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Assessment of stigma towards homosexuality in China: a study of men who have sex with men. Measuring perceived stigma in female sex workers in Chennai, India.

Seven different scenarios were explored before a version that the producer and director could continue with. The problem being little was actually known about the murder. Interrogations and files about the murder of Blonde Dolly had not been released in Nor was a perpetrator found. This meant that the writers could use their imagination. They Prostitutes Elst a psychological drama around the prostitute Blonde Dolly, who really Prostitutes Elst, and the fictional Eddy Cremer.

The alleged contacts of Blonde Dolly with high-ranking figures in Dutch society also added a spicy touch to the script. But it remains fiction: the film is not a reconstruction of the murder case. Auditions for the film were difficult, and a few days before Prostitutes Elst was due to start, nobody had been Prostitutes Elst for the title role. The Belgian actress Hilde Van Mieghem was eventually chosen.

The film was a struggle for director Jonne Severijn who was eventually replaced by his assistant director Gerrit van Elst. Listing from Filmvandaag: [11]. From Wikipedia, the free encyclopedia. Release date. Running Prostitutes Elst.

Retrieved 8 December British Film Institute. VPRO Cimema. TrosKompas in Dutch. Digitaal Vrouwenlexicon van Nederland. Archived from the original on 23 February Retrieved 13 March Nederlands Film Festival. Categories : Dutch-language films Dutch films films Films about murder Films about prostitution in Prostitutes Elst Netherlands Cultural depictions of prostitutes Cultural depictions of Dutch women.

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Help Learn to edit Community portal Recent changes Upload file. To support appropriate interpretation Prostitutes Elst comparisons of the burden of HIV among male sex workers to that of other MSM or even that Prostitutes Elst other men, age-stratified HIV incidence data are needed.

Globally, the sample size of data reported to UNGASS ranges from a few participants to thousands of participants, with data sources of varying quality. This complicates comparisons across countries or regions and interpretations of Prostitutes Elst. For instance, less than ten participants Prostitutes Elst included in the reports from diverse settings including Cape Verde, Cameroon, Algeria, Romania, and Kyrgyzstan. Prostitutes Elst addition, many of these studies include transgender women under Prostitutes Elst MSW indicator, further confounding interpretation.

For example, while Pakistan reported data specifically on the indicator for MSW, the study was focused nearly exclusively on hijras considered a third gender in India and Pakistan Prostitutes Elst the extramural peer-reviewed research listed here does not share the same biases as country-reported data, there are several methodological limitations that hinder inferential conclusions drawn from these studies, including varying, often unsophisticated sampling strategies pertinent data are generally derived from convenience samples with limited Prostitutes Elst to the broader population of MSW ; and the lack of a standard Prostitutes Elst recall window e.

Moreover, the increasing trend of sex work transitioning from being street-based to internet-based further complicates the identification, sampling, and assessment, limiting the scientific rigor of epidemiological research With these caveats posed by the proportion of partners of different types and risk practices by partner types, the epidemiological data suggest that Prostitutes Elst globally remain at very high risk for HIV acquisition and transmission, even compared to other high risk populations.

In this regard, we recommend five changes to MSW-specific data collection and reporting to support country-led programming. Second, surveillance guidelines should specifically suggest distinguishing between lifetime sex work and current past-year sex work to facilitate better estimations of MSW prevalence in communities and associations between past sex work and current HIV-related health outcomes.

Third, ensuring that risk transmission Prostitutes Elst encompass multiple options will allow for better distinctions among populations with intersecting risk behaviors e,g. Prostitutes Elst, better quantification of MSW-specific risks could be achieved by assessing commercial sexual risk by partner type and sex e. Finally, assessing career duration and sex work frequency number of paid sexual acts may contribute to better understanding of dose-response associations between selling sex and HIV transmission risk, and provide useful context for optimal intervention delivery.

While this level of disaggregation may not be necessary for all agencies tracking the burden Prostitutes Elst HIV, these indicators would support organizations and agencies focused on the implementation and evaluation of programs supporting male sex workers. Several approaches are available to assess determinants of risk and vulnerability to HIV in specific populations and contexts.

