Det er dejligt ansvarsløst og nemt for kunderne at lægge hele ansvaret for sundhed og graviditetsbeskyttelse over på kvinderne. Det er gennemgående i næsten hver eneste debat, at hele legaliseringsdebatten kører på kravet om at det er de prostituerede kvinder, der skal helbredsundersøges, de skal have sundhedsattester og de skal sørge for beskyttelse. Ikke et eneste ord om eller krav til kunderne om deres ansvar.
Det typiske i debatterne er så også, at det er kunder, der fremsætter disse "ønsker" om såkaldte ordnede forhold. Hvor er det nemt at lægge hele ansvaret over på kvinderne i stedet for at vende hele bøtten på hovedet og lade sundhedskravet følge kunden: Ingen gyldig sundhedsattest - ingen sexkøb! Der er vel heller ingen der går til fysioterapeut og beder fysioterapeuten om at fremlægge en sundhedsattest.
Længere nede på denne side er der en afdeling specifict med Human Papilloma Virus (HPV)
"The women had a median age of 35 years and the median age at first sex work was 20 years. A quarter identified as belonging to a sexual minority (e.g. lesbian, transgender). Overall, 54% reported soliciting for clients independently (e.g. through online advertising), 26% in indoor sex environments (e.g. brothels, massage parlours) and 71% in outdoor environments (e.g. streets). The investigators comment that this shows “the substantial overlap in terms of sex work solicitation environments”. There was an 11% HIV prevalence and 10% of women had a sexually transmitted infection (STI).
A total of 356 women (73%) reported being offered more money by clients for sex without a condom; 75 of these women reported accepting this money and agreeing to unprotected sex."
Safety in the Sex Industry
http://www.bioethics.org.au/Resources/Submissions/Safety%20in%20the%20sex%20industry.pdf
Undersøgelse fra 2003, der viser, at brugen af kondom langt fra er 'sikker sex' .
"In any case, studies relevant to the sex industry do not consistently show that increased
condom use is associated with a decrease in STIs. Most studies demonstrate a reduced
incidence of selected infections with increased condom use. But some studies which
demonstrated significant increases in condom use over time also showed:
• increase in genital/anal warts among prostitutes in Sydney
• no association between condom use and gonorrhoea, chlamydia, and genital herpes in
London prostitutes
• persistently high rates of chlamydia and c. trachomatis infection rates among
commercial sex workers in Japan
• condom use could not be isolated as a reason for declines in STIs, including HIV,
among Zairian prostitutes
• the presence of STIs was not associated with number of clients, duration of prostitution,
or condom failures, but with age and increasing number of non-paying partners among
prostitutes in London
• call girls in Sydney had lower levels of condom use and lower levels of STIs than
brothel workers"
Fra Queensland 2000 om den falske sikkerhed ved sundhedscheck af prostituerede.
Prostitution - A doctors warning.
http://www.webspawner.com/users/ruth11/
"“I have discovered that several people, including some MP’s, are under the misapprehension
that legalising prostitution (with controls like compulsory condoms) would ensure that S.A. prostitution becomes safe,” Dr. Hartwig said. Unfortunately, recent medical literature on sexually transmitted diseases does not support such optimism.
“Condoms provide significant protection against body fluid transmission of only HIV and gonorrhea,” Dr. Hartwig said. He said that condoms do not reliably prevent skin-contract transmission of genital warts and herpes, scabies and public lice, or fluid transmission A,B,C,D,E,F,G and non-specific urethritis, not to mention other diseases like shigella, salmonella, typhoid, giardiasis and bacterial vaginosis, which may be transmitted during sexual intercourse. "
Making the harm visible - Health effects of prostitution
af Janice Raymond.
"Women in prostitution are targeted as the problem instead of making the sex industry problematic and challenging the mass male consumption of women and children in commercial sex. This is institutionalized when governments and NGOs argue for the medicalization of prostitution when they propose laws on prostitution which subject women to periodic medical check-ups. It is stated that women in the sex industry would be better protected if they submitted, or were required to submit, to health and especially STD screening. The way in which sex industries are responsible for the widespread health problems of women and children is mystified with proposals to implement health checks of women in the industry. No proposals have been forthcoming, from those who would propose both mandatory and voluntary medical surveillance for women in the sex industry, to medically monitor the men who would purchase sex."
HIV risk behavior among patients with co-occurring bipolar and substance use disorders: Associations with mania and drug abuse
amerikansk undersøgelse fra 2007 af Christina S. Meade,* Fiona S. Graff, Margaret L. Griffin, and Roger D. Weiss - Department of Psychiatry, Harvard Medical School and McLean Hospital
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2262843/
(Se figur 1)
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2262843/figure/F1/
" The majority (75%) were sexually active in the past 6 months and reported high rates of sexual risk behaviors, including unprotected intercourse (69%), multiple partners (39%), sex with prostitutes (24%, men only), and sex trading (10%). In a multivariate linear regression model, recent manic episode, lower psychiatric severity, and greater drug severity were independent predictors of total HIV risk. Cocaine dependence was associated with increased risk of sex trading."
Prevalence and Health Correlates of Prostitution Among Patients Entering
Treatment for Substance Use Disordershttp://archpsyc.ama-assn.org/cgi/reprint/65/3/337
HPV - Human Papilloma Virus
HPV er så smitsomt, at kondomer kun giver ca 70% beskyttelse mod dem, men dog en form for beskyttelse.
