An activist hooker speaks out on safe sex

The scourge of AIDS has made many people think more than ever before about protecting themselves.


Tracy Quan
July 24, 2000 11:30PM (UTC)

South Africa has lately been at the center of the world prostitutes movement. The International Network of Sex Work Projects is currently based in Capetown. And not far from Capetown, the recent 13th International AIDS Conference was held July 9-14. But whether it occurs in Geneva or Durban, this event is a magnet for sex workers' rights activists and is a must-attend for anyone who plays a leadership role in the world prostitutes movement.

Right now, as I sit in New York, playing hooky from the biggest event of the year, alliances are forming and shifting, dying, reviving. Political love affairs are breaking down. Some are being tenderly nourished. Covert enemies are smiling at each other as they salivate over each other's funding. New factions are sprouting as former enemies are forced to share hotel rooms. Australians are dissing each other to their foreign allies, Latin Americans are making North Americans feel guilty and North Americans (especially from the U.S.) are trying not to offend anyone from Europe or any developing countries.

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AIDS is a tragedy of epic proportions, claiming millions of lives. But AIDS has also made the prostitutes movement a global one. Before AIDS, the movement sought its alliances among feminists, and this limited our growth. During the past decade this has changed and most of the important alliances tend to be AIDS related. AIDS is terrible, we all agree, but it helped our movement come of age. Many activist prostitutes have built innovative careers in public health, social and medical research and elsewhere because of AIDS.

In real life, far from the politicized atmosphere of the sex workers summit in Durban, working prostitutes also benefit from the very thing they fear. In the 1980s, when my friends in the life became aware of AIDS, some clients had trouble getting used to condoms. And one working girl I know expressed the problem personally. She told a client: "If you've ever had to sit next to the hospital bed of a friend who is dying of this disease, you'll appreciate the need for a condom!"

Yes, '80s foreplay was sometimes heavy-handed. But she wasn't kidding. One of this girl's best friends from high school, a gay man, had just died.

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Later, when just about everyone in our sphere -- clients, working girls, madams -- had converted to the cause of condoms, she told me: "Thank god for AIDS -- when I think of all the men I used to see without condoms, I just can't believe it!"

Her sorrow over a friend who died of AIDS was, is, still real. But AIDS gave her a good reason -- an "excuse" -- to use a device that had been unfashionable for a while. Condoms made her work a lot safer in general. Risks she had previously taken for granted pre-AIDS now seemed intolerable. Like any other person who has experienced technological improvements on the job, she was amazed at what she had once been able to live with.

Other prostitutes agreed with my friend. It was comforting to know you weren't being exposed to chlamydia, pregnancy or gonorrhea. Men, the selfish beasts, weren't so easily persuaded by the specter of curable ailments or of pregnancies that didn't affect them. The incurable specter of AIDS became a handy angel of guilt hovering over our beds, urging our customers to wear condoms.

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Pre-AIDS, when condoms were not always the norm, it was normal to get tested at least monthly for a range of STDs (sexually transmitted diseases). This wasn't just time-consuming, it was expensive. But worth it, of course.

"Before AIDS," one friend reminisced, "I used to spend $200 a month on gonorrhea cultures and lab tests. Once I actually had to get a penicillin shot." And once, she even got pregnant, as a result of the imperfections of the diaphragm method. Condoms have made her life safer and saner by reducing her medical and emotional overhead.

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When your body is your portable workstation, you fear for its safety. You're alert to the many bugs, glitches and unwelcome problems that can endanger its health, put you out of work, make you less marketable. For many prostitutes, AIDS is just one of these hazards and it's not even the largest threat in our sex lives.

Safe sex means more than preventing infection with HIV. It means increasing protection of your cervix from HPV (human papilloma virus) and cancer by using a barrier like a condom or a diaphragm. It means protecting your throat against gonorrhea, guarding against pregnancy, protecting your clients from infections. Nobody wants to expose a customer to an STD.

When it comes to prostitution and illness, it's the transmittable ailments that get all the front-page coverage. But for many hookers, the biggest health problems are work related yet noncontagious. So, safe sex can also mean abstaining from vaginal intercourse -- with lovers or clients -- to reduce the mechanical irritations leading to nonspecific urethritis and recurring bladder infections.

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"I had a UTI [urinary tract infection] that was actually caused by my boyfriend -- we were having too good a time -- and I couldn't work," one girl told me. "My doctor ordered me to stop fucking for two entire weeks. I didn't listen to him because I felt better -- the infection was gone. And then the problem came back a month later. I lost more time because I was too greedy to give my body a rest."

The second time around, she stuck to oral sex during the recovery period and was able to return to work.

In each case, then, "safe" takes on different meanings. Many readers of my fiction series have asked why fictional call girl Nancy Chan doesn't kiss. Is it, they ask, because kissing is too intimate? Not exactly. Refusing to kiss clients on the mouth is, for many professionals, a form of safe sex.

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Many working girls say that kissing increases their chance of catching a cold, and most prostitutes I know worry more about catching a cold than they do about contracting an exotic and deadly virus. The STD problem they've got covered -- with condoms -- but other bugs are harder to dodge. Many prostitutes say that being exposed at close quarters to so many people is a challenge to the immune system. They fanatically dose themselves with vitamin C and coenzyme Q, keep boxes of homeopathic cold remedies on hand and sleep a lot.

Even though a cold won't kill you, it will put you out of work for a week. Prostitution is demanding: You are required to look and act alert, happy, healthy and pretty at all times. You cannot do this with a runny nose or a sore throat. In some jobs, you might be regarded as a hero for struggling into the office with the remains of a head cold. In this job, you just look desperate.

