So I’ve started researching for the podcast and holy shit there’s a lot of stuff to attend to. If the goal is to eradicate the moral objections to sex work, mere philosophy won’t do. We need the statistics. At first glance, the statistics look grim. There’s no question that the industry contributes to STD rates worldwide, especially in third world countries where medical access is limited and survival sex is the rule. By no means is it the relationship causal, however.
The United States has the highest STD rates in the developed world, followed by Canada, where prostitution has only been legal since 2014 and New Zealand, where it’s been legal since 2003. Tenth on the leaderboard for infections is Belgium, where prostitution has been legal since 1948. There, the number of new HIV infections per 100,000 people in 2020 was 7.8, or roughly 2.4 people per day. That’s just about on par with Cambodia, with it’s famous red-light districts and where somewhere between 60% and 80% of men admit to buying sex. (The highest rate in the surveyed world.)
How does the United States compare? Well, for Cambodia’s high utilization of sexual services, they saw 1100 new HIV cases last year, or about three new infections each day. Far fewer men admit to purchasing sex in the US, just 15-20%, yet we tallied about 100 new infections every twenty four hours for a whopping total of 36,801 in 2019. That means it took us eleven days to create as many casualties as they did in a year. (For what it’s worth, HIV transmission is most likely to occur during blood transfusions. These numbers are not necessarily the consequence of sex work, it was just an informative comparison.)
Still, sex workers are about 30% more likely than the average person to contract HIV in the United States, a number challenged only by gay men. (Because, and this is actually really important and surprising: HIV is more transmissible through anal sex than through other intimate means. The anal lining is thinner than the vaginal one, making it easier for the virus to pass through and infect the body. Bottoms are at a higher risk than tops.) Part of this is thanks to stigma, and the fact that women often turn to sex work because of their poverty (a worldwide truth) which is associated with limited health care access anyway.
In Rhode Island between 2003 and 2014, the wording of one law effectively legalized indoor prostitution. The result was a decrease in gonorrhea transmission, suggesting that the stigma (which the podcast is about!) is a significant barrier to the testing and treatment required to effectively manage STD risk. Importantly, though unrelated, the Ocean State also saw a decrease in rape during the same time period.
So that’s the status on my research so far. I actually started this particular blog for a different reason though: To address the research which implies that buyers of sex are high in psychopathy. I think we’re looking at a sampling bias, since social and internalized stigmas likely prevent citizens who are not high in psychopathy from responding affirmatively to the question, “Have you ever purchased sex?” I mean, there’s an entire forum on Reddit of women chanting, “Refuse to date men who buy sex!” I’ve seen it, and I don’t even use Reddit. People are ashamed (though they needn’t be) and no level of anonymity feels absolute when you can clearly see your own hand marking the stigmatized box. Who else might see? By definition, those high in psychopathy, being anti-social, are less likely to adhere to social norms and to care about their deviance, and therefore are more likely to be honest.
I think an accurate account from sex industry patrons would find a rather representative population. That’s all. New research is needed.