Remarkable Variation in the Socio-Spatial Organization of Sex Work and Its Implications for STD/HIV Spread Sevgi Aral, PhD, Janet St. Lawrence, PhD, Anneli Uuskϋla, Dr MS, PhD, and Roman Dyatlov, MD, PhD

The findings and conclusions in this presentation are those of the authors and do not necessarily represent the views of [the Centers for Disease Control and Prevention.

Background Results

The organization of sex work in social and geographic In , (2), sex work does not have clear boundaries. In and Balakovo, Russia(3) the social organization of sex Internet brothels operate much the same as Internet shopping for Brothels do no advertising for clients and rely space influences the volume and pattern of sex worker – Whereas some women engage in sex work on a full-time basis, a work is variable. Sex wok in Saratov/Engels is more other purchases. Anyone with Internet access can go “on line”, entirely on the taxi drivers for their clientele, client contact which in turn impacts the spread of larger number apparently perform sex work on a part-time basis, differentiated, with more categories of SWs, pimps with well- type in the electronic brothel’s name and then “shop” for a whereas free standing “pleasure flats” sexually transmitted infections including HIV(1) intermittently, in addition to other employment. The lowest defined functions, and clearly formed escort services. In Balakovo, commercial sex worker by scrolling through a catalogue. advertise for clients in magazines and stratum of female sex workers is located in and around the railway sex work is confined to individual girls who are working as Another technological innovation in marketing commercial sex newspapers. stations, particularly Komsomolskaya Ploshchad, also called the freelancers, most of whom are drug users. More minors are work in St. Petersburg is the use of print catalogues and cell phone “Square of the Three Railway Stations.” Intermittent, truck stop, involved in the sex industry of Engels than in Saratov, where SWs orders. Catalogues are available in some, but not all, taxicabs in Elite brothels are disseminated throughout the and railway station sex workers may be the most important groups are primarily adults. In contrast to the visibility of female SWs, the central city and are made available to passengers upon request. city in higher cost suburban and residential in the dissemination of STIs. male SWs are a more hidden population, and less information is neighborhoods. Issue of access between sex Objectives available about them. In Tallinn, Estonia(5), sex work takes place in a descending services and clients are handled by the taxi Geomapping of commercial sex activity in Moscow revealed that hierarchy from elite brothels, hotels, nightclubs, dance clubs and drivers and having a central location is not an sex work is widely disseminated throughout the city. The spatial In Saratov, sex services provided through escort agencies are issue. Such dispersed locations provide To systematically compare the social and spatial strip tease bars, massage parlors, saunas, apartments or “pleasure patterning of sex work reflects the stratification of sex workers and geographically dispersed, while street sex work tends to be operators of elite houses maximum coverage of organization of sex work in 5 sites (Moscow, Russia; flats,” along the streets, bus stations, truck stops, and to specific the relationship of different strata with the police. Women geographically clustered. In Saratov City, street sex work is client space, ensuring that clients can be Saratov, Russia; Balakovo, Russia; St. Petersburg, highways. Both the police and representatives of organized crime working on the streets and in hotels in central Moscow have concentrated on three streets (Bolshaya Kazachya Street, accessed efficiently. Paradoxically, such Russia and Tallinn, Estonia) where rapid assessments agree that a large portion of sex work in Tallinn is controlled by extensive contact with the police. Women working around the Astrakhanskoya Street and Chapayev Street). In Engels, street locations place them in uncomfortable were conducted between 2000 and 2005. organized crime. Garden Ring (often referred to as the “love ring”), at truck stops SWs are observed along trolley lines. proximity to the general population thereby, outside the perimeter, and at railway stations have less contact Taxi drivers are key to the organizational structure of sex work in perhaps, creating the societal angst that seems with the police. In St. Petersburg, Russia(4), female SWs is ubiquitous. Sex workers Tallinn, particularly with respect to the functioning of elite to surround the issue of sex work in Tallinn. are available on the street, from “virtual” Internet brothels, in brothels and “pleasure flats”. The most effective way that sex The ecological pattern of sex work on the streets involves the illegal clubs, and from brothels located in large apartment workers access clients and clients locate sex work is through taxi tochka, where groups of 15 to 25 young women with their pimps, buildings. They are visible along transportation routes (on trains, drivers. Few sex workers stand on the streets and those who do, Conclusion Methods guards, and drivers wait for clients close to a major thoroughfare. along the roadside, at railway and Metro stations, and at truck usually drug users, are verbally discouraged by the taxi drivers. stops). In addition, they can be accessed from publicly advertised Positions at the highest levels of the social organization of sex work Additionally, clients would not be welcomed into a brothel without The socio-spatial organization of sex work is escort agencies, from photographic modeling agencies, “marriage” Focus groups and in-depth interviews with key in Moscow are covert and are not visible. Among the identifiable a character reference from the taxi driver. Thus the taxi drivers highly variable across local areas even within agencies (often reported to be involved with trafficking by informants; geo-mapping naturalistic observations and positions are pimps, assistant female pimps, guards, drivers, serve two functions – that of informants for clients and of gate the same region; it also changes rapidly over recruiting girls to go abroad), massage parlors, fitness clubs, porno review of available literature in 5 sites in the Former indicators, the sex workers themselves, and recruitment keepers who screen potential clients for inebriation of disruptive time. Prior to initiation of any epidemiological clubs, “banyas”, and hotels. Soviet Union. “pluckers”. behaviors for the brothels or intervention projects, the local socio-spatial organization should be assessed.

References: 1. Ghani AC, Aral SO. Patterns of Sex Worker–Client Contacts and 4. Aral SO, St. Lawrence JS, Dyatlov R, Kozlov Their Implications for the Persistence of Sexually Transmitted A. Commercial Sex Work, Drug Use, and Infections. JID 2005; 191(Suppl 1):S34–41. Sexually Transmitted Infections in St. 2. Aral SO, St. Lawrence JS, Tikhonova L, Safarova E, Parker KA, Petersburg, Russia. Social Science & Medicine Shakarishvili A, Ryan CA. The Social Organization of Commercial 2005; 60:2181-2190. Sex Work in Moscow, Russia. Sex Transm Dis 2003; 30(1):39-45. 5. Aral SO, St. Lawrence JS, Uuskϋla A. Sex 3. Aral SO, St. Lawrence JS. The Ecology of Sex Work and Drug Use Work in Tallinn, Estonia: The Socio-spatial in , Russia. Sex Transm Dis 2002; 29(12):798-805. Penetration of Sex Work into Society. Sex View from Three Station Square. To the left from the station is the pavilion leading to the Komsomolskaya-Koltsevaya station of the Transm Inf. Published online June 28, 2006. metro.