Money Well Spent on Women’s Health in the Sex Trade, or Not?
Money Well Spent on Women’s Health in the Sex Trade, or Not?
The New Zealand Prostitutes Collective (NZPC) was founded in 1987, ostensibly to aid New Zealand government efforts to address the spread of HIV/AIDS and other STIs. Since then, the organisation has received ongoing government funding. In 2010, they produced a guide for new ‘sex workers’ titled Stepping Forward. This article is a critique of certain aspects of that publication.
The NZPC played an integral role in the drafting and passage of legislation that decriminalised the sex trade in New Zealand – the Prostitution Reform Act 2003.
Imagine you’re starting a new job, and your induction manual features a detailed table of sexually transmitted diseases, with descriptions of symptoms, and modes of transmission, treatment protocols et cetera. There are some accompanying grainy, indistinct images of diseased penises (or penes) and vulvas (or vulvae), and, at first glance, a distinctly ‘medical’ character to a significant portion of the manual.
So, where are you working? A sexual health clinic? A community medical centre?
Are you teaching sex education at the local high school (and if you are, do you wish they had better graphics and visual aids)?
Or are you starting out in the ‘sex work’ business? Has someone at the New Zealand Prostitutes’ Collective (NZPC) handed you the 125-page ‘how to’ guide, Stepping Forward, as part of its New Workers’ Kit.
Historically, the NZPC has, since its inception in 1987, relied on a funding arrangement with the New Zealand Ministry of Health in order to survive. Official sources reveal this funding now tops out at around $1 million a year. The obligation of the NZPC in this cosy arrangement is to promote safe sex practices – ‘The main aims of the collective when it was established were to work towards the prevention of the spread of HIV infection amongst sex workers in a number of ways: to establish a community base in each of the main centres (and in other centres as appropriate); to employ coordinators in the main centres; to make contact with people in the sex industry; and to compile and distribute a magazine for people working in the sex industry’ (Chetwynd, J. (1996). The Prostitutes Collective: a uniquely New Zealand institution. In Davis, P. (ed). Intimate Details & Vital Statistics: AIDS, Sexuality, and the Social Order in New Zealand (p.139). Auckland University Press).
The fulfillment of this obligation, ensuring the ongoing funding and government patronage to which the NZPC has become accustomed, produced, in 2010, the expansive guide mentioned earlier. Almost half the content of Stepping Forward is concerned with the detail of known sexually transmitted infections (STIs), although the arrangement of the material could do with a revamp – the section entitled ‘working wisely’ starts the reader on a detailed journey through the minefield of STIs, but is interrupted almost immediately by a chapter on ‘bi-doubles’.
So, our novice ‘sex worker’ learns she (the material is almost entirely directed at female persons servicing male clients) must watch out for certain vaginal symptoms, get regular sexual health checks, and always use condoms properly or risk disease and/or prosecution under the Prostitution Reform Act 2003.
Turning the page, she reads, under the heading ‘bi-doubles’, that ‘the elusive threesome is a fantasy most, if not all, heterosexual males have thought and dreamed about’ (Stepping Forward, p. 67). There’s plenty of advice and tips on negotiating this service, if women in prostitution are pressured to provide it, emphasising the ‘workers’’ empowerment and control and suggesting they mock the client behind his back (being careful of mirrors) in order to get through the session.
And then it’s back to the ugly reality of sexually transmitted maladies, kicking off with cystitis – women ‘starting out’ in the sex trade are advised ‘it can also be helpful to avoid having intercourse….until the symptoms have passed – not very practical for sex workers’ (Stepping Forward, p. 75). Unlike women engaged in ANY other occupation, women in prostitution need to abandon their day to day work routines if they’re suffering from cystitis. Whilst we can sympathise with the advice – cystitis is an unpleasant, inconvenient affliction and vaginal intercourse both exacerbates the misery and encourages persistence of symptoms – can we really relate to the underlying premise of Stepping Forward, that ‘sex work’ is a job like any other?
Women NOT in prostitution can, practically, avoid intercourse and continue work while their body heals from a bout of cystitis.
For those in prostitution, cystitis is merely the tip of the sex-related disorders iceberg, with pelvic inflammatory disease, pubic lice, scabies, thrush, bacterial vaginosis, trichomoniasis, hepatitis A, B and C, HIV, gonorrhoea, syphilis, genital warts, genital herpes and non-specific urethritis lurking ominously below the surface.
The NZPC guide canvasses each of these with an admirable mix of medical information and accessible language, but there are several manifest issues with the content of the advice offered.
For each of the conditions, except pubic lice and scabies – but including HIV, and infectious syphilis and gonorrhoea – ‘sex workers’ are advised that ‘you should be able to work just as long as you use protection when having sex’ and ‘since you will always use protection when having sex, you shouldn’t need to tell the client your current sexual health status. However, if a condom breaks during sex you should advise the client to get a sexual health check-up’.
