Usage of the Terms Prostitution, Sex Work, Transactional Sex, and Survival Sex: Their Utility in HIV Prevention Research

Archives of Sexual Behavior volume 47, pages1517–1527(2018)Cite this article

Abstract

This article considers the terms prostitution, sex work, transactional sex, and survival sex, the logic of their deployment and utility to research concerned with people who are paid for sex, and HIV. The various names for paid sex in HIV research are invested in strategically differentiated positionings of people who receive payment and emphasize varying degrees of choice. The terminologies that seek to distinguish a range of economically motivated paid sex practices from sex work are characterized by an emphasis on the local and the particular, efforts to evade the stigma attached to the labels sex worker and prostitute, and an analytic prioritizing of culture. This works to bestow cultural legitimacy on some locally specific forms of paid sex and positions those practices as artifacts of culture rather than economy. This article contends that, in HIV research in particular, it is necessary to be cognizant of ways the deployment of alternative paid sex categories relocates and reinscribes stigma elsewhere. While local identity categories may be appropriate for program implementation, a global category is necessary for planning and funding purposes and offers a purview beyond that of isolated local phenomena. We argue that “sex work” is the most useful global term for use in research into economically motivated paid sex and HIV, primarily because it positions paid sex as a matter of labor, not culture or morality.

This is a preview of subscription content, log in to check access.

Access options

Buy single article

Instant access to the full article PDF.

US$ 39.95

Tax calculation will be finalised during checkout.

Notes

  1. 1.

    The surveillance, in the interests of public health, however, of women who sell sex predates the emergence of HIV (see Armstrong, 1995; Levine, 2003).

  2. 2.

    For this reason, this article focuses on how terminology positions those who provide sexual services, rather than the other actors in paid sex whose roles are also relevant to HIV prevention.

  3. 3.

    For the purposes of this article, paid sex refers only to sexual exchanges between consenting adults, to avoid confounding the issue with sex trafficking or child sexual exploitation.

  4. 4.

    Wardlow (2004) suggests that objections to paid sex reflect concerns about the commodification of intimacy and affection, perhaps referring to the manner in which sex for money destabilizes boundaries between the “public” sphere of business and the “private” sphere of domestic relationships. Tabet (2012) also, but differently, examines this through references to a continuum of sexual-economic exchange.

  5. 5.

    A tendency to view engagement in sex work or prostitution as an individual pathology is also evident in the mass of research seeking causes in personal histories of sexual or substance abuse, or in psychological problems (Goldhill, 2015).

  6. 6.

    Some sex workers and some modes of sex work are more likely to lead to encounters with the justice system than others (Hubbard, Matthews, & Scoular, 2008).

  7. 7.

    Signing an anti-prostitution pledge became an eligibility requirement for funding from the US President’s Emergency Plan for AIDS Relief in 2003.

  8. 8.

    Women’s engagement in prostitution in Victorian society has been similarly interpreted as a marker of agency (Walkowitz, 1980).

  9. 9.

    Yet, it is one that pervades numerous humanitarian efforts targeting those who are paid for sex (see McMillan & Worth, 2016).

References

  1. Abel, G. (2014). Sex workers’ utilisation of health services in a decriminalised environment. New Zealand Medical Journal, 127, 30–37.

    PubMed  Google Scholar 

  2. Agustín, L. (2005). The cultural study of commercial sex. Sexualities, 8, 618–631.

    Article  Google Scholar 

  3. Armstrong, D. (1995). The rise of surveillance medicine. Sociology of Health & Illness, 17, 393–404.

    Article  Google Scholar 

  4. Baral, S., Beyrer, C., Muessig, K., Poteat, T., Wirtz, A. L., Decker, M. R., … Kerrigan, D. (2012). Burden of HIV among female sex workers in low-income and middle-income countries: A systematic review and meta-analysis. Lancet Infectious Diseases, 12, 538–549.

  5. Bindman, J., & Doezema, J. (1997). Redefining prostitution as sex work on the international agenda. Retrieved from http://www.walnet.org/csis/papers/redefining.html.

  6. Bobashev, G. V., Zule, W. A., Osilla, K. C., Kline, T. L., & Wechsberg, W. M. (2009). Transactional sex among men and women in the south at high risk for HIV and other STI. Journal of Urban Health, 86, 532–547.

