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Declining Condom Use Among Sex Workers in Western Australia

Having seen a doctor during the previous six months was not associated with experience of oral sex. I also have had surgery to my prostate and am pretty much impotent. Stupid question?

Three did not specify the service. We visited 22 sexual service premises. Of these, 18 were brothels and four predominantly provided massage services. Eighty one percent of respondents were Prostitutes Oral. Over half of the respondents Table 2. Proportion of respondents reporting that clients requested sex without condoms in an average week.

Table Prostitutes Oral. The use of condoms with clients in an average week by respondents reporting this type of sex with clients. There was no association Prostitutes Oral reported illicit drug use in the past 6 months and condomless sex with clients. However, those respondents who reported drinking six or more standard drinks on any one occasion at least weekly were Prostitutes Oral likely than other respondents to report condom use always during oral, vaginal and anal sex with clients Table 4.

Table 4. Proportion of respondents reporting that all clients used condoms in an average week according to reported use of illicit drugs in the past 6 months and consuming six or more standard drinks on any one occasion at least weekly.

A lower proportion of sex workers who reported getting safe sex information from clients reported condom use with all clients in an average week during all forms of penetrative sex compared to respondents who reported Prostitutes Oral safe sex information from other sources Table 5. Table 5. Proportion of respondents reporting that all clients used condoms in an average week according to sources of information about safe sex skills among respondents having this type of sex Prostitutes Oral clients.

We interviewed everyone who agreed to be interviewed, and undertook 17 in-depth interviews.

Im studying in another country and have no one to share the stress of this with.

Twelve of the interview participants were female at birth, two were trans-women and three were men. Experience in the sex work industry varied from 6 months to more than 20 years. Fourteen participants were currently sex workers, two were not currently working in the industry but had done so in Prostitutes Oral last 12 Prostitutes Oral, and one was transitioning out of the Prostitutes Oral industry.

The majority of participants, Prostitutes Oral those who had worked Prostitutes Oral the industry for several years, indicated that the demand for condomless sex, particularly oral sex, had increased recently.

Sex workers who worked in brothels as well as those who worked privately reported requests for condomless sex—in the brothel setting usually at the time of service, as described by this participant who works in a brothel. I feel strongly against natural services, like you know people ask all the time pretty much every second client now when receiving like the standard service ID03, woman. More than one interview participant noted that decreased demand Prostitutes Oral sexual services ascribed to a downturn in the WA economy made it more difficult for sex workers to refuse to provide unprotected services.

And just because workers aren't Prostitutes Oral a position to pick and choose anymore, particularly for Prostitutes Oral sex that's gone way, way down…. Prostitutes Oral it's just people have got rent to pay ID14, woman. All stated that at least some of their clients Prostitutes Oral condomless sex. For some, this was more occasional, and they felt able to screen out these clients during the initial phone call, who can then seek condomless sex elsewhere if they wish.

They'll usually try and do it [ask] on the phone because they know they can get Prostitutes Oral who will ID06, woman. Those who received requests for condomless sex less frequently than others ascribed this to how they promote their services; by being clear about what services they do and do not provide.

One participant has recently focused on creating her brand. She stated that after doing this, requests for condomless sex decreased. I've got a website and done kind of like various things to get myself noticed online, and as I've done that and invested more and got more expensive, I don't know if that Prostitutes Oral any kind of correlation to it, I'm not Prostitutes Oral sure, but definitely the more effort I put into creating a brand presence, the less requests for natural services I started to have ID05, woman.

A few also reported that they had seen advertisements from other Prostitutes Oral workers offering unprotected oral sex. This was corroborated by our own findings. Some saw this as a threat to themselves and the industry by setting up client expectations of being able to purchase condomless sex and thereby making it more difficult for them to be able to make a living without offering it.

I think should have a better law enforcement to stop websites like… allowing advertisement for sex with no condom…It's very risky to all Prostitutes Oral Australia sex industry survey respondent, free text. Another participant expressed anger at people advertising condomless sex, even though she offered unprotected oral sex herself.

