Examining Links between Cocaine Use and Street-Based Sex Work in New South Wales, Australia
Degenhardt, Louisa, Day, Carolyn, Conroy, Elizabeth, Gilmour, Stuart, The Journal of Sex Research
There has been increasing interest in recent years in the study of sex workers as a marginalized group at increased risk for a range of poorer mental and physical health outcomes (Vanwesenbeeck, 2001). Previous research has documented the risks of blood-borne virus (BBV) transmission and sexually transmitted infections (STI) among sex workers due to unprotected sex with clients (Gossop, Powis, Griffiths, & Strang, 1995) and the potential risks posed to the broader community via BBV transmission through clients to the general population (Tuan et al., 2004).
Illegal drug use has previously been documented as common among street-based sex workers in particular (e.g., Gossop et al., 1995; Inciardi & Surratt, 2001; Leggett, 2001; Minichiello, Marino, Khan, & Browne, 2003; Roxburgh, Degenhardt, & Breen, 2005; Tuan et al., 2004). Drug use has been related to increased risk behaviors, including riskier sexual encounters (Minichiello et al., 2003) and risk of BBV transmission due to injection drug use and needle-sharing (Gossop et al.). Cocaine use in particular has been associated with significant BBV risk and sex risk behaviors among injection drug users (Hudgins, McCusker, & Stoddard, 1995; Tyndall et al., 2003).
Research indicates that drug use is an important predictor for poorer outcomes for sex workers, which has generated an interest in the role of drug use and drug use patterns among this group (Alegria et al., 1994). An ethnographic study of women in New York who engaged in sex work found that drug use played a substantial role in the way these women conducted their sex work (Maher, 1997). Crack-cocaine had a particularly deleterious effect on sex workers, as it was thought to lead to lowering of the price of sex work exchanges, to engender a hostile environment among sex workers and violent exchanges with clients, and to lead to an increased potential for high-risk sexual encounters. Many of the women interviewed also used crack in order to facilitate their engagement in sex work (Maher).
The Sex Work Industry in New South Wales
New South Wales (NSW), Australia, has a good tradition of measures designed to reduce harms related to the public health risks posed by sex work. Legalization exists in the form of brothels that operate under permits, and sex workers may operate from their own homes after obtaining permits from local councils, and along public thoroughfares as long as they are not in close proximity to churches or schools (Perkins, 1991). Outreach efforts have targeted sex workers in NSW with a strong focus on the reduction of sexual and other risk behaviors among this group. Harm-reduction and treatment measures for street-based sex workers engaging in injection drug use have been developed and targeted toward heroin use and injection, particularly outside the inner-city area.
Despite links between crack-cocaine use and sex work in the United Kingdom and United States (Gossop et al., 1995; Green, Day, & Ward, 2000; Inciardi & Surratt, 2001), less work has investigated in detail the potential relationships between cocaine use and street-based sex work in Australia. Given the apparent importance of context for both drug use and sexual encounters for sex workers (Aalbers, 2005; Fullilove, Lown, & Fullilove, 1992; Fullilove & McGrath, 2005; Green, Fullilove, & Fullilove, 2005; Maher, 1997), this is an important issue.
Drug Markets in NSW
Kings Cross has long been considered Australia's premier illegal drug market. American soldiers visiting Sydney on "rest and recreation" leave during the Vietnam War (1962-1972) introduced heroin to prostitutes and bohemians (McCoy, 1980). By the 1980s, Kings Cross was home to a thriving open-air drug market dealing in heroin, cannabis, and amphetamine. The drug market offered opportunities for small- and large-scale drug dealing (Southgate et al., 2003). The district …
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Publication information: Article title: Examining Links between Cocaine Use and Street-Based Sex Work in New South Wales, Australia. Contributors: Degenhardt, Louisa - Author, Day, Carolyn - Author, Conroy, Elizabeth - Author, Gilmour, Stuart - Author. Journal title: The Journal of Sex Research. Volume: 43. Issue: 2 Publication date: May 2006. Page number: 107+. © 2007 Taylor & Francis Group, LLC. COPYRIGHT 2006 Gale Group.
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