    Article  Google Scholar 

  7. Braun, Y. A. (2010). Gender, development, and sex work in Lesotho. Equality, Diversity and Inclusion, 29, 78–96.

    Article  Google Scholar 

  8. Brouard, P., & Crewe, M. (2012). Sweetening the deal? Sugar daddies, sugar mummies, sugar babies and HIV in contemporary South Africa. Agenda, 26(4), 48–56.

    Google Scholar 

  9. Chatterji, M., Murray, N., London, D., & Anglewicz, P. (2005). The factors influencing transactional sex among young men and women in 12 sub-Saharan African countries. Biodemography and Social Biology, 52, 56–72.

    Article  Google Scholar 

  10. Chen, Y., Li, X., Zhou, Y., Zhang, C., Wen, X., & Guo, W. (2012). Alcohol consumption in relation to work environment and key sociodemographic characteristics among female sex workers in China. Substance Use and Misuse, 47, 1086–1099.

    Article  PubMed  Google Scholar 

  11. Cluver, L., Orkin, M., Boyes, M., Gardiner, F., & Meinck, F. (2011). Transactional sex amongst AIDS-orphaned and AIDS-affected adolescents predicted by abuse and extreme poverty. Journal of Acquired Immune Deficiency Syndromes, 58, 336–343.

    Article  PubMed  Google Scholar 

  12. Decker, M. R., Crago, A. L., Chu, S. K., Sherman, S. G., Seshu, M. S., Buthelezi, K., … Beyrer, C. (2015). Human rights violations against sex workers: Burden and effect on HIV. Lancet, 385, 186–199.

  13. Dewey, S. (2011). Neon wasteland: On love, motherhood, and sex work in a rust belt town. Berkeley: University of California Press.

    Google Scholar 

  14. Donovan, B., Harcourt, C., Egger, S., Watchirs Smith, L., Schneider, K., Kaldor, J. M., … Tabrizi, S., (2012). The sex industry in New South Wales: A report to the NSW Ministry of Health. Sydney: Kirby Institute, University of New South Wales.

  15. Dunkle, K. L., Jewkes, R. K., Brown, H. C., Gray, G. E., McIntyre, J. A., & Harlow, S. D. (2004). Transactional sex among women in Soweto, South Africa: Prevalence, risk factors, and association with HIV infection. Social Science and Medicine, 59, 1581–1592.

    Article  PubMed  Google Scholar 

  16. Dunkle, K. L., Wingood, G. M., Camp, C. M., & DiClemente, R. J. (2010). Economically motivated relationships and transactional sex among unmarried African American and white women: Results from a US national telephone survey. Public Health Reports, 125(Suppl. 4), 90–100.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Epstein, H., & Halperin, D. (2007). Letter. Lancet, 369, 9561.

    Google Scholar 

  18. Galldin, K., Robertson, L., & Wiseman, C. (2011). Bedford v. Canada: A paradigmatic case toward ensuring the human and health rights of sex workers. HIV/AIDS Policy & Law Review, 15(3), 1–5.

    Google Scholar 

  19. Ghose, T., Swendeman, D., George, S., & Chowdhury, D. (2008). Mobilizing collective identity to reduce HIV risk among sex workers in Sonagachi, India: The boundaries, consciousness, negotiation framework. Social Science and Medicine, 67, 311–320.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Ghys, P., Jenkins, C., & Pisani, E. (2001). HIV surveillance among female sex workers. AIDS, 15(Suppl. 3), 33–40.

    Article  Google Scholar 

  21. Godwin, J. (2012). Sex work and the law in Asia and the Pacific. Bangkok: United Nations Development Programme.

    Google Scholar 

  22. Goldhill, S. (2015). The imperialism of historical arrogance: Where is the past in DSM’s idea of sexuality? Archives of Sexual Behavior, 44, 1099–1108.

    Article  PubMed  Google Scholar 

  23. Greene, J. M., Ennett, S. T., & Ringwalt, C. L. (1999). Prevalence and correlates of survival sex among runaway and homeless youth. American Journal of Public Health, 89, 1406–1409.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Halperin, D., & Epstein, H. (2004). Concurrent sexual partnerships help to explain HIV prevalence: Implications for prevention. Lancet, 363, 4–6.

