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Farley / HARMS OF PROSTITUTION

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less than survival. For this reason, the dissociated personality can be very persuasive. When Angie said she loved being a prostitute, loved servicing her clients, would have done it even without pay, she was persuasive because she believed it—and because she believed it, she was very credible. (Gage, in press, n.p.)

CAN WOMEN IN PROSTITUTION BE PROTECTED FROM HIV?

There is extensive medical documentation that HIV is trans- mitted from john to prostitute via vaginal and anal intercourse. Rape by customers is a primary source of HIV infection among prostituted women, adolescents, and children. Yet one of the lies about prostitution is that she is the source of infection. Although there has been an intense focus on the HIV risk posed by the pros- titute to men who buy her, at the same time there has been a lack of attention to psychological and physical violence against women in prostitution.

In the HIV literature from 1980 to 2000, most authors mini- mized or ignored HIV risk posed by the customer to the woman in prostitution. Most also failed to mention alternatives to prostitu- tion as a means of improving women’s health. For example, Karim and colleagues (1995) interviewed women who were pros- tituted at a truck stop located between Durban and Johannesburg, South Africa. This group of researchers found that women were at a higher risk for physical violence when they insisted on condom use with customers. Ignoring their own finding of the dangers to women who attempted to persuade customers to use condoms, the researchers recommended that women in prostitution learn negotiation and communication skills to reduce HIV risk. It seems tragically likely that this particular project, and others with comparable recommendations, may result in additional injury, even death, to some women in prostitution.

From the time that HIV was recognized as an epidemic in the early 1980s, HIV education programs focused on what has been called safer sex education or safer sex negotiation, assuming that if the woman in prostitution can be taught to be more assertive, then she can persuade the customer to use a condom. What many HIV prevention programs fail to address is the customer’s demand for sex without a condom in situations of vastly unequal

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