Since pubic lice and scabies can be obvious, the advice is more circumspect – stop working, disinfect sheets, towels et cetera, make sure regular clients, who you may have infected, don’t re-infect you, and advise fellow workers of your condition in case you have ‘clients’ in common. [On a lighter note, however, ‘most sex workers have abandoned pubic hair and as such have reduced the risk of acquiring pubic lice’ (Stepping Forward, p. 118). How does one ‘abandon’ pubic hair, by the way? Leave it at the train station like a broken umbrella, or drop it off at the local pubic hair shelter for care and re-homing? Newsflash – it keeps growing – you either painstakingly and painfully laser it all off or keep removing it by other means (also painful). It won’t go quietly.]
Perhaps most disturbingly, the NZPC advises that ‘so long as you use protection during sex: You do not have to disclose your HIV status’ and ‘No law can prevent you from working in the sex industry’ if you are HIV positive (Stepping Forward, p.109).
Remember, this advice is being dispensed by a government funded organisation that has agreed to assist in reduction of the incidence and spread of STIs in New Zealand.
So, how do their recommendations fit with formal health department guidelines?
First, HIV, Acquired Immunodeficiency Syndrome (AIDS), gonorrhoea and syphilis are infectious diseases notifiable to the New Zealand Medical Officer of Health.
Second, the New Zealand Sexual Health Society guidelines recommend that any person diagnosed with an STI makes contact with past sexual partners to advise them of their diagnosis, as follows
‘Who do I need to contact?
Usually anyone you have had sexual contact with (including oral, vaginal or anal sex) in the last 3 months, as advised by your doctor or nurse, even if you used condoms (emphasis added).
When should I do this?
soon as possible after finding out that you have an STI.
• Before you have sex with an untreated contact’
These guidelines are endorsed by the New Zealand health department as representing the government’s policy with respect to STIs.
So, we have a government that recommends notifying sexual partners of an STI diagnosis, even where protection was used during sex, funding an organisation that advises women in prostitution, who have numerous, anonymous sexual partners, to NOT disclose STI infection to their ‘clients’, and that it is safe to keep working as long as protection is used.
Is the incongruity not glaringly apparent? Does the government turn a willing blind eye, and is the NZPC taking advantage - perpetuating the myth that they are assisting government policy on STIs by educating women in prostitution whilst offering blatantly conflicting advice?
The number of women in prostitution in New Zealand is unknown – the NZPC has been quoting an unsourced figure of approximately 8 000 ‘sex workers’ for many years. As at 2005, the New Zealand Ministry of Justice was supposedly undertaking a project to collect and collate data on the sex trade in New Zealand, although a substantive report is yet to materialise.
In fact, the only information addressing numbers in the sex trade in New Zealand, and the ‘form of employment’ of those in prostitution, dates back to a 2001 New Zealand Police effort to canvass ‘sex workers’ in major metropolitan and provincial centres. The police study estimated around 4 500 persons (mostly women servicing men) in prostitution, with the vast majority (around 90 per cent) working in massage parlours, escort agencies or privately.
These figures pre-date the much vaunted decriminalisation of prostitution in New Zealand with the Prostitution Act 2003, so whilst they are of historical interest, they are useless in today’s context.
The New Zealand Prostitutes’ Collective, with its self-proclaimed broad reach into the ‘sex worker’ community, and its oodles of government cash, is, theoretically, ideally placed to undertake a comprehensive analysis of prostitution in New Zealand, and generate a thoroughly informative report.
But, it hasn’t, and it’s fair to ask why. Maybe the collective isn’t as widely supported by ‘sex workers’ as it claims. Maybe it’s unable, or unwilling, to undertake an unbiased investigation.
For its continuing, generous, monetary support, the government gets nothing more than a frankly dangerous guide for new ‘sex workers’ – a document that has way more style than substance. It’s a lengthy, boring read, and probably does more service as a doorstop than a genuine reference for women in prostitution.
And it gets a ‘health service’ that even the most fervent champion of decriminalisation of prostitution in New Zealand – Dr Gillian Abel – considers inadequate – ‘It would be beneficial to sex workers if they were able to make better use of NZPC for check-ups as these would be more thorough as disclosure is not an issue. However, clinics are only held on NZPC premises in the three main cities and these clinics do not provide adequate consultation hours’.
There’s clearly a certain self-serving synergy at play here. The government decriminalised prostitution (by one vote on the floor of the house) in 2003, and has a vested interest in NOT looking like a bunch of complete morons. All evidence suggests prostitution and sex trafficking have increased since the enactment of the Prostitution Reform Act, but no attempt has been made to investigate the current state of the New Zealand sex trade.
Instead, they throw vast government funds at a ‘sex worker’ lobby group and persuade themselves that women in prostitution are being adequately informed and cared for in the ‘workplace’.
It’s a con job of epic proportions, and like the minions grovelling before Hans Christian Andersen’s allegorical Emperor, many New Zealanders who should know better are keeping the ruse alive, lest they appear to be the fools they truly are.
And the NZPC is laughing all the way to the bank.