The modified social ecological model MSEM composed of multiple layers of risks for HIV acquisition and transmission ranging from individual level Prostitutes Elst such as biological and behavioral factors that potentiate HIV infection, characteristics of sexual networks, community level determinants including access to HIV prevention services Prostitutes Elst potential barriers to those services, and finally the national policies that potentiate or mitigate Prostitutes Elst potential coverage of HIV prevention, treatment, and care programs for male sex workers Subsequently, syndemics theory 30 facilitates understanding of how these disparities and consequent psychosocial health conditions further predispose Prostitutes Elst to increased HIV risk compared to other MSM populations Table 2.

History of commercial sex and prevalent HIV infection among men who have sex Prostitutes Elst men, — These biological risks have Prostitutes Elst well characterized and include the efficient transmission of HIV during unprotected anal intercourse. MSW are characterized by high numbers and frequencies of male partnerships resulting in large and non-dense sexual networks which have both been established as risk factors for HIV among MSM 3.

These risks have also been characterized in some countries among MSW such as Nigeria and Kenya 31 Similarly, the limited supply of condom-compatible lubricants CCL in many low and middle income countries may further increase risks among MSW There are several themes that emerge across regions when reviewing HIV risks affecting individual MSW including economic disparities, sexual and physical abuse, drug use, and low socioeconomic status as well as the occupation-related risks associated with commercial sex.

In many places Prostitutes Elst contexts, some MSW report high levels of background adversities, including sexual and physical abuse 18 ; homelessness 35 ; and low educational attainment Furthermore, MSW are more likely Prostitutes Elst other MSM to report racial and sexual minority statuses, Prostitutes Elst which are associated with higher likelihood of serodiscordant sexual partnerships in many high Prostitutes Elst settings such as the United States and the United Kingdom One of the most consistent Prostitutes Elst among MSW is the significant reporting of concurrent substance use among these men ranging from Prostitutes Elst to injecting drug use.

Alcohol Prostitutes Elst in Kenya and injecting and non injecting drug use in Asia have been shown to be associated with higher Prostitutes Elst sexual acts among MSW Occupational Prostitutes Elst risks among MSW have been shown in North America to include conditions of economic necessity fomenting unprotected sex 43 ; sex with multiple partners; sexual role versatility, depending on client preferences; and sex with male, Prostitutes Elst, and transgender partners, as well as reciprocal sex exchange — purchasing sex from other sex workers Potentiating the high acquisition Prostitutes Elst transmission risks associated with UAI are the high burden of prevalent and incident genital ulcerative diseases.

In some countries of Latin America and the Spanish speaking Caribbean, sex workers are often offered free medical check-ups at public health clinics Consequently, there may be significant levels of non- or minimally symptomatic STIs among these men given that condom use is less effective in preventing these infections as compared to HIV. While there is limited research of youth and adolescent men selling sex because of the complexity in ensuring appropriate informed consent, and the additional legal issues involved, many MSW across a number of regions report initiating sex work at young ages, sometimes under coercion or force The high prevalence of HIV observed among men in their late teens and early twenties in many Prostitutes Elst, suggests that HIV acquisition risks are likely significant during adolescence for some of these men.

At the community level, risk may be mitigated by available HIV prevention, treatment, and care services if barriers to the uptake of those services are removed. Stigma acts by devaluing, labeling, and stereotyping MSW resulting in the loss of status, unfair and unjust treatment, and social isolation of these men MSW often face intersecting stigmas: having sex with other men; engaging in Prostitutes Elst sexual activity; presumption of HIV infection, drug use; and differential socioeconomic status among racial minorities.

The illegal nature of sex work in much of the world, coupled with the Prostitutes Elst of male sexual partners, engenders an environment of multi layered marginalization. Even in locales with high acceptance of sexual diversity, the commercial nature of sex work creates a milieu removed from traditional gay community norms, which according to power dynamics may favor riskier sexual practices The majority of public policies affecting Prostitutes Elst represent structural barriers to care rather than improving access to it.

Broadly, there are three main Prostitutes Elst of criminalization that intersect with male sex work including the criminalization of sex work, the criminalization of same-sex practices, and the criminalization of non-disclosure of HIV infection. These policies or stigmatizing contexts may also drive emigration of MSW to countries with supportive legislation and improved working environments The relationship between criminalization of same-sex practices and difficulty in researching and addressing the HIV prevention, treatment, and care needs of MSM Prostitutes Elst been well described in the literature.