But now, everyone is fucking advertising that shit Prostitutes Oral oral sex] everywhere. I don't like that because Prostitutes Oral am funny old prude and like to keep shit behind Prostitutes Oral doors. Like my ad, you couldn't read my ad and know that I do unprotected oral services sometimes Prostitutes Oral, woman. This was not universal however, and other participants were clear that they didn't mind what other workers did.

They felt that people should be allowed to offer and provide the services that they wanted to. The term has connotations of increased desirability of condomless sex, and also may reduce clients' perceptions of the transactional nature of the Prostitutes Oral service they are purchasing.

I have this thing for starters where I don't call it natural because that sounds like you're implying that is unnatural to have sex with a condom ID10, woman. A number of interview participants described how they refused to provide condomless sex, even with persistent clients. Some of those who worked in brothels currently or previously described being coached by other sex workers on how to refuse to provide a service that they didn't want to provide.

They also described feeling supported in refusing by knowing that there were other people around in the brothel that they could call on if feeling threatened. Yeah, and being surrounded by the right environment of women around me saying, do not feel pressured to perform anything if you do not want to do it… Don't feel pressured… I'm not going to do it.

ID17, woman. So that's another thing about the team environment is knowing that you've got that support network of, if you do have a client who cracks the shits when you won't do natural, you've either got five, six girls all outside, plus your manager, your receptionist etc ID08, woman. Interview participants who worked privately also described their own strategies for declining condomless sex with persistent clients.

A couple of participants described giving three warnings and then telling the client to leave if they continued to persist. Another couple of participants described being very clear up front of what services they provide and therefore being clear that there was no room for Prostitutes Oral. And they'll throw anything on once, but if they get into the room, and they push me, I give them three warnings. And if they say something, you know inappropriate or pushy, I'll be like I've already got the money in my hand mother fucker.

I gave you three warnings. That's it. Prostitutes Oral for finishing my job early for the day. So mentally I feel like I'm Prostitutes Oral bossy, but to announce that, I'm like, oh, I'm not going to let anybody Prostitutes Oral me around that I can say something to ID06, woman. Yeah, and then I, I actually, I have a lot of control, because I built it, this is my service. As time goes by I have actually Prostitutes Oral it and I give them a list, like how you go to Prostitutes Oral hotel and you have a menu.

And so, if you only have to order what you have on the menu, you can't just order what they don't have.

Sex workers' perspectives on condom use for oral sex with clients: a qualitative study

And so, that week, Prostitutes Oral said this is all I will do. These are my limits. This is how far I will go. You take it or leave it ID04, man. Prostitutes Oral number of participants reported that they provided condomless sex at least some of the time predominantly oral sex. A couple of these had worked in the sex industry for many years but had only recently offered this service. The increasing demand for condomless sex and the knowledge that potential clients could obtain that service elsewhere was an important motivator for some.

One participant described providing more oral sex after offering Prostitutes Oral oral sex to clients. I was so steadfast for the first Prostitutes Oral years. I was like fucking no, no, no, no. And now I do natural oral for shit now [low payment] because now I just like give up. There's just no fucking Prostitutes Oral to beat the system on that one because if I charged bucks, and I gave a shit about my appearance, I'd probably get away with it but I can't be bothered ID06, woman.

They used to occasionally ask for natural oral, but not that often. It's got to the point now where they expect that they Prostitutes Oral pay extra for it. Don't get me wrong, you can still make a living Prostitutes Oral doing it, however they Prostitutes Oral about natural sex more often.

They never even used to ask about that. And the other difference I noticed, because Prostitutes Oral started offering, started changing what I offer, and what I primarily sell at the moment, and I still do my standard full service and all of that jazz, but the primary thing I sell is a blow job service right ID10, woman.

Related to the Prostitutes Oral was what Prostitutes Oral participant described as a sense of wanting to be upfront in offering condomless sex Prostitutes Oral than changing her mind during the service in response to client demand.

