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Prostitution and its link to Sexually Transmitted Disease and Mental Illness

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Scanning electron micrograph of HIV-1 budding from cultured lymphocyte."  courtesy of CDC Pubic Health Image Library (PHIL)

    Prostitution has been around since the creation of people, and its said to be  “one of the oldest of professions.”  (5)  The currency used may fluctuate from food and shelter to money but the act in itself is ultimately the same.  Prostitution is defined as the “act of granting sexual access for payment.  Although most commonly conducted by females for males, it may be performed by females or males for either females or males.”  (1)  Along with being ostracized by society, in the field of prostitution, then "Prostitutes are at risk of violent crime,[13] as well as possibly at higher risk of occupational mortality than any other group of women ever studied. For example, the homicide rate for female prostitutes was estimated to be 204 per 100,000 (Potterat et al, 2004), which is sometimes higher than that for the next riskiest occupations in the United States during a similar period (4 per 100,000 for female liquor store workers and 29 per 100,000 for male taxicab drivers) (Castillo et al., 1994)"  (3)  This act of social deviancy has brought negative feelings throughout the centuries.  The cause of prostitution in many cases seems to be lust on behalf of the man and a need for survival on behalf of the woman.  This is the common viewpoint, and exploitation of women is a very negative factor in the act of prostitution, but it’s also true that men are exploited as well.  One may think of a man being the ultimate beneficiary in this negative act of a woman selling her body for money, but there must be a reason why men would pay for something that is supposed to be done only in a loving relationship.  Without men willing to pay, then there wouldn’t be prostitution.  In the 21st century, the United States has supposively made prostitution illegal in every state except Nevada but strip clubs and massage parlors are legal.  In my opinion, these places are the same as the brothels in Nevada except that the police raid these areas every once in a while just to make city officials look good.  Its ridiculous how something like this can go basically unregulated.  Basically men must enjoy this behavior, and want to give their money away and ruin their families.  Or maybe there’s another reason for this immoral behavior.  From my point of view, I couldn't imagine seeking out another women and paying her money in exchange for sex especially if I was married or had a girlfriend, but a lot of happily married men seek this activity outside of the home.
   
    The causes for a person to subject themselves to prostitution, and ultimately selling their bodies to another person, may have a broad range of causes.  A number of factors may be involved which may include desperation, low self-esteem, being forced into it, drug addiction, and in some occurrences it may be caused by pure greed to make money by doing something that may be considered effortless in their minds.  There are two sides to prostitution; that of the seller and that of the buyer.  The focus on most research is why the seller engages in this heavily disdained activity but there wouldn't be a seller if there wasn’t a buyer.  The person seeking out sexual companionship from another, and willing to pay for this service should be the real focus of future research because if people are taught to see this as an awful part of society, then prostitution can be decreased in much the same way that the focus on drug addiction seeks to prevent letting controlled substances ruin someone’s life.  Prostitution seems to exist all around the world; from the richest countries to the poorest countries.  Laws in the United States are in effect to make prostitution illegal, but through the use of a variety of schemes, it seems to be just as legal and attainable throughout the U.S. as it is in other countries in Europe where it is legal.  Through the use of escort services, massage parlors, call girls, and strip clubs then the illegal act of prostitution has become seemingly as acceptable as marijuana drug usage. (http://en.wikipedia.org/wiki/Prostitution)  People like to say it’s a victimless crime between two consenting adults, but in most situations even if both people consent to it, then there is regret afterwards for one or both parties.  The victim is the participant’s mental health, and the degradation of mental sanity in one’s life can lead to a vast assortment of psychological issues which may include financial failure and failed relationships.  Increased mortality may also be a result of mental illness, not to mention increased mortality causes by Sexually Transmitted Infections (STI's).  "Some prostitutes’ explanation for becoming involved in prostitution include “having a history of sexual abuse, having grown up without love from the significant adults in their lives, being enticed by a male of female friend or by peer pressure from a group of friends, and needing money. Those who used drugs prior to their involvement in prostitution activities mention their addiction as a major reason for trading sex for money or drugs.”" (8)  A woman who is forced into prostitution is a victim of sexual abuse, and basically rape.  Its an awful situation when a woman is manipulated into doing something that she’ll regret for the rest of her life. 
   
