Prostitution in Europe
Lilian Mathieu Sociologist
CNRS sociology research worker Author of Prostitution et sida (L'Harmattan, 2000)
and Mobilisations de prostituées (Belin, 2001). This e-mail address is being protected from spambots. You need JavaScript enabled to view it

Most prostitutes in Europe have adopted the use of condoms. However, those taking drugs are more vulnerable and more highly exposed to the risks of sexual contamination.

In Europe, the results of many studies have shown that the rumours spread by the alarmists were unfounded.

The new ways in which prostitutes are being thought of and reached nowadays differ completely from previous medico-social practices. In the early 80's, as soon as the information began to circulate that a new lethal sexually transmissible disease had arrived, male and female prostitutes were immediately accused of being responsible for its transmission. The fact that prostitutes were being used as scapegoats for the epidemic because they contributed to the spread of venereal disease back in the 19th. Century gave rise to some heated debate in France as to whether it might not be appropriate to bring back a system of strictly regulated brothels subject to obligatory public health inspection. The social workers' organisations which had been dealing with prostitutes for a long time (mainly with a view to reintegrating them into society) objected that legal measures of this kind were liable to have stigmatising effects and were likely to be ineffective.

In Europe (1), the results of many surveys have shown that the rumours spread by the alarmists were unfounded: people who go in for prostitution have a relatively low rate of HIV infection, since they make regular use of condoms. The main risks of contamination arise in situations involving "private" partners with whom no condoms are used, and most of all, in situations involving drug addicts. Prostitutes who are drug addicts and often carry out casual prostitution under extremely poor conditions of hygiene and social integration are the most highly exposed to contamination by the HIV virus.

The results of sociological studies have made it possible to establish the links which exist between prostitution, drug abuse and exposure to the HIV virus. Drug addicts who inject themselves intravenously with narcotic substances not only run risks if they share their syringes with others, but they are even more liable to be contaminated if they also go in for prostitution: since they lack the money they need to buy the drugs they need, they are more likely to agree to having unprotected sexual relations, which many of their clients ask for. The altered states of consciousness induced by drugs also make them less capable of refusing their clients' demands, and are thus more liable to have high-risk practices imposed on them against their will. The latter hazard constitutes a threat not only to those under the influence of drugs, but to all those under the influence of psychoactive substances* of all kinds, whatever their legal status may be.

The role played by drug abuse in exposing prostitutes to contamination by the HIV virus has led the organisations involved in AIDS control to mobilise similar preventive strategies to those used on drug addicts, based on harm reduction*, peer education* and community health approaches.

EDUCATIONAL EFFORTS FOCUS ON PROSTITUTES OF BOTH SEXES

When AIDS first arrived, it was immediately realised that prostitutes could not be reached via the existing system of education. The participation of the prostitutes themselves was required before anything could be done to help this population. Most of the preventive efforts made in Europe these days involve not only health professionals, but also professional drug prevention workers who were formerly prostitutes themselves, and whose knowledge of life on the streets therefore makes them ideal candidates for working with their peers. The idea underlying this mode of intervention is to create a new, less stigmatising picture of prostitution, which is no longer to be regarded as a social blemish, but as a legitimate, freely chosen form of activity. The fact that the term "sex trade workers" is tending to be used increasingly instead of the word prostitute in the context of AIDS prevention indicates that some changes are in fact occurring on these lines.

REACHING OUT TO THE STREETS AND PAVEMENTS

Preventive organisations are also characte ristically undertaking Outreach activities. Since they are often dealing with people in highly precarious situations, who do not necessarily identify health problems as such and either do not know about the services available or are reluctant to make use of them, these services have to be highly mobile in order to be able to keep up with their potential users, whose activities are often carried out on the streets. Prevention workers often use camping-cars, which provide a friendly setting where it is possible to discuss any health problems over a cup of tea, to obtain counselling, to find out how to avoid being contaminated, to collect free condoms and syringes and make an appointment to be accompanied during the day to attend a consultation at a health care or social centre. "Boutiques" have also been opened in the hot spots where many prostitutes are plying their trade: these structures have similar objectives and provide similar services to those already catering for drug addicts. The fact that activities based on peer education and community health have proved to be effective during the last ten years does not mean that there are no new challenges to be met. These challenges, including those resulting from the changing patterns of drug abuse (the use of heroin is decreasing in favour of ecstasy, cocaine and crack) and the arrival of new populations of prostitutes, such as those originating from Eastern European countries, who usually know very little about the HIV virus, mean that the people responsible for preventive efforts must constantly re-assess both the ways in which they intervene and the objectives they set themselves.

1 contrary to what occurs in poorer countries, where people are more liable to be prepared to do anything to earn more money.

The statistics on Thailand have shown that one woman and one child out of every two who go in for prostitution have been infected with the HIV virus.