In this way the participant could maintain her sense of control of the situation and also ensure upfront payment for the additional service. And so I was like, well, I may as well make the choice to do it because half the fucking time I am doing it anyway. I was feeling shitty about doing it because I felt morally, or whatever, I was doing it; it didn't twist right in my head and I felt guilty as shit. Like I'd been tricked, whereas now I'm just like, man, whatever, you've just been tricked into an Prostitutes Oral 50 bucks ID06, woman.

Several sex workers reported a reduction in the demand for Prostitutes Oral services in WA due to the downturn in the WA economy, and possibly an increase in the number of sex workers. The combination of the reduction in demand for services and the increasing demand for condomless sex was what led to the decision for a couple of participants to offer condomless sex.

This is in addition to the ability to charge more for providing condomless sex. That, but the thing was, why was I doing that [providing unprotected sex]? It was because it was just getting hard to make money ID11, woman. A participant who recently left WA with a view to exiting the industry said Prostitutes Oral she hadn't Prostitutes Oral condomless sex but thought that she would have if she'd stayed in the industry.

If like, if I stayed in WA and stayed in the industry, I probably would have had to do it. You know, like it was the way things were going ID14, woman. A male sex worker who had always offered unprotected oral sex described now providing unprotected anal sex to Prostitutes Oral clients.

He described feeling bad about doing this but felt that he had to Prostitutes Oral it sometimes as he could no longer compete with younger well-built men.

Therefore, his decision was Prostitutes Oral financial one. And Prostitutes Oral I felt shit about Prostitutes Oral ID02, man. This sense of competition with other Prostitutes Oral was also described by some female sex workers in the context of knowing that they will potentially receive poor online reviews if they don't offer unprotected oral sex, or risk clients not returning. There, a lot of the girls that do start in the industry are quite young, and they do get sucked into the whole review system by punters if you want to call them that, clients.

They will review girls and then complain that they didn't offer this service. And they're charging so much money and they really should be offering this ID17, woman. Some interview Prostitutes Oral who offered or provided condomless sex described risk management strategies, such as inspection of the clients' genitals for evidence of herpes, discharge, Prostitutes Oral or genital warts.

One also noted that unprotected oral sex is less risky for HIV transmission and also for the male client, but Prostitutes Oral potentially more risky for the sex worker in terms of other STIs. Therefore, the onus is more on the sex worker than the client in terms of protecting themselves from STIs. You're very unlikely to pick anything up by sticking your dick in someone's mouth, but you're very likely to pick something up the other way from letting someone stick their dick in your mouth.

So Prostitutes Oral guess I feel concerned that I Prostitutes Oral going to catch something. And also, oral Prostitutes Oral is quite Prostitutes Oral in terms of transmission.

And most of the things you can catch that way are curable. Or if they aren't curable like warts or herpes Prostitutes Oral are more likely going to need to see something going on in order for it to infect you ID10, woman. A male respondent who said he did occasionally provide unprotected anal sex described two risk management strategies: being the insertive partner mostly ; and trusting his instincts that the client was safe.

So, I did that. And it was me fucking them, also the other way, but maybe only twice. But yeah it is something that has happened and something I have always avoided apart from just this year ID02, man. We found higher rates of condomless sex with clients Prostitutes Oral by sex workers in our study Prostitutes Oral we would have expected from previous studies.

Increasing client demand for condomless sex and concerns about reductions in income if condomless sex is not offered were important factors relating to the provision of condomless sex. Condomless sex with clients was not associated with drug use in our study but was associated with binge drinking Prostitutes Oral least weekly. Condomless sex was also associated with obtaining information about safe sex from clients rather than other sources such as sex worker organizations and health services, suggesting that a lack of engagement with education, health and support services may be an important factor in condomless sex.

These data point to the importance of peer-based education and support services for sex workers as well as accessible health services for sex workers. This has become more challenging with the growth in private sex work, and points to the need for greater investment in outreach services.

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Interview participants reported a range of strategies to Prostitutes Oral condomless sex including upfront Prostitutes Oral of which services they Prostitutes Oral provide, Prostitutes Oral warnings that Prostitutes Oral service will not proceed if the client insists, and seeking support from workmates in the brothel setting.

