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The Netherlands

Strong connections between use of drugs and unsafe sex work

On the initiative of Mainline, Prostitutie & Gezondheidscentrum 292 / Prostitution & Health Centre 292, P&G292 carried out a survey of male and transgender sex workers between November 2013 and February 2014 in close cooperation with the Public Health Service of Amsterdam (GGD).

The goal was to gain more insight into the type and function of drug use during the sex work and the influence of drug use on sexual behaviour.

The results showed that the group targeted by the monitoring report uses drugs relatively frequently during their work. While under the influence of drugs they engage in riskier sexual behaviour. P&G292 finds the information provided by Mainline so relevant that they are carrying out an in-depth study among this group.


Relevance
Mainline and P&G292 see it as important that male and transgender sex workers who use drugs be informed about conscious use. Such information is expected both to have a positive effect on damage to health due to drug use (harm reduction) and to help to prevent sexually risky behaviour under the influence of drugs.


Most important signals from the monitoring report

• Twenty-five of the thirty respondents used drugs while working
The assortment of drugs used is broad. Poppers, sniffing cocaine, alcohol, Viagra/Kamagra, and cannabis were used most frequently. The frequency with which drugs are taken during sex work varies. More than half of the respondents indicated that they regularly, usually, or always used drugs while they were working.

• More than half of the respondents who use drugs engaged in riskier sexual behaviour when they were under the influence of drugs
It is striking that the group of seropositive men engages in riskier sexual behaviour and more often uses a variety of different drugs. Unprotected anal contact occurs frequently in this connection. Half of the respondents had experienced negative effects as a result of their drug use.

• Under the influence: Consistently safe or more risky
More than half of the respondents who use drugs said that they engaged in riskier sexual behaviour when they were under the influence of drugs. According to their own statements, the respondents are either very consistent with regard to practising safe sex during their work when they are under an influence or regularly take sexual risks.

• Unprotected oral contact more often seen as a given
The fact that this is the case could be interpreted as indicating that men do not see such contact as risky sexual behaviour, but no specific questions were asked in this regard.

• The reason for drug use during sex work is mainly commercial in nature

Use is frequently a tool for delivering ‘better sex’ (read: earning more money). For the most part, the sex workersdo not use drugs because they are dependent; rather, the quality and quantity of their work are both reasons for them to use drugs.

• Use of uppers (crack cocaine, sniffing cocaine, speed, crystal meth)
Strikingly often, the use of uppers is said to have the function of prolonging sex (which results in more money being earned). In this connection, there may be a risk that condoms can tear due to insufficient lubricant (for longer-lasting sex) or that mucous membranes can dry out, leading to the development of sores. In connection with unprotected anal contact there is a significantly greater risk of transmission of STDs, HIV, and hepatitis C.

• There is a need for nuanced information regarding drug use, specifically in relation to sex work
The provision of individualized information and the provision of information via a website for sex workers are highly desirable. The existing websites provide good information about the various drugs, but clear, nuanced information on combination use (which combinations are good and which are not) cannot be found online.

• New online information
In cooperation with Mainline, P&G292 has developed a new site for this specific target group (male sex workers) with clear information.

See www.info4escorts.nl


Contactperson: Renate van Bodegom

Our current projects


HARM REDUCTION FOR STIMULANT USERS

A MAINLINE-GIZ STUDY

With the support of the Global Partnership on Drug Policies and Development (GPDPD), a project implemented by Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH, a team of three Mainline researchers conduct a study into effective harm reduction interventions for stimulant users. The study includes a detailed description of eight best practices in different world regions. 

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Kenya

Kenya (population 45 million) is an East-African country on the Indian Ocean that borders Somalia, Tanzania, Uganda, South-Sudan and Ethiopia.

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Tanzania

Harm reduction in Tanzania: a delicate balance Under the Bridging the Gaps 2 programme, Mainline aspires to support harm reduction services in Tanzania. To fully understand the opportunities, needs and socio-political circumstances, Mainline organised two scoping visits in 2016. The situation for people who use drugs in the United Republic of Tanzania is delicate.

