSV2 since their classification as STIs is identical, even though it’s estimated that up to 80% OF THE POPULATION HAS BEEN EXPOSED TO HSV1 and the majority of people never had a symptom (or one so mild they misssed it). How would these people make a disclosure? Also, standard STI screening does not include herpes unless there is a sore present.
HIV on the other hand…
Expensive drug therapies. Counseling. Eventual, if slow, demise.
I may have something “incurable” but it barely registers on my health radar.
Those aren’t the same thing, right?