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Through an ethnographic lens: The HIV risk environment of exotic dance clubs

Through an ethnographic lens: The HIV risk environment of exotic dance clubs. Susan G. Sherman, Jacqueline Reuben, Pam Lilleston, Chris Serio Chapman. “The Block”. Established (70+ years) red light district 25 strip clubs, bars, and other adult-entertainment establishments

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Through an ethnographic lens: The HIV risk environment of exotic dance clubs

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  1. Through an ethnographic lens: The HIV risk environment of exotic dance clubs Susan G. Sherman, Jacqueline Reuben, Pam Lilleston, Chris Serio Chapman

  2. “The Block” • Established (70+ years) red light district • 25 strip clubs, bars, and other adult-entertainment establishments • 1.5 block strip (down the street from Central Police Station) • Dancing on the block = selling sex (for many women)

  3. Exploratory • What is the prevalence of transactional sex and illicit drug use on the Block? • What are correlates of transactional sex and illicit drug use on the Block?

  4. Methods Baltimore Needle Exchange Program began in May, 2008 • 1 night/week (10pm-1am) JHBSPH • Cross-sectional survey: 05/08 – 01/09 (N=101) • Ethnographic study: 06/09 – 08/09 (N=40) Inclusion criteria (both studies) • >18 • dance on the block

  5. Demographics (N=101)

  6. Current Sexual and Drug Behaviors 42% sold sex (95% began in clubs) 25% injected drugs (50% started in clubs) • 64% injected weekly 28% smoked crack (54% started in clubs) 13% snorted cocaine (38% started in clubs) 22% drank alcohol daily

  7. Correlates of Transactional Sex Context?? Individual Level African American (PrR: 0.43) Ever arrested (PrR: 3.0) Used drugs in clubs (PrR: 4.0) controlling for age, heroin use, crack smoking Current Transactional Sex

  8. Led to…. • What are the characteristics of exotic dance clubs that are associated with risk? • Risk Environment Framework • Policy • Social • Economic • physical

  9. Qualitative Methods • Interviews (30-75 minutes) conducted privately by three trained interviewers • Taped and transcribed verbatim • Inductive coding approach developed by three analysts, compared, revised, and finalized • Transcripts entered into Atlas.ti and coded

  10. Coding Scheme

  11. Risk Environment Conceptual Framework

  12. Physical Environment Where are the cameras? Everywhere. We have somebody that does watch them. If they see something they'll come charging down the steps. He'll watch-- he's like behind the scenes. You don't even know he's here, but he's here. So we feel pretty secure in here. (24 years old) [Why she does not sell sex] Because when you're going in the basement of the club, they can do whatever they want to do to you while you're there nobody hears you, and that's my dilemma. (20 years old)

  13. Social Environment: Expectations Who is putting the pressure on you [to sell sex]? The bartender a lot of times will try to sell it cuz he gets money every time you do anything. A lot of bartenders force girls to do bottles. Well it is like the mixture of people, like the bartender and the customers. The men expect stuff. They don't expect to talk to some 18-year-old, paying $20.00 just to talk to you and not to touch you. (21 years old) . (23 years old)

  14. Economic Environment: Incentives for Dancers Why did you start selling sex? I wasn't making it, $30 a night and paying my bills. So I had to step up the pace a little bit. And then I see how much money I made on that and I was like, ‘Hmm, walking out of the club with $30 or walking out of the club with $700,’ big difference. (24 years old) Why don’t you leave? This place is like a vacuum cleaner, man. I think right now, it's actually because I can't find a job that pays me the money that I make here. I can't make money like this anywhere else that's enough to pay my bills. That's the honest to G-d's truth. (27 year old)

  15. Selling Sex What sex is sold in the club? Sex. Oral sex, regular sex, lap dances. The lap dances kind of turn into sex anyway, but it’s really ridiculous. You know, you can do what you want. As long as you got the money, you can do what you want. (38 year old staff)

  16. Using Drugs Why do dancers start using drugs? Dancing ain't me. I've got to get messed up in order to do it. The Block is a real bad place to be if you are struggling from drug addiction, struggling from an alcohol problem. It will bring you down in a heartbeat…. Ninety-nine point nine percent of the people that you see walking on the block are drug dealers. They come down here. The dancers make money. They sell their drugs. (24 years old)

  17. Conceptual Framework

  18. Research Questions • To characterize the RE of exotic dance clubs through the development of four measures that capture the risk environment domains. • To determine whether the length of time dancing in a riskier exotic dance club environment predicts the cumulative incidence of HIV/STIs and initiation or escalation of sexual and drug) risk behaviors and among female exotic dancers in Baltimore, MD over 12 months.

  19. Acknowledgements • NIDA • Women who dance numerous hours for little pay on the block

  20. Risk Environment Conceptual Framework

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