Male sex workers: between safe sex and risk. Ethnography in a gay sauna in Barcelona, Spain

Jacques-Aviñó, Constanza; Andrés, Anna de; Roldán, Llanos; Fernández-Quevedo, Manuel; Olalla, Patricia García de; Díez, Elia; Romaní, Oriol; Caylà, Joan A.

doi:10.1590/1413-812320182412.27842017

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FREE THEMES • Ciênc. saúde coletiva 24 (12) • Dec 2019 • https://doi.org/10.1590/1413-812320182412.27842017 copy

Male sex workers: between safe sex and risk. Ethnography in a gay sauna in Barcelona, Spain

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

This ethnography was conducted in Barcelona, a city that provides different gay leisure resources, such as gay saunas. We aimed to analyze from studies on gender and masculinities, how sexuality, perception of HIV infection and other sexually transmitted infections (STIs), and preventive measures are articulated in gay sauna male sex workers (MSW). Ten in-depth interviews and observation were conducted between 2012 and 2016. Safe sex practices are more frequent with clients, while risk practices are carried out more with non-commercial partners. Sexual orientation plays an important role. Homosexuals assume riskier practices in sex work than heterosexuals. Drug use or lack of support networks were associated with higher social vulnerability and risk behaviors. Contracting HIV still creates fear, while having other STIs is perceived as part of a man’s sexual life. The MSW affirms masculinity with concurrent sexual partners, breadwinner, and on the other hand, questions a heteronormative model. Interventions for the prevention of HIV and STIs in this group should consider social determinants such as inferior work alternatives and the provision of more significant social support.

Key words
Sex work; Masculinity; HIV; Ethnography; Sauna

Topics to explore
Reasons for having started sex work
Experiences associated with the exercise of sex work in the sauna, with clients and partners
Socialization of sexuality and attitude towards homosexuality
Experiences and representations about sexual practices by commercial and non-commercial sexual partners

Representations of HIV and other sexually transmitted infections
Perceived and proposed needs for the prevention of HIV and other sexually transmitted infections in MSW

Id	Age	Country of birth (year of arrival)	Schooling	Marital status	Self-reported sexual orientation	Places/strategy to contact clients	Sex work start year	HIV serological status	Regular status³ 3 Regular status: having a residence or nationality that allows one to live in the European Union in an administratively legal way.	TSI⁴ 4 TSI: Individual Health Card, the document that allows access to the benefits of the Spanish public health system.
1	26	Panama (2011)	Primary School	Married to a woman	Heterosexual	Sauna	2014	Negative	Yes	Yes
2	21	Brazil (2015)	Secondary School	Single	Homosexual	Sauna / advertisements¹ 1 Advertisements: Offer of paid sex through the announcement on the app or Internet for sexual contacts.	2015	Negative	No	No
3	29	Romania (2007)	Illiterate	Single	Heterosexual	Sauna / nightclubs	2011	Negative	Yes	Yes
4	26	Romania (2009)	Secondary School (Incomplete Higher Education)	With female partner	Heterosexual	Sauna	2010	Negative	Yes	Yes
5	37	Brazil (2003)	Secondary School (Incomplete Higher Education)	Single	Homosexual	Sauna / advertisements	2000	Positive	Yes	Yes
6	26	Brazil (2014)	Secondary School	With male partner	Homosexual	Sauna / advertisements	2014	Negative	No	Yes
7	29	Spain	Secondary School	Single	Homosexual	Sauna /nightclubs	2004	Negative	Yes	Yes
8	30	Brazil (2006)	Primary School	Single (follamiga = friends with benefits)² 2 Follamiga (Friendship with benefits): couple relationship that combines friendship and the possibility of having sex, without committing as a sChart partner.	Heterosexual	Sauna / advertisements	2006	Negative	No	No
9	26	Venezuela (2003)	Secondary School (Incomplete Higher Education)	With male partner	Homosexual	Sauna / advertisements	2014	Negative	No	Yes
10	34	Senegal (2007)	Primary School	Single	Bisexual	Sauna	2009	Negative	No	Yes