Several interviewees stressed Prostitutes Oral importance of knowing that they can refuse to provide a particular service, and that the support of peers was important for them in feeling confident about refusing to provide services including condomless sex that they did not wish to provide.

These findings again stress the importance of peer support, and the need to ensure that sex workers working privately are also able to access this support.

We found much higher rates of condomless sex than was Prostitutes Oral in previous studies using the same survey instrument 12. While the current and previous studies used the same questions in relation to condom use, the sampling methodologies were different. The studies recruited sex workers in brothels, who completed their questionnaires on-site.

While we also approached sex workers in brothels and provided them with hard-copy surveys, the majority of our survey respondents completed the survey online and were recruited via social networks and social and other electronic media.

In spite of these study differences, our finding of a reduction in condom use is likely to reflect Prostitutes Oral real change, given that it is consistent with our observations and reports from sex workers. This is also consistent with our findings of low rates of consistent condom use during oral sex with clients. Studies conducted in other countries have Prostitutes Oral found lower rates of condom use with clients among private compared to brothel-based sex workers 15 — Oral sex, particularly for the insertive partner, is low risk for HIV transmission Our findings of higher levels of Prostitutes Oral condomless oral sex compared to anal and vaginal sex is likely to reflect an assessment of HIV risk in relation Prostitutes Oral condomless sex by sex workers and their clients.

However, condomless oral sex can be important for the Prostitutes Oral of other STIs such as chlamydia and gonorrhea In addition, pharyngeal gonorrhea could be an important reservoir for ongoing transmission 4 While some interview participants described using visual inspection of a client's genitals as a risk management strategy for reducing the risk of acquiring a STI from their clients during condomless oral sex, visual inspection is ineffective at detecting all STIs.

Our findings point to the importance of screening for pharyngeal gonorrhea and chlamydia when doing sexual health checks with sex workers. A systematic review of structural drivers of HIV infection among sex workers found that strong client demand and economic incentives were drivers of inconsistent condom use with clients, consistent with our findings The review also found that legislation making sex work illegal was a driver of inconsistent condom use through increasing stigma, economic uncertainty and workplace violence.

This may reflect WA legislation where brothels are illegal In their systematic review, Shannon et al. Making these policies explicit through signage and making condoms available on-site, therefore, Prostitutes Oral likely to assist sex workers to Prostitutes Oral condomless sex and may also reduce the number of clients requesting unprotected services.

The findings of this review, together with our own, demonstrate the importance of decriminalization of sex work in improving the health and safety of sex workers in WA. Our findings suggest that client demand for condomless sex is a strong driver of the reduction in consistent condom use among sex workers in WA.

We did not interview clients so were unable to ascertain what is behind this increasing demand. Many men and women find sex without condoms to be more pleasurable than sex with condoms However, as the demand for condomless sex appears to be increasing, there are likely to be other factors also contributing to this, including possibly a perception by clients that condomless sex is not risky. Further research is needed in order to gain Prostitutes Oral deeper understanding about what is leading to an increasing demand Prostitutes Oral condomless sex by clients in WA in order to inform interventions to reduce this demand and support sex workers in refusing to provide condomless sexual services should they wish to do so.

There were a number of limitations in our study. Prostitutes Oral our study was relatively large, the sample was not randomly selected and our recruitment strategies relied Prostitutes Oral on word of mouth, and social and other electronic media. About 2 months ago, i had oral sex with a high risk prostitute back home in Pakistan.

She looked perfectly healthy, and it was a momment of madness, which i really really feel guilty about. I had oral sex for about 2 minutes, and was just using my lips, not toungue etc, i Prostitutes Oral my Prostitutes Oral too, so it was just the edge that came in contact. I FEEL really stupid and guilty Your HIV-acquisition risk from cunnilingus is extremely remote. That your mouth was apparently closed throughout the session puts the risk into the essentially nonexistent category.

I'll repost below some Prostitutes Oral about cunnilingus being an extremely low-risk activity. Your problem is primarily one of guilt made worse by your very religious upbringing and newly married status.

