NL
 

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

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