Topics	Verbatim
Sex work in a gay sauna	"That is why I left there (from the apartment) ... once the client went to pay me... and I discovered that they paid € 150 an hour and... the owner paid me € 40 per hour, and when I discovered what the owner was charging, I saw that it was not fair" (Id6) "I do a ritual of spiritual, emotional, and physical cleansing. I wake up, I pray, and I engage in physical activity, and in the end, I go to work and enter hell, that's what we, who do not like women, call the sauna." (Id8)
Sex work: benefits and disadvantages	""I stayed four years in jail... I had been there several times (for theft), I am very grateful to be living in Spain and for the opportunity to have a more honest job that generates money for me, such as prostitution" (Id3). "You can earn money if you are clever. I have bought two apartments over two years" (Id6) "People need the drug to stay awake, to fuck with people" (Id9) "(With the tub) What I noticed sexually is that I began to have thoughts that seemed like they were not mine: from dirty talking or fetishes, you dare to do certain things that you would not do regularly, you break barriers." (Id 5)
Dynamics and social relationships in the sauna	"The client likes me, and he is not any client. He knows that there is a price and a special place for them... he will want a drug-and-sex party and have a good time..." (Id1) "Poop, piss, vomiting... Complicated people, which I think are a little retarded. You can end up crazy if you are not mentally strong." (Id8) "They like to pay because they get the idea that this is a product that it is a boy who is rented for specific practice and the customer likes that kind of idea or vice or morbidity..." (Id9) "Many clients make you feel good, they treat you very well, and you feel loved and accepted..." (Id7)
Sex work as a man	"... I don't like to call myself a prostitute, nor do I like to be called hustler, because we are all promiscuous; men, in general, are promiscuous; they are promiscuous by nature" (Id 9) "I started very early, with my cousins, with the female housekeeper who worked in my house. Nothing homosexual, I learned through experience. In Brazil, things are clear. I saw my aunt from my room, fucking ... I was 7 or 8 years old. Then I saw another aunt..." (Id 8) "Most gays are very vicious and use many drugs, and don't think much about the risks." (Id2) "... Normally they look for very unclean guys, very slender bodies, curved bodies: the fat ones would not enter there... for work no, as clients yes." (Id9) "What is it to be a man? Be clear and make things clear. I seek life here" (Id1)
Sexual practices by type of couple	"With customers, it is colder than with the boy I am with. No kisses, always with a condom ..., sometimes, I don't use a condom with non-commercial partners." (Id2) "Me and most of the guys use prevention with customers, but not with their partners." (Id5) "With women, I use it (the condom) at first, but then not; why? Because I always trust... the clients... with women, I ask for the tests [and if they don't do it?] then I'm going to do them..." (Id3) "Gays are more likely to catch a disease because they like what they do. As if I had to work with women." (Id8)
HIV / STI / Prevention	"Doing it without a condom ... gonorrhea, things like that ... because I have touched that girl you know and after a month you get these things... I get angry because I have not taken care of myself, and it could have been worse" (Id1) "(HIV) That you can die, there are medications but I am very afraid" (Id2) "I had some of these, syphilis, perhaps... I went to the pharmacy, they gave me an antibiotic and it disappeared" (Id7) "Those who want everything... if a client asks you if you fuck without a condom, for me he is already showing that he has AIDS. If he sucks your semen... and you don't know that person, it means that he does it with everyone and is not healthy." (Id8) "There's nothing you can do. It's all the same to them, they like what's behind ... boys are informed but don't want to take care of themselves." (Id 3)

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[1] Collaborations

C Jacques-Aviñó, JA Caylà, O Romaní and PG Olalla collaborated in the design of the project. C Jacques-Aviñó collected data, analyzed and interpreted the results, and drafted the first version of the paper. A Andrés, L Roldán, M Fernández-Quevedo participated in the fieldwork and data analysis. All authors collaborated in the interpretation of the results, performed a critical review of the paper, and approved its final version.