The best way to confront your guilt is to level with your wife. It's also the right thing to do. You can use condoms with your wife while waiting for your confirmatory negative Prostitutes Oral, if this would help you and your wife to feel safer during the window period. Stop smoking! If you don't, it will kill you in a very painful and undignified fashion. My dear brother died of cigarette-induced lung and brain cancer.

Don't let this happen Prostitutes Oral you or anyone you love. Donation information can be found on the foundation's Web site at www. Your gift is warmly appreciated.

I'm quite certain it will indeed be negative.

Reasons given by sex workers for not using condoms for oral sex as compared to vaginal sex included self-perception of low vulnerability to AIDS and sexually. Clients may ask for oral sex without a condom, 'natural oral', 'natural French', a. '​bareback blow job' (BBBJ) or 'cum in mouth'. (CIM). Often, clients don't know the.

First of all let me say this is the only place I would trust the information that is given and I think that is why so many come here for answers to their worries.

I have written to your forum a couple of times and was not able to get an answer to any of my questions. Perhaps my problem is trivial to the questions asked by others, but none the less still troublesome for me. I am almost 60 years old. I Prostitutes Oral have had surgery to my prostate and am pretty much impotent. Recently, after a Prostitutes Oral of years of no sex, met a lady and performed oral sex on her. I got little from this other then making someone else feel good.

This is the Prostitutes Oral exposure I have had in at least two years. A couple of days after this exposure, i expereinced terrible stomach problems and Prostitutes Oral headaches. I often have bouts of slight pain in the area of my parotid gland even before this exposure. I went to my Rhuematolgist and was tested for CBC with differential and other tests specific to other autoimune problems such as Lupuse, etc.

The only thing that came of that Prostitutes Oral Vitamin D deficiency and positive for SS. I am however feeling uncomfortable in the left side of my neck, left arm pit and Prostitutes Oral groin area. Laying down and getting rest, or after a nights sleep, relieves these symptoms and everything starts out fine but as the day Prostitutes Oral my left parotid gland area, feels puffy, and tender, then later in the day the groin will really start to hurt.

My head itches a a lot at night, and I am using a medicated shampoo to relieve this but still iches. I have had no fever, night sweats, or other problem and it has been two Prostitutes Oral since my exposure. Here are my questions: 1. Does someone with SS have a greater Prostitutes Oral of becoming infected from a low risk exposure such as mine.

Oral sex with prostitute-Scared like hell.

Can the nodes come and go each day or would they be swollen constantly I have never ever felt a node but they do hurt in the area they would be found. If one has such symptoms and is indeed infected would he test postive at Prostitutes Oral time. Would someone who takes plaquenil for SS experience less symtoms then someone who does not take any medicaations. Before addressing your specific questions, I'll point out Prostitutes Oral few facts.

First of all, the symptoms you experienced "a couple of days" after your "lunch at the Y" cunnilingus would not be HIV Prostitutes Oral.

Eighty one percent of respondents were women.

Acute retroviral syndrome ARS symptoms take weeks, not hours or days, to appear. Second, cunnilingus carries an extremely Prostitutes Oral risk for HIV transmission. See below. Third, swollen lymph glands related to HIV disease would not be limited only to one side of the body.

The virus quickly spreads throughout the body and therefore the symptoms would be generalized, not unilateral. Lymphadenopathy associated with HIV is a more constant phenomenon.

I do not believe your symptoms are HIV related. HIV-antibody tests taken prior to three months are not considered to be definitive, symptoms or no symptoms. One week - three months after exposure: diarrhoea, fatigue, mild fever, white coated tongue, sore throat, cough, red rashes on chest and thighs, Prostitutes Oral lymph nodes 4 on thigh.

Three months - ten months after exposure: swollen nodes remain, red itchy rashes on and off, muscles start paining with limited activity very quick lactic acid formation.

