Male Sex Work in China: Understanding the HIV Risk Environments of Shenzhen’S Migrant Money Boys

Male Sex Work in China: Understanding the HIV Risk Environments of Shenzhen’s Migrant Money Boys Paul Alexandre Bouanchaud The London School of Economics and Political Science A thesis submitted to the Department of Social Policy at the London School of Economics for the degree of Doctor of Philosophy June, 2014 1 Declaration of authorship I certify that the thesis I have presented for examination for the MPhil/PhD degree of the London School of Economics and Political Science is solely my own work other than where I have clearly indicated that it is the work of others (in which case the extent of any work carried out jointly by me and any other person is clearly identified in it). The copyright of this thesis rests with the author. Quotation from it is permitted, provided that full acknowledgement is made. This thesis may not be reproduced without my prior written consent. I warrant that this authorisation does not, to the best of my belief, infringe the rights of any third party. I declare that my thesis consists of 82,361 words. I can confirm that my thesis was copy edited for conventions of language, spelling and grammar by Emily Freeman, Louise Caffrey, Ellie Hukin, Oliver Mustill and Rachel Deacon. ______________________________ Paul Bouanchaud 2 Abstract This study contributes to our understanding of the social organisation and lived experience of men in China’s sex industry. It employs a social epidemiological model to analyse the multiple levels of influence on HIV (and other non-HIV) risks to which this highly marginalised group are exposed. It highlights the complex interrelations between different factors influencing the lives of male and transgender sex workers (MSW) in China. It is the first mixed methods study of its kind in the Chinese MSW context. The thesis analyses data collected during five months of fieldwork in Shenzhen, China. Working through a community-based MSW organisation, a participatory approach was taken to study design and data collection. Community advisory boards were organised and used to develop and test study instruments. A structured survey was undertaken with MSW (n=251), with a sub-sample purposely selected for semi- structured interviews (n=21). Key informant interviews were conducted with representatives from local and international organisations (n=5). Multiple linear and binary logistic regressions were used for quantitative data analyses, while qualitative data were coded thematically. Both data types are given equal weight throughout the analysis. The thesis demonstrates how China’s recent macro-level social and economic changes, characterised here through the microcosm of life in the city of Shenzhen, interact with the lived experiences of the men in the study, driving their rural-urban migration and contributing to their entry into sex work. The phrase “laugh at poverty, not at prostitution” was used by many of the respondents to explain their decision to sell sex, but this apparently simple idiom belies a more complex reality in which economic factors intersect with social networks, sexual orientation and an escalation in the provision of sexual services. Sex work careers are represented as providing both opportunities (for escaping poverty, expressing sexual identity, and accessing cosmopolitan lifestyles), as well as risks. Risk, understood as a socially constructed phenomenon, refers not only to HIV transmission, but also violence from clients, control by mami (pimps), and entrapment and arrest by the police. Multiple risks and opportunities arise through a range of social and professional interactions between the 3 different actors involved in the industry, necessitating their dynamic management by the MSW. Sex work, HIV and homosexuality alongside migrant identities are highly stigmatised in China, and the active management of these intersecting identities, in part through their sexual practices, allows the MSW in this study to continue in their work without ‘losing face’. The MSW have complex sexual networks of male and female, paid and paying, and non-commercial partners. In exploring their partner concurrency, this complexity is examined, through the lenses of stigma and identity. Local, emic understandings of ‘safe sex’ indicate that while levels of HIV fear are substantial among the MSW, and condom use is commonly discussed, safety and hygiene are frequently conflated, and both are associated with HIV-avoidance. Hygiene, through showering and general cleanliness, is considered an important part of ‘safe sex’ for this group, but also emerges as a metaphor employed to counter the perceived dirtiness of selling sex for some of the MSW. The findings highlight the complexities involved in selling sex for these men. They must actively negotiate their work, risks and identities, while also being subject to unequal power relations and forces largely beyond their control. This thesis aims to present a nuanced account of these dynamic processes. 4 Acknowledgments First and foremost I want to express my thanks for the generosity of the study participants in giving up their time to share their experiences, knowledge and stories with me. Without them, this study would have been impossible. To all of the staff and volunteers at the male sex worker organisation, who were not only central to this project’s success, but also incredibly kind, welcoming and supportive, there are no words to express my thanks. Particularly to Ray, who was a rock, never tiring of my incessant questions and always providing me with insightful and welcome comments, I owe an enormous debt of gratitude. This research would also not have been possible had it not been for the support I received from Professor Huso Yi and Professor Joseph Lau at the Chinese University of Hong Kong, to whom I am so grateful for providing me with academic and institutional support at a time when I thought I would no longer be able to undertake this research in China. Ernestina Coast has been truly inspirational supervisor throughout this process, both academically and pastorally, making herself available even for desperate Skype calls from Beijing, and confused late night emails panicking about sampling strategies in the field. I was also fortunate to benefit from supervision from Bingqin Li during the first two years of my doctoral studies, giving essential information about the vagaries of undertaking fieldwork in China, amongst many other things. In the final years of this PhD, Hakan Seckinelgin’s supervision has been invaluable. He has never failed to share his expertise and support generously. It has been a real privilege to study under their supervision, and I am eternally grateful for their guidance, support, patience and encouragement throughout. I would also like to thank Phalee Chan, Chase Cheng, Chris Poon, Sandy Leung, the staff at the Beijing LGBT Centre, and my friends in China and Hong Kong for all of their support, help and ideas. 5 I feel incredibly privileged to have been able to work on this PhD surrounded by so many brilliant and generous people at the LSE. To Ellie Hukin, Emily Freeman, Louise Caffrey, Dwan Kaoukji, Ben Wilson, Alice Goisis, Anne Marie Brady, Rachel Deacon, Eleri Jones, Valeria Cetorelli, Melody Mohebi, Dan Bear, Katie Bates, Yang Shen, Victoria De Menil, Jani Puradiredja and Shaffa Hameed – thank you for your encouragement, support, and for making this process so much more fun than I ever thought possible. Special thanks go to Wei Yang and Bo Hu, both of whom were not only brilliant, supportive colleagues, but also so generously proofread my Chinese interview translations for errors when they themselves were busy completing their PhDs. The research was funded by the Economic and Social Research Council (Grant number: ES/G017948/1), and subsequently by the London School of Economic. My parents also very kindly provided me with additional financial support throughout. Finally, I cannot express enough gratitude to my family and friends who have supported me through this process in more ways than I could ever outline here. 6 Table of contents Declaration of authorship............................................................................................ 2 Abstract ......................................................................................................................... 3 Acknowledgments ........................................................................................................ 5 Table of contents .......................................................................................................... 7 Table of figures ............................................................................................................. 9 Table of tables ............................................................................................................ 11 Glossary ...................................................................................................................... 12 Acronyms and abbreviations .................................................................................... 13 1 Introduction ........................................................................................................ 14 1.1 HIV in China .................................................................................................... 16 1.2 The reform period and the sexual revolution ................................................... 20 1.3 Masculinities in reform-era China................................................................... 22 1.4 Sexualities

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