comment by [deleted] ·
2016-01-09T13:54:06.595Z · LW(p) · GW(p)
Problem: Arousal & hazard
The near unanimous opinion of /r/sex redditors is that sex without a condom is a transcendental experience incomparable to sex with a condom. This is both arousing and risky. It’s an information hazard.
What’s the primary hazard: HIV. Can this be worked around without protection? Yes - with safe partners. Is that a prospect for me? Not in the forseeable future. How about a trustless system? That exists too: Truveda - a drug that reliable prevents HIV with minor side-effects.
It’s a hassle, though. I for one have used it when I was working as a sex worker, but do no longer since I generally downregulated my sexual activity (that hedonic treadmill). I can outsource that hassle to my partner though, right? No, because my heterosexual partners who are usually sex-workers aren’t too keen on being Truveda whores.
Obstacles to a solution: PreP for sex worker
AIDS organisations lament that condom promotion programs are good enough. I reckon this has more to do with sunk costs and vested interests of condom manufacturers than public health interest.
Australians premier sex worker association reports that sex workers are aware of Truveda and other PreP’s but are skepitcal of it’s efficacy. It saddens me that there isn’t increased outreach for the efficacy of PreP, but not just for my personal hedonic endeavours, but because condoms break, particularly with rough and frequent use.
Solution: Promoting PreP use among sex-workers
Collaborate with sex worker associations
Sex worker associations like SWOP and RHed tend to be highly effective at education and looking after their own kind. They are, however, rather xenophobic. People without histories or relatives that are sex workers are seen as suspect and outside the community - inappropriate for working within. This creates a ‘safe space’, but I reckon it should definately have representation of ‘Johns’ at the least. As one RheD magazine article advertisement extolling decriminalisation of soliciting working girls/boys read: ‘hands off our clients!’. They have significant problems interacting with outside organisations though. That’s probably because of stigma. But that isn’t an issue in this case. I see several approach to raising PreP awareness among sex workers:
Collaborate with testing services
In Melbourne, the Melbourne Sexual Health Clinic free tests anyone’s sexual health. They give homosexuals who had unprotected sex free Truveda, which is used for post-exposure prophylaxis of HIV, and could, with some lying, be used to solicit is surrepticiously as PreP. However, it’s technically not approved for that use in Australia and one may have to buy it. That creates an inequity that I reckon is dangerous for sex workers. Those who can afford it least are probably at more risk of riskier situations, and then put their clients at risk.
What I reckon are the next public health steps are:
- estimating the impact that providing free PreP for sex workers would be
if it’s an economic health investment,
- lobbying the government for it
- reevaluating the sensibility of condom-sex worker legislation, which are no longer necessary to protect against hiv. Technically some laws say a prophylactic must be used rather than specifically condoms so maybe it’s okay, but I’m not a lawyer nor dispensing legal advice).
- targeting the existing black-market for bareback sex with pro-PreP messages, and encouraging working people to put their PreP use in their online advertisements to promote PreP in competitors doing market research and to boost their appeal to Johns looking for bareback sex
Can you help me with any of the above 4 steps or critique my logic?
The only extanct campaign I have heard of it in this vain is Seeitclearly2020 but that focusses on gay men, rather than sex workers or women and hetero men who engage in risky behaviour.