When your body is your business, you don't find it insulting to be told about the latest new STD test -- you actively want the latest and the best in prevention, detection and (if need be) treatment.

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A friend of mine in the business says, "If you don't get an HIV test, if you don't sit down and think about every sex act you perform, you're unprofessional. If you don't use condoms, if you don't get your blood tested, you're an incredible slob. It's piggish not to care if you're a pro. But if you're not a pro, it's romantic; it's a sign of your innocence perhaps or your purity."

In 1992, one of my closest friends, an editor in her 20s, was still on the Pill. I knew what this meant: She wasn't using condoms! How relentlessly I nagged her, and how merrily she resisted my finger-wagging warnings. "Oh, I'm just being very fin de sihcle about it," she said, cheerfully. "Besides, I'm not as much of a feminist about this condom thing as you are, Tracy."

That really shut me up, since I regarded myself not as a feminist but as a post-feminist. God, was HIV turning me into one of those preachy militant friends -- the kind of female friend who advises you not to lose weight because she fears you'll develop an eating disorder (even though you really need to lose 15 pounds)?

I was somewhat pissed off with her. A prostitute who decides to take risks with her body would be viewed as a social menace in need of rehab, a dangerous vector of disease, perhaps even a felon in some parts of the United States. Only a shameless amateur could get away with this.

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It was indeed a very fin de sihcle moment: My "virtuous" friend had never disapproved of my sexual conduct, was quite supportive of my right to do it, and I was the scandalized, self-righteous one. I wanted to be a good sexual citizen and she didn't care one way or the other. In reality, I was more preoccupied with sex-based "virtue" than she was. I consoled myself with the thought that I, the responsible sex professional, was taking proper care of my intimate equipment.

But again, the concept of "safe" keeps changing. This year I began to read about the possible dangers posed by monthly ovulation and the likely benefits of the Pill. I was horrified and humbled by the realization that my Pill-taking friend -- the self-confessed sexual amateur who'd slept with perhaps seven men in her entire life, who once told me "there has to be a patina of respectability" when she goes to bed with a man -- had probably done a better job of protecting her ovaries and her uterus than I had! While practicing safe sex with condoms and reducing one set of risks, I had inadvertently exposed myself to other risks.

I called up a fellow activist, an ex-prostitute with a Ph.D. in public health who frequently gives lectures on how to reduce HIV risk among sex workers. I railed about the possible harm caused by our movement's obsession with HIV -- condom-using sex workers are exposing their ovaries to possible cancer for years on end!

"Is it possible that, in some cases, a female prostitute is more at risk of contracting ovarian cancer than HIV? That if she had to choose between the Pill and a condom she might, because of her particular style of working, be safer with the Pill?" I asked.

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I expected her to cluck disapprovingly. HIV after all is a sacred cow. I didn't know what she would say about the ovarian cancer risk posed by monthly ovulation. Just another crackpot theory?

"Actually," she said, "I think there's something to it. In the Netherlands, a lot of prostitutes use Depo-Provera. Their work schedules aren't interrupted by menstruation and they use condoms, too." She surprised me by agreeing that a sex worker's HIV risk can be grossly exaggerated. But we both felt that saying this too loudly in the prostitutes movement would be perceived as irresponsible.

Just as professionals are often divided from "amateurs" by their attitudes toward safe sex, testing and risk, prostitutes themselves are sexually factionalized.

There is the faction that always uses a condom for oral sex. There is the faction that prefers to but sometimes goes without.

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There's also a generation gap. Call girls and madams of a certain age, who still embrace the free and easy mores of the '60s and '70s, are often repelled by the idea of performing oral sex with a condom. Or they have trouble taking the idea seriously.

Prostitutes in their 20s and 30s are accustomed to taking extra precautions. They're often impatient with relaxed sexual attitudes. "Forget it!" a friend once said, describing a madam's special request. "Never! It's not worth getting gonorrhea of the throat for $300."

It's commonly accepted that while AIDS is the harbinger, the use of latex protects working girls against less deadly bugs. Despite all the talk of death, the working girl feels she is winning a daily, weekly, hourly battle with mundane things like trichomoniasis, nonspecific vaginal infections, gonorrhea and chlamydia.

But some professionals feel justified in making exceptions. "I have a regular who is so biiiiiig," says another girl. "I just can't get a latex condom onto him. We've tried everything, even the larger latex ones." When she confessed to using a rolled Trojan lambskin, she quickly added, "I put nonoxynol-9 in the tip, just in case." Why, some readers might wonder, doesn't a successful call girl just drop a client if he's too well-endowed to deal with a latex condom? Nobody knows better than she that we're experiencing an economic boom.

"I like him," she shrugs, "and he's really quick. I know latex is the safest and lambskin's kind of risky. But really, I think the risk is minimal."

Safer sex is harder sex. In assessing a client's value, some prostitutes just look at his price. Others realize that a client's true "price" or value isn't just what he pays.

"My safest client," says my friend with the well-endowed client, "is a guy who takes forever in bed. I don't mind because he's so ultrasafe. But he's a lot of work. I feel drained after he leaves. I know he would come so much faster if I took off the damn condom ... Sometimes I'm tempted. I could just take that thing off and he'd be done! It's very tempting. But life is full of temptations, isn't it?"


Tracy Quan

Tracy Quan is the author of "Diary of a Manhattan Call Girl."

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