Swingers, Sex Workers, STIs: Same Data, Different Day

http://sexuality.about.com/b/2010/06/28/swingers-sex-workers-stis-same-data-different-day.htm

On Friday I wrote about a study in the Netherlands of swingers STI rates. Usually when I read research that involves data and statistics I have a piece of paper beside me and I write the numbers out as I read them. Numbers, after all, represent something. The experience of sitting there and reading an academic paper can be so unbelievably boring and also passive, it's easy to take in the information without feeling or thinking too much about it. I find that re-writing the data on my own forces me to pay close attention, think carefully about what I'm doing, and even feel something about the data set. I did this with the swinger STI data. Here's what it looked like:

chlamydia

MSM, 10.2%

straight people, 9.7%

swingers, 6.4%

sex workers, 4.2%

gonorrhea

MSM, 6.3%

sex workers, 0.8%

straight people, 0.6%

swingers, 4.3%

combined

MSM, 14.2%

straight people, 10.1%

swingers, 10.4%

sex workers, 4.8%

These numbers represent the percentage of people from each group that tested positive for chlamydia, gonorrhea, or both (MSM stands for "men who have sex with men"). This isn't the order or form that the data were presented in the paper, but that's part of why doing this is a good exercise. When I draw the data on a page I do it several different ways, sometimes there are doodles too. But I digress.

The point of this post is that what struck me about the data after transposing it onto my own paper was the STI rates for sex workers. Most of the media coverage of this article has noted this too. Well, sort of. The coverage has mostly talked about the sex worker rates in the context of how shocking it is that swinger rates are higher than sex workers. No one said anything about how much LOWER the sex worker rates were. Looking at these numbers we see that for this (admittedly small, and non-representative) group of people, sex workers had less than half the rate of STIs as other people coming to the clinic for testing.

Does it surprise you that sex workers had lower rates of STIs than swingers, MSM or the fourth, utterly generic, "heterosexual" category? It might. After all, the dominant narrative about sex workers is that they are fundamentally broken, and probably diseased. This is the story we read in the newspapers, the one we see on TV, the one we encounter in most online discussions, regardless of the stated sexual politics of those having the discussions. This is the story we know because we're usually told stories about sex work from people who aren't sex workers (although if you take the time to look, their voices are out there).

The truth is that sex workers as a group are no more homogeneous than any other group, and no more broken than actors in LA or psychiatrists in ERs. And while sex workers are at greater risk for STIs because of their work, it doesn't always mean they've got them, as this particular study points out.

I don't know enough about STI rates among sex workers so I called a good friend who has been involved for many years in sex worker rights in Canada. The first thing she told me was that looking at the numbers reminded her of something Danny Cockerline, a Canadian male sex worker and activist is often quoted as having said; "most people get STDs for free." He also apparently said it specifically about HIV, but essentially what he meant was that people are less likely to get STIs when they're paying for it.

She cautioned me not to generalize based on this small study. She said that it isn't necessarily surprising that if you take a country where sex work is decriminalized, where the population as a whole have better access to sex information, education, and sexual health services, and where sex workers have access to basic human and legal rights, that you'd find sex worker STI rates were low. After all, sex workers have been among the most organized and outspoken activists and advocates for safer sex. At the same time, she reminded me, it's unsurprising that in places where sex workers don't have basic rights, where the population as a whole has higher rates of STIs, and where access to sex education and sexual health services are minimal, that you'd find STI rates higher among sex workers.

I spend so much of my time bitching about quantitative data that today was a nice reminder for me that like almost anything else, numbers are what we make of them. Some people see these numbers and think about how bad it must be for swingers if they're worse off than sex workers. I see them and look at evidence of a powerful counter narrative that it's too easy to ignore.

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