Health

Home Health

Bareback: Re-Opening The Dialogue On Safer Sex In The Age of U=U

Bareback sex feels fucking amazing.

I know, we’re not supposed to talk about that. We’re not supposed to talk about bareback fucking without following it up with that ubiquitous “but use a condom!” statement. However, many communities face significant barriers to condom use and have very legitimate reasons for foregoing them—and these are the communities whose voices have largely been excluded from broader conversations defining “safe sex.”

That’s a big problem. As harm reductionists and sex educators, we can’t talk openly about what people are really doing behind closed doors. We aren’t supposed to legitimize sex without a condom as an option, or rather, we aren’t supposed to acknowledge that it may be the only option for many marginalized people. And that’s exactly the kind of dishonesty that allows HIV stigma to proliferate.

As an HIV counselor and longtime public health activist, as well as an ex-sex worker and IV drug user, I want this attitude to change. We need to re-open the conversation around what safe sex means in America and internationally, because while condoms can be an excellent means of STI protection, they are by no means a realistic option for every person in every situation. And sex workers in particular need to be involved in this conversation, since it is the most marginalized groups among us—drug-using sex workers, sex working trans women, street workers, sex workers of color, and people who fit into many or all of the above categories—who most often find ourselves in situations in which providing bareback services is our only option if we want to make a living.

Ask Ms. Harm Reduction: She’s Pregnant and on Dope

Ms. HR wants the best for you and your bun in the oven. (image via Flickr user trialsanderrors)
Ms. HR wants the best for you and your bun in the oven. Though you probably won’t want to nurse your tot if you’re on methadone after it’s born. (“Nurse the Baby” poster by Erik Hans Krause, via Wikipedia Commons)

All the queries Ms. Harm Reduction answers are actual questions from readers. If you have a quandary related to drugs, sex, work, or any of the other pitfalls and pleasures of life that you need Ms. Harm Reduction’s solution for, please write in at info@titsandsass.com.

Dear Ms. Harm Reduction,
I’m a recovering addict/alcoholic stripper (20 months clean) and I just found out my best friend at work is a pregnant heroin addict. I’m one of the only people who knows she is pregnant, and I’ve been trying to talk her into getting some prenatal care as well as food stamps and WIC because she never seems to have enough to eat. Last week I learned that she doesn’t want to go to the doctor about her pregnancy because she’s a heroin addict. The resident dope dealer/stripper [at work] (also a pretty close friend) confided in me that she is also worried about her. I always thought she was falling asleep at work because she works too much but now I realize she was nodding off, and now I also understand why she never has enough money despite doing well at dancing and why she’s so underweight. Lately, she’s been looking extra pale, dark circles under her eyes, and crying a lot. I’m worried. I know she’s hiding her addiction from me because she knows I’m in recovery and because I’m somewhat of a mentor to her and she doesn’t want to disappoint me. I also understand firsthand the painful shame that often accompanies drug addiction.

I don’t want to embarrass her or make her feel defensive, but I also want to let her know that I do love her regardless and most importantly I would like to give her some information about harm reduction. Is there a way I can go about this that won’t feel invasive? I know a former sex worker who works at a harm reduction center that will give her clean needles. I’ve also been hearing a lot about a bad batch of heroin that’s been going around my city. We’ve had a huge spike in overdoses and I want to make sure she knows it’s out there.

And finally, what the hell is a pregnant drug addict supposed to do? Will she be arrested when her baby tests positive for heroin? Drug addict or not, she needs prenatal care. I can understand the difficult position she is in.

I’m not naive enough to think I can talk her out of her addiction, but I also don’t want her to feel like she needs to hide it from me. I want her to know I’m not judging her and that I’m here to help her if she decides she needs it.

Sincerely,  

Girl On Opiates is a Great, Amazing Homey

That’s Not A Real Doctor: VICE’s Buttloads of Pain Investigates the Butt Shot Underground

via flickr user panavatar
via flickr user panavatar

VICE sent a reporter to Florida to report on the ass shot underground, where not-doctors inject everything from Fix-A-Flat to mineral oil into the buttocks of those seeking a bigger booty. Last week the accompanying documentary debuted online, and it’s worth watching, but be warned that the images of procedures-gone-wrong are horrifying. Reporter Wilbert Cooper talks to Miami-area plastic surgeons and follows Corey Eubanks, who is on probation for charges related to an association with Oneal Ron Morris, “The Duchess,” who had one of her clients die from complications from injections (there is some misgendering of Morris at the beginning of the documentary when Cooper is speaking with a detective about the case). There’s a segment in famous Miami strip club King of Diamonds where Cooper interviews dancers about their procedures and one dancer tells him that she estimates 75% of her coworkers have had some kind of ass augmentation.