    Article  Google Scholar 

  25. Helleringer, S., & Kohler, H. P. (2007). Sexual network structure and the spread of HIV in Africa: Evidence for Likoma, Malawi. AIDS, 21, 2323–2332.

    Article  PubMed  Google Scholar 

  26. Hubbard, P., Matthews, R., & Scoular, J. (2008). Regulating sex work in the EU: Prostitute women and the new spaces of exclusion. Gender, Place & Culture, 15, 137–152.

    Article  Google Scholar 

  27. Hubbard, P., & Sanders, T. (2003). Making space for sex work: Female street prostitution and the production of urban space. International Journal of Urban and Regional Research, 27, 75–89.

    Article  Google Scholar 

  28. Hunter, M. (2002). The materiality of everyday sex: Thinking beyond ‘prostitution’. African Studies, 61, 99–120.

    Article  Google Scholar 

  29. Jenkins, C., & Buchanan-Aruwafu, H. (2007). Culture and contexts matter: Understanding and preventing HIV in the Pacific. Manila: Asian Development Bank.

    Google Scholar 

  30. Jewkes, R., Morrell, R., Sikweyiya, Y., Dunkle, K., & Penn-Kekana, L. (2012). Men, prostitution and the provider role: Understanding the intersections of economic exchange, sex, crime and violence in South Africa. PLoS ONE, 7, e40821. https://doi.org/10.1371/journal.pone.0040821.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Kaufman, C., & Stavrou, S. (2004). ‘Bus fare please’: The economics of sex and gifts among young people in urban South Africa. Culture, Health and Sexuality, 6, 377–391.

    Article  Google Scholar 

  32. Kerrigan, D., Kennedy, C., & Morgan-Thomas, R. (2014). A community empowerment approach to the HIV response among sex workers: Effectiveness, challenges, and considerations for implementation and scale-up. Lancet, 385, 172–185.

    Article  PubMed  Google Scholar 

  33. Kerrigan, D., Wirtz, A., Baral, S., Stanciole, A., Butler, J., Oelrichs, R., & Beyer, C. (2013). The global HIV epidemics among sex workers. Washington, DC: World Bank.

    Google Scholar 

  34. Kippax, S. (2012). Effective HIV prevention: The indispensable role of social science. Journal of the International AIDS Society, 15(2), 17357.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Kirby Institute. (2011). HIV/AIDS, viral hepatitis, and sexually transmissible infections in Australia Annual Surveillance Report 2011. Sydney: Kirby Institute, UNSW.

    Google Scholar 

  36. Kwena, Z. A., Shisanya, C. A., Bukusi, E. A., Turan, J. M., Dworkin, S. L., Rota, G. A., & Mwanzo, I. J. (2017). Jaboya (“Sex for Fish”): A qualitative analysis of contextual risk factors for extramarital partnerships in the fishing communities in Western Kenya. Archives of Sexual Behavior, 46, 1877–1890.

    Article  PubMed  Google Scholar 

  37. Leclerc-Madlala, S. (2003). Transactional sex and the pursuit of modernity. Social Dynamics, 29, 213–233.

    Article  Google Scholar 

  38. Levine, P. (2003). Prostitution, race and politics: Policing venereal disease in the British empire. London: Routledge.

    Google Scholar 

  39. Longfield, K. (2004). Rich fools, spare tyres and boyfriends: Partner categories, relationship dynamics and Ivorian women’s risk for STIs and HIV. Culture, Health and Sexuality, 6, 483–500.

    Article  Google Scholar 

  40. Luke, N. (2005). Confronting the sugar daddy stereotype: Age and economic asymmetries and risky sexual behavior in urban Kenya. International Family Planning Perspectives, 31, 6–14.

    Article  PubMed  Google Scholar 

  41. Maganja, R. K., Maman, S., Groves, A., & Mbwambo, J. K. (2007). Skinning the goat and pulling the load: Transactional sex among youth in Dar es Salaam, Tanzania. AIDS Care, 19, 974–981.

    Article  PubMed  Google Scholar 

  42. Masvawure, T. (2010). ‘I just need to be flashy on campus’: Female students and transactional sex at a university in Zimbabwe. Culture, Health and Sexuality, 12, 857–870.