    The "john", or the buyer, in the event of prostitution where a man buys sex from a woman ultimately is the one who holds the key in decreasing this indiscretion in society.  The causes for men to exhibit this behavior may be caused by a mental illness factor, and some men may have been sexually abused as children which causes them to have this constant need for sexual activity with not just their spouse but with other women as well.  There are many causes for adult sexual behavior ranging from past life experience to just an innate need for lust.  Sex in mammals is used for reproduction, and the driving force for this is the ultimate pleasure that is obtained from this.  To exchange money, or other goods, for pleasure is completely acceptable when it comes to buying food, seeing a movie, and countless other socially acceptable pleasures.  Religiously speaking, without quoting the bible, it’s basically wrong to have sex outside of a marriage and many societies have strict laws to punish certain indiscretions.  But, it has become socially acceptable in the U.S. for men to look at women and have multiple relationships with more than one woman.  This social acceptance of sexual promiscuity and its continued degradation upon society allows for men to justify their need to be with more than one woman.  It’s henceforth, a niche that is filled by women in the field of prostitution.  But, most men have never been with a prostitute and a lot of men have never even been to a strip club.  So, is it a certain type of man who would falls into this desperate move of paying a woman for sexual pleasure rather than go through the proper protocol of courtship?  Is it that certain men are vulnerable to this temptation, or could it be that mental illness plays a role as the motivating factor? In much the same way that some people are more susceptible to becoming alcoholics or drug addicts, it could be that people who succumb to soliciting prostitution are just as vulnerable.  Prostitution should be seen as a pandemic that's causing societal immorality, and needs to be handled just as seriously as any other crime.  When someone is caught selling drugs, then the judge will through the book at this person.  Maybe, it’s too harsh to put a person jail for 5 years for prostitution; but maybe new laws need to be passed so that it’s slowly implemented so that people can realize that it’s just as bad as any other crime, and that the result could be death if an incurable infectious disease is transmitted.  With HIV, there's no current cure as of yet but with trials for vaccinations then it probably will be eradicated from earth in the future.  But, microbes are always evolving, and another infection will take its place so there's no cure for evolution and the only way to solve this problem of STI's is prevention. 

    The effects of prostitution are disastrous in many cases, and disease transmission will ultimately reduce the quality of life for those involved.  Aside from disease, depression stemming from the stigma of being called a "whore" and having giving something sacred to a man in exchange for money will cause one's mental health to be compromised.  Throughout one's life, they will live with knowing what they've done.  It’s like a criminal who repents for his or her crime for the rest of their life; it’s something that can change a person's whole view on life and upon their self-worth.  When it comes to getting a real job, then the expectation of opportunities will be diminished and medial jobs will be accepted, and become accepted as the expected outcome in their life.  The reduced opportunities for healthcare upon retirement age will correspondingly reduce the access to preventive healthcare options and result in higher mortality rates upon former prostitutes.  Other negative effects of prostitution exist in the fact that prostitution can actually lead to further criminal activity, and this is described by the fact that "Prostitution is often the gateway crime for women (Chesney-Lind, 1997). It has been reported that 70% of female inmates in American prisons were initially arrested for prostitution (Boyer & James, 1983, p. 131)." (6)  This alarming fact shows how prostitution will change someone’s behavior, and lead them down a path of self regret and certain negative consequences.  Prostitution is in many ways similar to drugs; its starts small and snowballs into a horrible ending.  In cases of voluntary prostitution, then it basically starts out of pure desperation for money, drugs, or even just a place to live.  Like, a young adult who has left his or her parents’ house because of an assortment of reasons may encounter a variety of possible problems when prostitution seems to be the only way to survive and this can be described in the way that “Homeless youth who trade sex are likely to experience numerous negative health outcomes, such as being sexually victimized, attempting suicide, being depressed, contracting sexually transmitted diseases, and becoming pregnant, among others” (8)

