ABSTRACT
Many street sexworkers in the Bronx, New York, ‘stroll’ to support a drug habit. To say that these individuals are at risk for HIV may be correct, but they have more immediately threatening occupational risks: harassment, assault, rape, robbery and arrest due to the visible and unprotected nature of their employment; plus the skin and vein infections, trademarks, and circulatory damage common to poorly managed IV drug use. AIDS education as it is normally delivered in New York City will not satisfy the needs of this population as it focuses only on AIDS and does nothing to address the more visible, stigmatizing and damaging aspects of their lives. Appropriate health education for this group needs to include lessons in safer professional sex and proper needle use. An individual can be taught to secure as much money as possible in as short a time as possible, thereby lessening the sexual risks and the possibility of coming to the attention of law enforcement personnel. The more attractive sexworkers appear, the more likely they’ll be approached by clients, and the more money they make per trick, the less tricks they’ll have to turn. Teaching needle sterilization is not always well accepted because it is an extra step, but teaching trademark prevention and more competent injection techniques requires no extra time, can be taught in a few simple lessons, and provides information that most IV drug users desire. AIDS education, offered in this context, is more meaningful to the drug user and facilitates better connections with health care professionals. This chapter will focus on a simple course in self-injection, abscess prevention, and safer professional sex that has been found effective with a mostly homeless group of sexworkers in the South Bronx.