Finally, the criminalization of non-disclosure of HIV infection is relevant to MSW in many countries Prostitutes Elst a potential barrier to the uptake of HIV-related services including testing A recent report from Human Rights Watch in Tanzania found multiple accounts of rape of male sex workers by police further highlighting the limited repercussion of rights violations affecting these men The general lack of legal recourse after violence observed in numerous settings, limited economic resources, and increasing tendency to use condom-carrying as evidence of sex work all further complicate safer male sex work.

Despite Prostitutes Elst high burden of HIV infection and elevated risk status, limited intervention studies have specifically addressed the needs of MSW Table 3. Few randomized controlled trials have assessed interventions developed to help MSW reduce their HIV risks, though many interventions for MSM and female sex workers have been tested.

There is a pressing need for HIV prevention programs targeting MSW given the efficient transmission of HIV during anal intercourse and the persistent necessity Prostitutes Elst high numbers of sexual partnerships to support income. Given the complex Prostitutes Elst environment for these men and akin to other populations, the most effective intervention designs likely represent combinations of behavioral, biomedical, and structural approaches.

Intervention approaches should probably be very specific to the local contexts, paying attention to the legal framework, levels of Prostitutes Elst as well as specific identities of MSW, and the Prostitutes Elst of both general and MSM-focused HIV services. By no means should interventions expose MSW to public sight — beyond their own choices, and legal threats should be specifically prevented. In various contexts, formative research suggests that individual- and Prostitutes Elst interventions incorporating incentivized harm reduction approaches 53 and access to social services and resources, and medical including mental health care 44 could be coupled with community-level anti-stigma campaigns 54 for maximal effectiveness.

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Bio-behavioral approaches that incorporate the use of antiretroviral drugs for pre-and post-exposure prophylaxis PrEP and PEP, respectively likely represent options with significant utility among MSW As described earlier, some MSW report difficulties negotiating condom use during anal sex with clients Prostitutes Elst may accept higher rates for unprotected sex.

Innovations in testing are emerging as an important area in addressing the crucial problem of undiagnosed HIV infections 56 Given the limited targeted services, significant social stigma, and high incidence and prevalence of HIV among many Prostitutes Elst, those who acquire HIV infection may remain undiagnosed for a long time.

In addition, mean and total viral Prostitutes Elst in a population has been linked to population-level transmission Prostitutes Elst of HIV For MSW, ART-based prevention approaches may represent a relevant option as those may Prostitutes Elst them to control their HIV risks not solely based on condom use, though strategies to ensure adherence would be needed if those approaches are employed This approach is currently being implemented and evaluated The role of structural changes, including those needed in legal frameworks, is fundamental in many parts of the world.

In South Africa, protective constitutional provisions for gay men and other MSM are at odds with sex work remaining illegal. Consequently, there Prostitutes Elst no national program to address the needs of MSW, and such task is covered in part by non-governmental organizations such as the Sex Worker Education and Advocacy Taskforce SWEAT to address the needs of sex workers. The work of SWEAT and its allies resulted Prostitutes Elst the South African government including decriminalization of sex work in earlier iterations of its national health strategic plan NSPthough this did not materialize.

The decriminalization of sex work in South Africa would be akin to the Delhi High Court overturning Penal Code —as a means of protecting public health Decriminalization of sex work and access to protective public health and legal structures would likely Prostitutes Elst our understanding of MSW-specific health issues, improve service uptake, and, from an occupational health perspective, foster improved working conditions However, legal frameworks affecting MSM are becoming ever more complicated with new laws in Nigeria, Uganda, and the reinstatement of Penal Code in India in These laws may further limit the ability to effectively address the needs of MSW.

In the U. Thus, while governmental entities are crucial stakeholders, it is communities of MSW that need to be supported to be at Prostitutes Elst anchor of an effective response to their needs. There are several active community-driven networks that include MSW. The ICRSE strives to raise awareness about the social exclusion of female, male and transgender sex workers in Europe, to promote the human and civil rights of all Prostitutes Elst workers at national, regional and global levels and to create strong alliances between sex workers, allies and other civil society organizations.

Given Prostitutes Elst increasing use of Internet sites and smart phone applications among MSW such as Craigslist, Rent Prostitutes Elst, Manhunt, and Grindr to arrange commercial sex encounters, new interventions provided in virtual spheres have great potential for saliency and reach, although they have, so far, been sparingly evaluated.

While there has been limited study or systematic surveillance of the burden of HIV among these men, consistent evidence is emerging Prostitutes Elst shows that their HIV burden has been sustained or increasing in the context of rising HIV rates among MSM more broadly.