Nedenunder er samlet en del undersøgelser om HPV.
HPV - HUMAN PAPILLOMA VIRUS
Genital Human Papilloma Virus - fra Brisbane prostitutions service
http://georgiafrench.files.wordpress.com/2011/04/hpv_website.pdf
"Safer sex equipment—Using dental dams, condoms and gloves reduces the risks of transmitting or acquiring HPV through skin-to-skin contact. However, it’s important to remember it only reduces the risks because genital warts can be present in places that a condom or dental dam does not cover, and you may not necessarily be able to see them."
Undersøgelse af prostituerede i Belgien 2004 for HPV og cancer.
Cervical smears and human papillomavirus typing in sex workers. http://www.virushunters.net/showabstract.php?pmid=15054172
"CONCLUSION: Abnormal smears and high risk HPV were significantly more prevalent in sex workers than in controls. Current screening policy would miss many sex workers with an abnormal smear who should be referred for further follow up. It is proposed to screen sex workers when they enter prostitution regardless of their age."
Undersøgelse fra Holland 2004 om Human Papilloma virus. 96 ikke-prostituerede og 63 prostituerede deltog.
http://www.ghapro.be/NEDERLANDS/Ghapro_artikel-08.pdf
The Prevalence of the Human Papillomavirus in Cervix and Vagina in Low-risk and High-risk Populations
Tallet (17) der står nævnt sidst i citatet refererer til undersøgelsen: Do condoms prevent genital HPV infection, external genital warts, or cervical neoplasia? A meta-analysis.
"Condom use is generally associated with more risky sexual activity, as is witnessed by significantly more frequent condom use in the STI clinic population. Sex workers are at higher risk for HPV as well as for other STI (16). On the other hand, this finding is in line with the suggestion that condom use does not protect against HPV infection (17)."
"RESULTS: Among 27 estimates from 20 studies, there was no consistent evidence that condom use reduces the risk of becoming HPV DNA-positive. However, risk for genital warts, CIN of grade II or III (CIN II or III), and ICC was somewhat reduced."
http://jcm.asm.org/cgi/content/full/42/3/1330#R17
Concordance of Prevalence of Human Papillomavirus DNA in Anogenital and Oral Infections in a High-Risk Population
"The overall HPV DNA prevalence at the gynecological sites of 39.4% was quite similar to the prevalence reported for other populations of similar age and sexual behavior. A previous study in Denmark (17) reported a similar HPV prevalence (47%) among prostitutes, representing an almost threefold-increased prevalence compared to that in the general population of that country. In our study, HPV prevalence among sex workers was 10-fold higher than that observed in an age-matched sample of the general population (24). These differences are consistent with the low HPV infection rate in the general population of Spain (9). "
Den danske undersøgelse, der henvises til, er her:
http://journals.lww.com/stdjournal/Fulltext/2000/09000/Human_Papillomavirus_Infection_in_Danish_Female.3.aspx
En interessant dansk undersøgelse - se især de to figurer.
Ovennævnte undersøgelse findes på dansk her:
http://www.ugeskriftet.dk/portal/page/portal/LAEGERDK/UGESKRIFT_FOR_LAEGER/KLINISKE_VAERKTOEJER/KLARINGSRAPPORTER/Human%20papillomavirus%20%28HPV%29.pdf
"I danske undersøgelser er der fundet en HPV prævalens på 15% blandt 1000 tilfældigt udvalgte 20-29 årige kvinder (26) og en HPV prævalens på henholdsvis 35% blandt kvindeligeHvor mange kunder har slæbt en lille - undertiden dødelig - hilsen med hjem til partneren. HPV er kønsvorter og kønsvorter er det virus, der giver livmoderhalskræft. En kræftform, der alt for ofte bliver opdaget for sent. HPV er en stærk smitsom virus.
venereapatienter (27) og 32% blandt kvindelige prostituerede (28) .
HPV er også mistænkt for at give halskræft.
http://www.scitopics.com/Human_papilloma_virus_vaccination.html
Vaccinating against oncogenic Human papilloma virus: are the high expectations justified?
"Since boys are not vaccinated an enormous pool of HPV maintains. The role of man in spreading HPV is well known. Monogamous women were infected by their husbands that visited prostitutes [5]. The prevalence of HPV is orders of magnitude higher in workers in the sex industry than in normal controls [6]. This holds for different countries [3] [7,8] . Since sexually active man visit Asian countries to have sex also Asian serotypes will arise [9]. Those serotypes are oncogenic and not in the vaccine. High prevalence of HPV-51 is also detected in Poland [10]. Moreover, the occurrence of other serotypes than the ones in the vaccine are now already circulating in the “adult” industry."
http://ajph.aphapublications.org/cgi/content/full/99/4/659
Structural and Environmental Barriers to Condom Use Negotiation With Clients Among Female Sex Workers: Implications for HIV-Prevention Strategies and Policy En undersøgelse fra Vancouver om ubeskyttet sex og smitte.
"This pattern was also reflected in the overall HPV DNA detection rate, in which sex workers had a higher HPV prevalence (47%) than women in the STD group (43%) and from the general population sample (15%). In all three groups, HPV‐16 was the most prevalent single type, followed by the HPV‐X group, which was detected in 25% to 29% of the women (data not shown). The prevalence of infections with more than one HPV type was 11.7%, 15.7%, and 12.9% in sex workers, STD clinic attendees, and cytologically normal women from the general population sample, respectively."