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The Netherlands

Tina and Slamming in a sexual setting

Mainline, together with SOA Aids Nederland, presented: 'Tina and Slamming'. This report addresses the use of methamphetamine (crystal meth or tina) and slamming (intravenous use) as a route of administration, by men who have sex with men (MSM), in a sexual setting - also known as chemsex.

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Bridging the Gaps2: 2016 - 2020

Indonesia, Kenya, Nepal, Pakistan, South Africa and Tanzania (new!)

The Bridging the Gaps programme is awarded a second phase of funding by the Dutch Ministry of Foreign Affairs. Bridging the Gaps 2 started in January 2016 and continues to 2020. The shared goals remain the same as the first programme: to improve the health and rights of people who use drugs, sex workers and lesbian, gay, bisexual and transgender (LGBT) people.

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Nepal

Nepal has a long history of drug use. Cannabis is sanctioned for use on certain religious occasions. The use of smoked opium has been quite common in the country. But drug use only began to be seen as a problem in the country in the mid-1960s and early 1970s with the influx of travelling hippies from Europe and the US.

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Georgia

Transition management in Georgia: everyone deserves a second chance!

Everyone deserves a second chance in life. But how can you best support people who were just released from prison? What does quality support look like where it comes to the rehabilitation and resocialisation of inmates, former inmates and probationers? And what level of additional support does a person who uses drugs need in this process? A new project in Georgia intends to set the standard.

> Read more
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Indonesia

Mainline has a long, positive track record in Indonesia. We’ve invested in direct service delivery for drug users in East Kalimantan for many years. In 2015, we started to collaborate and support three very promising new partners in West Java.

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South Africa

The main drugs of choice in South Africa are alcohol, cannabis, heroin and methamphetamine. Methamphetamine is locally known as tik. Most heroin is smoked mixed with cannabis, a popular mix called whoonga, cocktail or nyope. Heroin injection, however, has been increasing in recent years. 

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Innovations in Pakistan

Harm reduction programmes to improve the health and rights of People Who Use Drugs (PWUD) show similarities all over the world. In countries where PWUD lack access of quality harm reduction services; are being criminalised; and human rights are being violated, Mainline works hard to promote health and rights to the often ostracised and hidden populations. 

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Our finished projects

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Bridging the Gaps1: 2011 - 2015

Indonesia, Kenya, Nepal, Pakistan, South Africa and Tanzania (BtG2)

In the context of the Bridging the Gaps program, Mainline works with local partners in five countries to improve the health and human rights of drug users.

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Georgia

Back to Society

Over two years ago, a new government came to power in Georgia. Many prisoners were then released at a rapid pace. They were not well prepared for their release and encountered problems with reintegration. Among these persons were many who use drugs.

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The Netherlands & Belgium

Prevention of GHB overdose

In the Netherlands and Belgium, the number of young people frequently using gamma-hydroxybutyric acid (GHB) has been rising. GHB is used in nightlife. It is estimated that in the Netherlands alone there is a group of 22,000 people who use GHB daily and who have developed a strong physical dependence on GHB.

> Read more
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Georgia

Hepatitis C care for PUD

From 2014 till 2015 Mainline, together with its local partner Tanadgoma, implemented a series of interventions around Hepatitis C (HCV). The aim of the project was to understand the gaps and barriers to enrolment in the care cascade of hepatitis C prevention and treatment from the community perspective.

> Read more
nationaal

The Netherlands

Strong connections between use of drugs and unsafe sex work

On the initiative of Mainline, Prostitutie & Gezondheidscentrum 292 / Prostitution & Health Centre 292, P&G292 carried out a survey of male and transgender sex workers between November 2013 and February 2014 in close cooperation with the Public Health Service of Amsterdam (GGD).

> Read more
internationaal

South Africa

Tikking the Boxes

Until 2014, Mainline worked on the project Tikking the Boxes in South Africa. Since January 2015, South Africa has been participating in the Bridging the Gaps programme.

> Read more
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