Prostitutes Elst are several clear facilitators for HIV acquisition and transmission including biological, behavioural, and structural factors. Prostitutes Elst, many public health questions regarding MSW remain understudied. Given their diverse identities and contexts, to what extent could partially standardized definitions be used to facilitate programme design and implementation? What individual- community- and structural-level factors mediate and modify HIV risksposed by commercial sex?

There is a pressing need for HIV prevention programs targeting MSW given the efficient transmission of HIV during anal intercourse and the persistent necessity of high numbers of sexual partnerships to support income.

How could MSW be offered comprehensive health services Prostitutes Elst, respecting their autonomy, can prevent an increase in their vulnerability?

Is there significant scientific stigma related to conducting HIV prevention and research with MSW, and has this manifested to limit our knowledge base? Encouragingly, public and private funders are Prostitutes Elst that high-impact HIV prevention and care has to include key populations such as MSW Prostitutes Elst part of comprehensive HIV responses 66 Programs such as these Prostitutes Elst support strengthening of community groups focused on addressing the needs of male sex workers specifically to ensure provision and uptake of the range of proven and emerging HIV prevention, treatment, and care strategies are crucial to ensure a changing trajectory of the HIV epidemic among these men.

Ultimately, dedicated advocacy, funding, surveillance, research initiatives, and a range of preventive options for MSW are essential for not only public health, but also social justice and human rights.

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The burdens of HIV and health-related needs of men who sell sex are understudied with the majority of research conducted within studies of men who have sex with men, female sex workers, and transgender women. The majority of clients of men who sell sex are other men. However, those male clients often do not self-identify as gay or bisexual and many may have regular female partners. Risks for HIV acquisition exist at multiple levels for MSW including the efficient transmission of HIV in unprotected anal intercourse, high numbers of sexual partners, large and complex sexual networks, and compounded intersectional stigmas.

Criminalization of sex work, same-sex practices, and HIV non-disclosure all represent barriers to safe commercial sex offered by men. Increasing access to condoms and condom Prostitutes Elst is necessary and represents a core strategy for HIV prevention, but will not be sufficient to change the trajectory of sustained and growing HIV epidemics among MSW.

Dedicated advocacy, funding, definitional consistency for surveillance, and research initiatives for MSW are essential for Prostitutes Elst sake of not only public health, but also social justice and human rights. Publisher's Disclaimer: This is a PDF Prostitutes Elst of an unedited manuscript that has been accepted for publication. As a service to our customers Prostitutes Elst are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form.

Please note that during the production process errors may be discovered Prostitutes Elst could affect the content, and all legal disclaimers that apply to the journal pertain. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. Claire E. National Center for Biotechnology InformationU. Author manuscript; available in PMC Jan Stefan David BaralM. Reuel Prostitutes Elst.

Author information Copyright and License information Prostitutes Elst. Copyright notice. The publisher's final edited version of this article is available at Prostitutes Elst. See other articles in PMC that cite the published article.

Introduction Men who sell sex for money or goods MSW comprise an extremely diverse Prostitutes Elst across regions and within countries worldwide.

Open in a separate window. Table 2 History of commercial sex and prevalent HIV infection among men who have sex with men, — Perception of severity of HIV Prostitutes Elst associated with risk behavior. Increased perceived susceptibility and perceived benefit of condom use associated with increased risk-taking behavior. Collective action social transformatory model may be more appropriate than peer education model.

Bar-based interventions need to be developed that are focused on Prostitutes Elst and agency, not identity; and that build peer and managerial support. Interventions should be developed that are comprehensive and multi-level, and reduce stigma associated with male sex work.

More focus should be given to understanding context relative to more Prostitutes Elst behavioral determinants. Interventions should be developed that address structural vulnerabilities: access to healthcare, prevention information and tools; community social support; stigma and discrimination; and sexual exploitation. Increased access to and management of social and material resources were significantly associated with fewer unprotected sex acts.

Liu, Mysore India Purposive sampling Not provided Structural: drop-in center; police liaisons; peer education; rapid response teams Effective MSW Prostitutes Elst FSW aggregate data Structural interventions drop-in center, police liaisons, rapid response team and peer education associated with Prostitutes Elst decrease in violent incidents reported by sex workers MSW and FSW results aggregated.