Actually I could probably use you as a "textbook example" of someone convinced he is HIV positive when in reality he is not. Dude, I've said it before and now I'll say it again: Symptoms, no matter what they are, are notoriously unreliable in predicting who is and is not HIV infected. My advice is to get a rapid HIV test. You'll have a definitive answer in as few Prostitutes Oral 20 minutes. Statistically the odds are astronomically in your favor that you did not contract HIV from your "lunch at the Y.

But if you peruse the archives you'll find I've already got gazillions of Prostitutes Oral "textbook examples" identical to you! So join the crowd of ex-worried wells, OK? So what are you waiting for dude? Get moving! Get tested! Cunnilingus carries a negligible risk Prostitutes Oral HIV transmission. Prostitutes Oral main reason for you to consider HIV testing would be to put any residual Prostitutes Oral you might be harboring permanently to rest.

The HIV test Prostitutes Oral will undoubtedly be negative. I'll print some information below from the archives that addresses the issue of HIV risk associated with cunnilingus. Let me begin by saying how much I love this site. I'm currently working abroad and unfortunately have no peeps I would feel comfortable disclosing my HIV concerns.

I plan on making a donation upon my arrival back to home. I'm a 26 year-old heterosexual male living Prostitutes Oral Japan.

Inconsistency in condom use during oral sex has been reported among female sex workers attending a sexual health clinic in Sydney (4). Some sex workers could get all their clients to use condoms for oral sex by using negotiation skills, including the positive approach, the fear.

My Prostitutes Oral is that recently I had an encounter with a Japanese women. I asked if she had ever been tested and she responded no. A bit worriesome but unfornately not uncommon in Japan. We had sex with limited penetration Unfortunately she could only stand the the girth of my manhood for a few moments :. I used multiple condoms provided in the love hotel for multiple attempts, lol. However, I did perform unprotected cunnilingus Prostitutes Oral her at least twice and for an extended period of time minutues.

I didn't notice any sores, there was no blood, my good oral health on my part, and Prostitutes Oral showered and cleaned her vagina beforehand. It's been 2 weeks since this encounter and I have developed a white tongue with painless white rings and I am freaking out!!!!

As a result, I am losing sleep and appetite and I am terrified everytime Prostitutes Oral get a headache or feel discomfort. Here are my Prostitutes Oral - 1 What are the current risks of contracting HIV from Prostitutes Oral heterosexual women in Japan who is not a sex-worker? The condom did not Prostitutes Oral or slip off - what are the chances of transmission via flavoured condoms? I have read some horror stories on the internet concerning HIV transmission over here even though from all the statistics the rate is extremely low here at least reported rate.

I've been tested 2 times this year and I am worried if I show up a third time they'll offer me a straight jacket with the free condoms! Sorry, a specific HIV-transmission risk statistic for "heterosexual women in Japan Prostitutes Oral are not sex-workers" doesn't exist any more than a specific statistic for "bisexual cross-dressing Mormon midgets with webbed toes in Salt Lake City". Assuming the latex condoms Prostitutes Oral on the "beer can" and did not break, your HIV risk would be limited to cunnilingus on a partner of unknown serostatus.

This carries a negligible risk for HIV transmission. HIV testing would be primarily for peace Prostitutes Oral mind. The estimated per-act risk for acquiring HIV from unprotected insertive oral sex with a partner confirmed to be HIV positive is 0. Depends on the flavor!

Why not bring your own condoms the extra girth variety next time you visit Prostitutes Oral love shack? About Prostitutes Oral months ago I asked you a question and you responded, which was awesome! I feel like I am talking to a celebrity. I really admire you and all that you do.

Sex Transm Dis.

I know I said I was going to send a donation and Prostitutes Oral will Prostitutes Oral promise as soon as I get back to the states next month. Anyways, my question is regarding HIV and oral sex. I know by reading in the archives that it is a low risk but for some reason I keep on worrying.

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Condomless sex with clients was not associated with drug use in our study but was associated with binge drinking at least weekly. But there is just something about hearing it directly from you. To the best of our knowledge, this study is the first research of its kind to examine factors associated with oral sex among low-tier FSWs in China.