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What Antis Can Do To Help, Part Two: Aiding Those Leaving The Industry

Stiletto by Massimo Dogana
Stiletto by Massimo Dogana

In case you missed it, read Part One here.

I am a sex worker who not only hates the sex industry, but, more often than not, sex work itself. At the very least, I am not the Charlotte York of Sex Work and the City; I didn’t set out on my current career path screaming, “I choose my choice!” Rather, I got here mostly through a series of shitty happenstances primarily relating to my mental illness.

I’ve been crazy for the entirety of my life, but I managed my poor mental health well enough for most of it. In what should have been my last year of college, my overall health rapidly declined, aided by a series of sexual assaults. I might have been able to continue school part-time, but the conditions of my scholarship meant that I would lose the remaining $20,000 if I couldn’t manage twelve credits at once. So I chose to take some time off from college and work instead.

I searched for a job for five months. I sent out dozens of applications and got rejected repeatedly, including from being a hostess at restaurants. Given that my peers with BA’s were now desperately applying to the same low-wage jobs, the fact that I was unemployable without a degree shouldn’t have come as a surprise. I might have joined those peers in returning home for a while in debt and defeat, except that I don’t really have that option. I grew up with an abusive father, and I spent most of my teen years dealing with child protective services and the family court system. And so, with two weeks left until I’d have to either move back in with my father or become homeless, I chose to answer an ad on Craigslist about becoming a dominatrix.

That was eighteen months ago, or approximately five years in sex work time. Since then, my health has gotten even worse. I wouldn’t be able to work a full-time job now even if I could find one, so I continue on as a pro domme—a pro switch, actually. I’m pleased to say that the work has proved more enjoyable than I originally anticipated. It’s intellectually challenging, creative, and occasionally fun. Unfortunately, any enjoyment I get out of it is overshadowed by the risks it entails. I’ve already dealt with almost every kind of nastiness at my job, from verbal abuse to grand larceny to petty wage theft to yet more sexual assault to the constant threat of arrest (some things pro switches do are more legal than others). My welfare has improved since transitioning to independent work, but I still spend far too much time worrying about my physical, emotional, and financial security in this job. I want out of this business, sooner rather than later. But I fell stuck for a lack of other options.

Mine is exactly the kind of situation that anti-sex work feminists claim to want to remedy. Their plan for helping me, though, involves not much more than “ending demand” for my services. Even if that were an achievable goal, it would leave me back where I was eighteen months ago: unable to pay rent. Any solution to my dilemma and to the dilemmas of so many sex workers who feel trapped in our work to varying degrees will be far more complex than eliminating our clients. It will need to be systemic and holistic. It will need to attack multiple issues at once, and it will need to be spearheaded by sex workers.

PrEP: What It Is and How Sex Workers Can Use It

Truvada, the only HIV medication approved to be used in PrEP so far. (Photo by Jeffrey Beall, via Wikipedia Commons.)
Truvada, the only HIV medication approved to be used in PrEP so far. (Photo by Jeffrey Beall, via Wikipedia Commons.)

Lindsay Roth cowrote this post with sex worker ally and colleague Cassie Warren. Roth and Warren work together at PxROAR (Research, Outreach, Advocacy, and Representation), a program for community activists which offers training and support around biomedical HIV prevention research and advocacy. Readers can contact them with questions about PrEP at lindsay@swopusa.org and cassandra.r.warren@gmail.com.

So you’re telling me you can take a pill to prevent HIV?

Yup. We believe that if done right, PrEP has the potential to be one of the best tools brought to market for receptive partner protection and power since the pill in the 1960’s. PrEP doesn’t double as a contraceptive, but it does reduce your risk of HIV by 90% when taken correctly. It’s still a sweet tool to have in your make-up bag, hard femme box, tool kit, whatever you call it. We are still in the middle of an epidemic, with trans and cis women, men who have sex with men, and injection drug users still being hit hard and unjustly. We deserve to have access to all the options that protect us against HIV.

In what follows, we’d like to lay out the basics of PrEP (no really, what is it? does it cost the first month’s rent?), add context to some of the controversies, and offer our take on what this means for sex workers. We do not anticipate that we’ll be able to answer all the questions people have in this one post, and we hope that you will comment or reach out to us directly if you’d like to know more.

What the heck is it?

PrEP stands for Pre-Exposure Prophylaxis. The main part to note here is “pre,” implying treatment before exposure. In this context, we are talking about exposure to HIV (Human Immunodeficiency Virus). So, PrEP is a medication an HIV-negative person would take to prevent them from becoming positive. Currently, Truvada is the only form of PrEP approved by the Food and Drug Administration.

Truvada is an NRTI (nucleoside analog reverse transcriptase inhibitor) which is just a fancy name for an HIV medication. It has been used to treat HIV since 2004. We used to know HIV as the virus that caused AIDS, and knew AIDS as a death sentence. However, because of advancements in the treatment of HIV, positive folks can live long, healthy lives. Folks can even be positive, on treatment, and unable to transmit the virus to anyone else. Recently the medical establishment stopped giving AIDS diagnoses: Because of new treatment options people can be at various stages in their HIV diagnosis, and we now classify HIV as stage 0, 1, 2 or 3 HIV.

Many readers may be familiar with PrEP’s sibling, PEP, or post-exposure prophylaxis, the use of antiretroviral drugs—ARVs (again, a fancy name for HIV medications)—to mitigate the risk of HIV transmission after a potential exposure. Any doctor can write a prescription for PEP, most Medicaid programs pay for it, and Gilead, the large research based pharmaceutical company which makes Truvada, has a patient assistance program to cover the the costs for the uninsured or underinsured, regardless of immigration status.