Reza-Paul, Miami and Ft. Friedman, All authors provided input and guidance on the concept and outline of the manuscript. Each author then wrote different sections of the manuscript with guidance from SB.

References 1. Burden of HIV among female sex workers in low-income and middle-income countries: a systematic review and meta-analysis. The Lancet infectious diseases. Elevated risk for HIV infection among Prostitutes Elst who have sex with men in low- and middle-income countries — a systematic review.

PLoS Med. Global epidemiology of HIV infection in men who have sex with men. From personal survival to public health: community leadership by men Prostitutes Elst have sex with men in the response to HIV. Perlongher NO. In: Men who sell sex in Peru: evolving technological and Prostitutes Elst cultures. Aggleton P, RP, editors. London: Prostitutes Elst and Francis; Forthcoming.

Social context, Prostitutes Elst risk perceptions and stigma: HIV vulnerability among male sex workers in Mombasa, Kenya. Cult Health Sex American Journal of Public Health. Money boys, HIV risks, and the associations between norms and safer sex: a respondent-driven sampling study in Shenzhen, China. AIDS Behav.

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High HIV prevalence among men who have sex with men in Nigeria: implications for combination prevention. J Acquir Immune Defic Syndr.

Sex Transm Dis Male youth engaged in sex work: health disparities and outcomes in early adulthood. AIDS Care HIV, sexually transmitted infections, and risk behaviours in male commercial sex workers in Sydney. Sex Transm Infect Pleasure and Sexual Health. AIDS Behav Risk behaviors and sexually transmitted diseases in gay and heterosexual men attending an STD clinic in Tel Aviv, Israel: a cross-sectional Prostitutes Elst.

Isr Med Assoc J Multiple risks among male and transgender sex workers in Pakistan. Journal of LGBT Prostitutes Elst research. Morbidity and Mortality Weekly Report. Street workers and internet escorts: contextual and psychosocial factors surrounding HIV risk behavior among men who engage in Prostitutes Elst work with other men.

Journal of urban health Prostitutes Elst bulletin of the New York Academy of Medicine. Modified social ecological model: a tool to guide Prostitutes Elst assessment Prostitutes Elst the risks and risk contexts of HIV epidemics. BMC Public Health. Adversity and syndemic production among men participating in the multicenter AIDS cohort study: a life-course approach.

American journal of public health. High levels of bisexual behavior and factors associated Prostitutes Elst bisexual behavior among men having sex with men MSM in Nigeria. Aids Care. The impact of peer outreach on HIV knowledge and prevention behaviours of male sex workers in Mombasa, Kenya.

Male sex workers who sell sex to men also engage in anal intercourse with women: evidence from Mombasa, Kenya. A call to action for comprehensive HIV services for men who have sex with men. Survival sex work and increased HIV risk among sexual minority street-involved youth.

J Acquir Immune Defic Syndr Sex trade involvement and rates of human immunodeficiency virus positivity among young gay Prostitutes Elst bisexual men. International journal of epidemiology. The Lancet. Liu S, Detels Prostitutes Elst. Recreational drug use: an emerging concern among venue-based male sex workers in China. Commercial sex work and risk of HIV infection among young drug-injecting men who have sex with men in San Francisco. Sexually Transmitted Diseases.

Acceptability of pre-exposure prophylaxis as an HIV prevention strategy: barriers Prostitutes Elst facilitators to pre-exposure prophylaxis uptake among at-risk Peruvian populations. HIV infection among men who have sex with men in Prostitutes Elst, Uganda--a respondent driven sampling survey.

Katsulis Y, Durfee A. Prevalence and correlates of sexual risk among male and female sex workers in Tijuana, Mexico.

Facilitating access to sexual health services for men who have sex with men and male-to-female transgender persons in Guatemala City.

Identifying at-risk populations in Kenya and South Africa: HIV incidence in cohorts of men who report sex with men, sex workers, and youth. High prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae infections among HIV-1 negative men who have sex with men in coastal Kenya. HIV prevention interventions for young male commercial sex workers. HIV, gender, race, sexual orientation, and sex work: a qualitative study of intersectional stigma experienced by HIV-positive women in Ontario, Canada.

Gay men and other men who have sex with men in West Africa: Prostitutes Elst from the field.

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In the latter case, please turn on Javascript support in Prostitutes Elst web browser and reload this page. Titles and abstracts of the remaining 6, entries were screened: 5, Isr Med Assoc J

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