    In some countries prostitution is legal, and it’s even taxed like any other profession, but in the United States it’s supposed to be illegal in all 50 states plus Puerto Rico and US territories except for parts of Nevada. Through the use of openly accepted manipulations of the law, prostitution is basically openly practiced throughout the United States by the use of massage parlors, escort services, and obviously by women on the side of the streets.  When thinking of smoking, then it’s openly known that it causes cancer and it’s just bad for your health but it’s legal.  Bars and nightclubs serve alcohol, and people have to drive home afterwards so where's the sense in that?  It’s ridiculous how such public health risks are basically allowed in society even though they have caused numerous fatalities, and destroyed millions of lives.  The transmission of disease during transactional sex has a correlation with respect to where the transaction of prostitution occurs.  Like, if a prostitute engages in this activity on the side of the street there's a much lower occurrence of condom usage as compared to prostitutes who work in a controlled environment such as a brothel.  This phenomenon of transactional sex, and its relation to disease transmission can be depicted as "Those with a lower socioeconomic status were more likely than those with a higher socioeconomic status to be infected with HIV-1 (17 versus 4%), syphilis (66 versus 24%) and hepatitis B (52 versus 26%), but there were no differences in prevalence rates by city." (4)

    When the word prostitution is said, then people think of women on the side of the street at night, but that's only one part of the problem.   This societal illness involves both men and women selling their bodies; both heterosexual and homosexual.  Especially, with the way society views gay men, then it’s obvious that a lot of men in this situation do not see themselves as having a viable choice of being able to just tell their families that they're gay.  For this reason, it’s a classic example of how such sexual needs would cause such men to engage in prostitution.  Homosexuality is not a mental illness from a psychological viewpoint since there's no way to correct it, but from a biological viewpoint, then it would inhibit reproduction which is the main goal of life.  People may see life as an endless world of optimistic possibilities, but from a biological viewpoint then its really not; the goal of all life forms is to reproduce and that's why such strong sexual desires exist in all life forms and its the foundation for evolution in itself.  Prostitution is an evil byproduct for the need for this sexual desire, and it promotes destruction of the normal criteria needed to build a family that can be nurtured and prepared for further reproduction.   Male sex workers encounter the same diseases as female sex workers, but certain problems that females may have with respect to be forced into it are less prevalent.  (9) The use male prostitutes is something more private, and not glamorized in society since many of the clients for male prostitutes are also men.  This world is more discreet, and not talked about nor examined by society. 

        A darker side of prostitution even worse than the mental manipulation of women into this horrible field of making a living is that of sex trafficking which is the blatant use of force to make women sell their bodies for money.  Its basic slavery, and a purely despicable action by people so they can make money by selling other people's bodies.  This disgusting use of sex slavery can be described as "Trafficking across or within national borders for purposes of sexual exploitation including forced prostitution, ie, sex trafficking, is recognized as a major gender-based human rights violation with significant individual and public health consequences1-2 and is increasingly discussed as a potentially critical mechanism in the spread of human immunodeficiency virus (HIV) across developing nations." (2)  Forceful trafficking of young women to fulfill the needs of sick men has resulted in the increased transmission of HIV.  The young women who are trafficked into this situation are victims, and they undergo unimaginable pain both physically and mentally.  Its simply inconceivable that a person could treat another person in this manner when the same men who pay for sex, and force women to do it without condoms, would be the same men who would take violent action if someone even looked at their sisters and mothers in a perverted manner.  Sexual transmitted infections have plagued those who prefer promiscuity since the beginning of man and "Among 287 repatriated Nepalese sex-trafficked girls and women, 109 (38.0%) tested positive for HIV. Among those with complete documentation of trafficking experiences (n = 225), median age at time of trafficking was 17.0 years, with 33 (14.7%) trafficked prior to age 15 years. Compared with those trafficked at 18 years or older, girls trafficked prior to age 15 years were at increased risk for HIV (adjusted odds ratio [AOR], 3.70; 95% confidence interval [CI], 1.32-10.34), with 20 of 33 (60.6%) infected among this youngest age group. Additional factors associated with HIV positivity included being trafficked to Mumbai (AOR, 4.85; 95% CI, 2.16-10.89) and longer duration of forced prostitution (AOR, 1.02; 95% CI, 1.01-1.03; indicating increased risk per additional month of brothel servitude). In post hoc analyses, girls trafficked prior to age 15 years had increased odds of having been detained in multiple brothels (odds ratio [OR], 5.03; 95% CI, 1.96-12.93) and in brothels for a duration of 1 year or more (OR, 2.67; 95% CI, 1.12-6.33) vs those trafficked at 18 years or older."  Therefore, the incidence rates of HIV infection increased dramatically with respect to the factors of the age of young women when forced into sex slavery, and with respect to how many brothels they had been forced to work at.  These rates will ultimately increase mortality rates as the immune response is suppressed by HIV giving way to opportunistic infections, and causing decreased life expectancy in these young women.  The men who contract this virus will spread it to their wives, and it just causes an epidemic of senseless heart break and all because these promiscuous men couldn't control themselves.  "Human trafficking is the fastest growing form of modern day slavery[15] and is the third largest and fastest growing criminal industry in the world." (6) The mental health of those who are forced into sex slavery can be permanently destroyed by the fact that  “Physical and sexual abuses may start early in the travel/transit stage of trafficking with pacification and brainwashing of victims through repeated raping, physical assaults and food and sleep deprivation” and these actions will create a decline in mental health in such a way that this “...social restriction and marginalization overlap with psychological abuse, further jeopardizing women’s mental health” (10)

