Safer sex: Lessons from the male sex industry

Discerning the complex factors influencing male sex work is an important element of understanding HIV transmission. The present study examines a sample of London-based masseurs and street workers' ideas concerning their sexual encounters, their partners and their role in society. Unsafe sex is associated with (1) a lack of perception of control in the sexual encounter, (2) attractive clients, and (3) loving relationships with non-clients. The ways in which personal needs and stigma influence sexual practices and the men's sense of identity are considered. For some of the men, unsafe sex demarcates a sphere containing a type of intimacy that is absent from their working life. Since working life is associated with negative social judgements, the importance of this separate sphere is heightened. The findings call into question models of health behaviour that are built on individualist, reason-based tenets and highlight the importance of social and emotional factors in safer sexual behaviour. The implications of the findings for prevention programmes and future research are discussed.