    Article  PubMed  Google Scholar 

  43. McMillan, K., & Worth, H. (2011). Sex workers and HIV prevention in Fiji—After the Fiji Crimes Decree. Sydney: International HIV Research Group, UNSW.

    Google Scholar 

  44. McMillan, K., & Worth, H. (2015). Problematics of empowerment: Sex worker HIV prevention in the Pacific. Health Promotion International, 31, 946–953. https://doi.org/10.1093/heapro/dav069.

    PubMed  Google Scholar 

  45. McMillan, K., & Worth, H. (2016). Patrulhando as periferias: Trabalho sexual, protoclos sobre tráfico humano e prevenção do VIH no Pacífico. In O. Sacramento & F. Ribeiro (Eds.), Planeta sida: Diversidade, políticas e respostas sociais (pp. 277–300). Ribeirão: Húmus.

    Google Scholar 

  46. Miller, C. L., Fielden, S. J., Tyndall, M. W., Zhang, R., Gibson, K., & Shannon, K. (2011). Individual and structural vulnerability among female youth who exchange sex for survival. Journal of Adolescent Health, 49, 36–41.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Morris, M., & Kretzschmar, M. (1997). Concurrent partnerships and the spread of HIV. AIDS, 11, 641–648.

    Article  PubMed  Google Scholar 

  48. Pando, M., Coloccini, R., Reynaga, E., Fermepin, M., Vaulet, L., Kochel, T., … Avila, M. (2013). Violence as a barrier for HIV prevention among female sex workers in Argentina. PLoS ONE, 8, e54147. https://doi.org/10.1371/journal.pone.0054147.

  49. Plumridge, L., & Abel, G. (2001). A ‘segmented’ sex industry in New Zealand: Sexual and personal safety of female sex workers. Australian and New Zealand Journal of Public Health, 25, 78–83.

    Article  PubMed  Google Scholar 

  50. Poulin, M. (2007). Sex, money, and premarital partnership in southern Malawi. Social Science and Medicine, 65, 2383–2393.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Pyett, P., & Warr, D. (1997). Vulnerability on the streets: Female sex workers and HIV risk. AIDS Care, 9, 539–547.

    Article  PubMed  Google Scholar 

  52. Rojanapithayakorn, W. (2006). The 100% condom use programme in Asia. Reproductive Health Matters, 14, 41–52.

    Article  PubMed  Google Scholar 

  53. Shannon, K., & Csete, J. (2010). Violence, condom negotiation and HIV risk among sex workers. Journal of the American Medical Association, 304, 573–574.

    Article  PubMed  Google Scholar 

  54. Shannon, K., Kerr, T., Marshall, B., Li, K., Zhang, R., Strathdee, S. A., … Wood, E. (2010). Survival sex work involvement as a primary risk factor for hepatitis C virus acquisition in drug-using youths in a Canadian setting. Archives of Pediatrics & Adolescent Medicine, 164, 61–65.

  55. Shannon, K., & Montaner, J. (2012). The politics and policies of HIV prevention in sex work. Lancet Infectious Diseases, 12, 500–502. https://doi.org/10.1016/S1473-3099(12)70065-8.

    Article  PubMed  Google Scholar 

  56. Shannon, K., Strathdee, S., Goldenberg, S., Duff, P., Mwangi, P., Rusakova, M., … Boily, M. (2015). Global epidemiology of HIV among female sex workers: Influence of structural determinants. Lancet, 385, 55–71.

  57. Shannon, K., Strathdee, S., Shoveller, J., Rusch, M., Kerr, T., … Tyndall, M. (2009). Structural and environmental barriers to condom use negotiation with clients among female sex workers: Implications for HIV-prevention strategies and policy. American Journal of Public Health, 99, 659–665.

  58. Shaver, F., Lewis, J., & Maticka-Tyndale, E. (2011). Rising to the challenge: Addressing the concerns of people working in the sex industry. Canadian Review of Sociology/Revue canadienne de sociologie, 48, 47–65.

    Article  PubMed  Google Scholar 

  59. Shorter Oxford English Dictionary. (3rd ed.). (1959). New York: Oxford University Press.

  60. Simic, M., & Rhodes, T. (2010). Violence, dignity and HIV vulnerability: Street sex work in Serbia. Sociology of Health & Illness, 31, 1–16.