    The pandemic of prostitution seemingly will never end as long as people innately have a promiscuity gene and as long as economically suppressed people need basic essentials in life like food and water.  A way of helping to reduce sexually transmitted infections may be by government regulation since it’s probably not feasible to expect that people will marry just one person and always live happily ever after.  Monogamy can be seen as a preventative measure along with the use of contraceptives.  In an effort to combat sexually transmitted diseases such as HIV, billions of dollars have been designated in efforts to prevent disease transmission and this can be represented as "Within the detailed plan, Congress expressed concern about the social, cultural, and behavioral causes of HIV, specifically naming prostitution and sex trafficking as among the behavioral forces behind the spread of the virus. This legislation advanced a new policy goal for the US: the global eradication of prostitution [1]."  (7)    Monetary funds have been set aside to help fight the transmission of HIV in particular, and with prostitution being the most heavily used vector for transmission of HIV, then efforts are being sought to destroy the practice of prostitution.  The monetary amounts can be represented by the fact that "In January 2003, United States President George W. Bush announced the President's Emergency Plan for AIDS Relief (PEPFAR), the appropriation of $15 billion dollars for programs to combat the global HIV/AIDS epidemic, in his State of the Union address." and further amounts have been designated as well in a diligent effort prevent and cure the world of such massive pain and suffering.  The laws throughout the world should be changed, and prostitution should be abolished, and blatantly illegal the same way slavery is.

1.  http://www.questia.com/library/sociology-and-anthropology/criminology-and-crime/sexcrimes/prostitution.jsp?CRID=prostitution&OFFID=se1&KEY=prostitution_history

2.   Jay G. Silverman, PhD; Michele R. Decker, MPH; Jhumka Gupta, ScD, MPH; Ayonija Maheshwari, MD, MPH; Brian M. Willis, JD, MPH; Anita Raj, PhD   2007
 HIV Prevalence and Predictors of Infection in Sex-Trafficked Nepalese Girls and Women.  JAMA. 298:536-542.

3. Wikipedia  http://en.wikipedia.org/wiki/Prostitution

4.  Lurie P, Fernandes ME, Hughes V, Arevalo EI, Hudes ES, Reingold A, Hearst N. 1995  Socioeconomic status and risk of HIV-1, syphilis and hepatitis B infection among sex workers in São Paulo State, Brazil. Instituto Adolfo Lutz Study Group. AIDS. Jul;9 Suppl 1:S31-7.

5.   Hickenbottom, Iris Leos  2002.  Prositution: Then and Now.  Utexas.edu

6.    http://www.wmich.edu/~destiny/statistics.htm

7.  Nicole Franck Masenior* and Chris Beyrer  2007  The US Anti-Prostitution Pledge: First Amendment Challenges and Public Health Priorities  Public Library of Science  v.4(7); Jul

8.  Tyler, Kimberly A.; Johnson, Katherine A.  2006
Trading Sex: Voluntary or Coerced? The Experiences of Homeless Youth.  Journal of Sex Research.  Aug2006, Vol. 43 Issue 3, p208-216, 9p

9.  Philip A Chan1 and Omar A Khan  2007 Risk factors for HIV infection in Males who have Sex with Males (MSM) in Bangladesh  BMC Public Health. 2007; 7: 153.

10. OLGA GAJIC-VELJANOSKI & DONNA E. STEWART
Women Trafficked Into Prostitution: Determinants,
Human Rights and Health Needs.  TRANSCULT PSYCHIATRY 2007; 44; 338