To summarize, PrEP vs. PEP:

  • Truvada as PrEP is taken before an exposure to HIV, specifically one pill a day, every day.
  • PEP is taken after an exposure to HIV, specifically within 72 hours, and consists of 30 days of full-regimen HIV treatment medication.
  • Both prevent you from acquiring HIV.

How does PrEP work?

The rationale behind PrEP is based on the way most doctors are treating HIV-positive individuals with ARVs. Truvada is a combination of two medications, tenofovir and emtricitabine. If HIV is presenting itself in one’s body, this medication blocks the replication of HIV in the body. Doctors currently prescribe one pill a day, as the medication must be present in the body to do its work. However, there are trials underway to test the efficacy of other ways of taking PrEP. So far, the results of the iPrEX OLE (open label extension) say that if you take it 2-4 times a week you are protected 85% of the time against HIV, and if you take it 5-7 times a week, you are protected 99% of the time against HIV (not other STIs or pregnancy). If you take it less than 2 times a week you have zero protection. 1

Can I take it right before I meet a date?

No. PrEP acts like a full metal jacket around your T-cells, so if HIV is introduced to your body it can’t get into the cells it wants to infect and replicate itself.2 It takes about seven days to make this metaphorical metal jacket around the cells in the rectum (drugs taken orally are absorbed quicker in the digestive track), and about 20 days to make a metal jacket around the cells in the vagina (our apologies if you call your junk something else) and in the bloodstream. So, for full protection, you’d need to be taking it every day for a week before you’re protected during anal sex, and every day for three weeks before you are protected during vaginal sex or during any activity in which you would share blood (e.g., sharing needles for tattoos, hormones, drugs, piercings, etc.).

A Tale of Two Petitions: CATW’s Amnesty Open Letter Fail

Why listen to us when you could listen to Meryl Streep? (Photo by Flickr user mostribus84)
Why listen to us when you could listen to Meryl Streep? (Photo by Flickr user mostribus84)

On July 22, a long list of prohibitionists, working through the Coalition Against Trafficking in Women, released an open letter to Amnesty International as part of their long-running fight to stop them from officially adopting a pro-decriminalization of sex work stance. The letter urged the organization to vote against a draft proposal supporting decriminalization at their International Council meeting in Dublin this coming week. Besides roping in many of the usual suspects in anti-sex work circles—Janice Raymond, Julie Bindel, Rachel Moran, Robin Morgan, Meagan Tyler, etc.—the petition sought celebrity endorsements in an attempt to use fame to advance its cause. And sign on the celebrities did: Lena Dunham, Kate Winslet, Meryl Streep, Anne Hathaway, Emma Thompson, Lisa Kudrow, Kevin Kline, Christine Baranski, and Chris Cooper were among the more prominent names included.

When I first read that list, besides feeling like half of my favorite films had just been ruined for me, I was also really worried. People look up to these names. Who would listen to us in the sex workers’ rights movement when they could listen to Meryl Streep? The battle to support Amnesty International’s proposed stance has been a long and draining one for sex workers internationally, and it saw some particularly nasty fights here in Australia when prohibitionists tried to shout down sex workers at Amnesty Australia’s annual general meeting last July. As absurd as it was that a bunch of Hollywood’s most privileged could consider their voices about our oppression more important than our own, there was a lot of power and money in that list of names, and I was concerned that it might actually shift the course of Amnesty’s vote.

SWOP-Seattle Battles Washington Legislation

image via SWOP-Seattle on Twitter
image via SWOP-Seattle on Twitter

The Seattle City Council’s unanimous vote to change the legal terminology for buying sexual services from “patronizing a prostitute” to “sexual exploitation” is an example of the limits of the city’s politically progressive character. Seattle’s progressive leaders think it’s their mission to perpetuate the idea that sex workers are victims who need rescuing and eradicate the adult entertainment industry to stop violence against women.

There have been a shocking number of bills introduced in the Washington state legislature this session regarding sex work and human trafficking. The language in these bills synonymizes consensual adult sex work with trafficking, coloring all sex workers as victims and all sex work as victimization. Senate Bill 5041 goes so far as to say that prostitution is “modern day slavery.” The bills embrace the increasingly popular “End Demand” model and suggest such measures as giving local law enforcement the authority to seize clients’ assets if they are used in the crime of buying sex (e.g., confiscating their vehicles if they negotiate with street workers from them), increasing the penalty of soliciting a prostitute from a simple misdemeanor to a gross misdemeanor, and amending the state’s definition of human trafficking to include forced labor by “abuse of power, or abuse of position or vulnerability.” This vague language conflates sex work with trafficking and the bills as written would erase any remaining legal concept of sex workers’ individual agency.

These bills are a reaction to the trafficking hysteria pervading the country and Seattle in particular. Anti-trafficking groups in the area are more active than ever, hosting panel discussions and other public events, spreading misleading statistics and creating moral panic in concerned citizens. These groups fail to recognize that their efforts directly endanger consensual adult sex workers. They cannot conceive of anybody willingly choosing to do sex work.

Indigenous People In The Sex Trade Speak Out

We collectively and steadfastly resist the so-called “rescuing” and “saving” approaches to the issues going on in our lives that comes from the (in)justice system, social service agencies, prohibitionist groups, and many other areas.  What we are asking for is not to be saved or rescued or consistently painted as victims – we come from generations of peoples who have resisted this approach for the last 500+ years so we could be here today. We are asking for support that is unconditional and meets us where we are at.

From the Native Youth Sexual Health Network

(Original text can be found here; the statement is also reprinted in full below.)