Ask Ms. Harm Reduction: I Have Herpes

Visual approximation of Ms. Harm Reduction and her gal pals. (Photo via Flickr user gbaku at the Creative Commons.)
Visual approximation of Ms. Harm Reduction and her gal pals. (Photo via Flickr user gbaku and the Creative Commons.)

Dear Ms. Harm Reduction,
About six months ago I had my first ever genital herpes outbreak. I am a cis female and a full service provider. I don’t do bareback, but I do still continue to work. I am on herbal suppressive therapy (lysine, other immune boosters and stress management) and haven’t had an outbreak since the first one. I know it’s controversial, but I love my job and I don’t want to do any other type of work. I just want to know how to be as safe as possible. Also how big of a risk is this? Am I totally fucked up for working? For the record I would never work during an outbreak, but outside of that, is it ok? I was also wondering if internal condoms (female condoms) offer more protection because they cover external surface area?

Best,
Sexy Or Risky? Escort

Activist Spotlight Interview: Sarah Patterson on Health, Access, and Risk

Sarah Patterson
Sarah Patterson (photo by Tara Israel)

In January 2012, Sarah Elspeth Patterson and a group of other sex worker activists in NYC went to work offering health care and social services to sex workers. The much needed outcome, Persist Health Project, is the 2nd sex worker only health clinic in the United States, after Saint James Infirmary in San Francisco.

While there is limited funding for it as of yet, the Persist team are diligently working on their labor of love and helping to put an end to the lack of non-biased services for sex workers. Sex workers have a history of being subjected to discrimination, stigma, and forced hospitalization and testing in the mainstream healthcare system. NYC’s Persist strives to be a safe space where sex workers can be open and receive the care they need. You can help contribute to the growth of Persist by donating here. Every little bit helps!

I got a chance to speak with Sarah about the project upon her return from this year’s Desiree Alliance conference.

How would you describe Persist and it’s work?

Persist Health Project (Persist) is a peer-led organization that connects folks in the sex trade in New York City with providers who are either from the community themselves or awesome allies. In addition to coordinating care for people —people can call us and have a provider hand-picked for them, based on their needs —we also offer workshops on health topics, such as burnout, sexual health, and general health. To keep enhancing our network of providers, we offer trainings for health care professionals on how to work with folks in the sex trade better.

Persist was co-founded in January of 2012 by a group of sex worker activists, nurse practitioners, and social workers who are also current workers, former workers, or very committed allies. I brought together people I knew were valuable members of sex worker organizing groups, who were either interested in health for sex workers because of their own experiences with sex work or had transitioned from sex work to health or social services. Many of us had been doing organizing together, were friends or peers, and saw a collective need. Others had dreamed for a long time of opening a clinic space just for sex workers.

What was your motivation for working on this project?

I didn’t give my health a lot of thought until I became a healthcare professional and was expected to be an “expert” on these things. After I got my degree, I found myself doing sexual health education and thinking, what about my own personal health decisions? Am I really being “safe” all the time, or do I do things that are “risky?” Are there better ways to think about this, outside of thinking about everything —drugs, alcohol, smoking, sex, food, so on—as a “risk”? What’s realistic for my life, rather than what is generally taught as the “best” thing to do? Of course, the concept of making health choices that fit your life  is one the fundamentals of harm reduction. But it was only after getting the “right” answers from education that I wondered about the value of what I already knew from my own life experience, and how that might be useful to others.

I think it’s incredibly valuable to be offering positive, affirming peer support to one another from within communities involved with or impacted by the sex trade. In addition to creating communities and shared life experiences, trading sexual services can also be very competitive, anxiety-inducing and isolating. So part of Persist’s goal is to break the feeling of isolation in health care by shifting ideas of what support can look like.