    Article  Google Scholar 

  61. Tabet, P. (2012). Through the looking-glass: Sexual-economic exchange. In F. Omokaro, & F. Reysoo (Eds.). Chic, chèque, choc. Transactions autour des corps and stratégies amoureuses contemporaines (pp. 39–51). Genève: Open Edition Books.

  62. Todd, J., Cremin, I., McGrath, N., Bwanika, J., Wringe, A., Marston, M., … Żaba, B. (2009). Reported number of sexual partners: Comparison of data from four African longitudinal studies. Sexually Transmitted Infections, 85(Suppl. 1), i72–i80.

  63. Turshen, M. (1998). The political ecology of AIDS in Africa. In M. Singer (Ed.), The political economy of AIDS (pp. 167–182). New York: Baywood.

    Google Scholar 

  64. Vanwesenbeeck, I. (2001). Another decade of social scientific work on sex work: A review of research 1990–2000. Annual Review of Sex Research, 12, 242–289.

    PubMed  Google Scholar 

  65. Vanwesenbeeck, I. (2017). Sex work criminalization is barking up the wrong tree. Archives of Sexual Behavior, 46, 1631–1640.

    Article  PubMed  PubMed Central  Google Scholar 

  66. Vuylsteke, B., Das, A., Dallabetta, G., & Laga, M. (2002). Preventing HIV among sex workers. In K. Mayer & H. Pizer (Eds.), HIV prevention: A comprehensive approach (pp. 376–406). Amsterdam: Elsevier.

    Google Scholar 

  67. Walkowitz, J. (1980). Prostitution and victorian society: Women, class and the state. New York: Cambridge University Press.

    Google Scholar 

  68. Walls, N., & Bell, S. (2011). Correlates of engaging in survival sex among homeless youth and young adults. Journal of Sex Research, 48, 423–436.

    Article  PubMed  Google Scholar 

  69. Wardlow, H. (2004). Anger, economy, and female agency: Problematizing ‘prostitution’ and ‘sex work’ among Huli of Papua New Guinea. Signs, 29, 1017–1040.

    Article  Google Scholar 

  70. Wardlow, H. (2006). Wayward women: Sexuality and agency in a New Guinea Society. Berkeley: University of California Press.

    Google Scholar 

  71. Watson, J. (2011). Understanding survival sex: Young women, homelessness and intimate relationships. Journal of Youth Studies, 14, 639–655.

    Article  Google Scholar 

  72. Wojcicki, J. (2002a). Commercial sex work or Ukuphanda? Sex-for-money exchange in Soweto and Hammanskraal, South Africa. Culture, Medicine and Psychiatry, 26, 339–370.

    Article  PubMed  Google Scholar 

  73. Wojcicki, J. (2002b). ‘She drank his money’: Survival sex and the problem of violence in taverns in Gauteng Province, South Africa. Medical Anthropology Quarterly, 16, 267–293.

    Article  PubMed  Google Scholar 

  74. Worth, H., Patton, C., & Goldstein, D. (2005). Reckless vectors: The infecting ‘other’ in HIV/AIDS law. Sexuality Research and Social Policy, 2, 3–4.

    Article  Google Scholar 

  75. Zheng, T. (2009). Red lights: The lives of sex workers in postsocialist China. Minneapolis: University of Minnesota Press.

    Google Scholar 

Download references

Author information

Affiliations

  1. School of Public Health and Community Medicine, Faculty of Medicine, University of New South Wales, Sydney, 2052, Australia

    Karen McMillan, Heather Worth & Patrick Rawstorne

Authors
  1. Karen McMillan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Heather Worth
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Patrick Rawstorne
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Karen McMillan.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

McMillan, K., Worth, H. & Rawstorne, P. Usage of the Terms Prostitution, Sex Work, Transactional Sex, and Survival Sex: Their Utility in HIV Prevention Research. Arch Sex Behav 47, 1517–1527 (2018). https://doi.org/10.1007/s10508-017-1140-0

Download citation

Keywords

  • Prostitution
  • Sex work
  • Transactional sex
  • Survival sex
  • HIV research