Increase in monkeypox concerns sex workers

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With monkeypox on the rise, Lady Kay decided to stop visiting customers in hotel rooms or private dungeons.

Domintrix, 32, was already taking precautions to protect herself from the coronavirus, insisting that clients show they were vaccinated against COVID-19 or had recently tested negative. Now a South Los Angeles resident was concerned about the latest outbreak – a contagious virus that can travel through skin-to-skin contact and is spread through intimate encounters.

“I want to get more to make sure my limbs are covered,” said Lady Kay, a transgender woman who asked to go by the pseudonym she uses for sexual function. “And I definitely want to wear gloves in a more discreet way—latex gloves. Which adds to the aesthetic anyway.”

As monkeypox spreads in Los Angeles and across the country, sex workers have fretted about how to protect themselves from a virus that can cause excruciating wounds and people are forced to isolate for weeks. can force.

The virus has hit mainly gay and bisexual men so far, but the rise of monkeypox has worried Angelinos of other genders and orientations who make a living from sex work – an umbrella term that includes stripping, in adult movies or performing on webcam, and others. as selling sexual services. Many remember the historical trajectory of HIV infection.

“On the streets, they’re not thinking that it’s just someone who has sex with another person,” said Trisonda Marbury, Senior outreach coordinator with Project SHEE, a sex worker outreach program under the non-profit Sistahfriends Women’s Counseling and Eldercare Management. After seeing how HIV got into other groups, “with monkeypox, they’re like, ‘We’re not falling for this.'”

Marbury, who rose early to distribute condoms and other care supplies to sex workers on Western Avenue, cautions them to keep their clothes on as long as possible. “It’s not your personal partner. Taking off the clothes is not a part of whatever conversation you have,” she said.

Activists are already familiar with condoms to protect against many infections, but Marbury also advises them to “keep hands off” as much as possible during their conversations. Yolanda Whittington, The chief executive of Sistahfriends said his group is encouraging sex workers to check for bumps or boils on clients.

If clients insist for more physical contact, “What we’re telling our sex workers to do is really stick with them – ‘Look, given that the risk of monkeypox has gone up, we don’t want to. That you are at risk, we don’t want to be at risk. We are changing things,'” Whittington said.

In Los Angeles, sex workers have quickly become aware of monkeypox, but many of them “don’t know much about how to keep themselves safe,” says Kimberly Fuentes, services and outreach director of the Sex Workers Outreach Project Los Angeles. he said.

Health officials say the virus can be spread through close or continuous skin-to-skin contact during sexual activity. The rapid rise in US cases has given rise to the question of whether oral and anal sex itself is increasingly transmitted through semen and other bodily fluids, with some experts Arguing that the way it is spreading is analogous to a sexually transmitted infection.

Other experts have suggested that monkeypox may be spread more easily during sexual encounters because infectious lesions in the rectum or urethra can be particularly difficult to detect – meaning a person may not realize that They have the virus until the rash spreads beyond the genital and anal areas. ,

Several health officials and community groups have warned against counting other forms of potential exposure associated with skin contact: a person Speaking said at a recent legislative hearing that he contracted the virus after hugging and kissing a friend on the cheek.

The Sex Workers Outreach Project Los Angeles has tried to emphasize the term “intimate contact” rather than sexual contact, to make sure sex workers understand the risks of infection, Fuentes said.

For Devine, an exotic dancer who works in Los Angeles, “there’s always a layer of touching,” with clients’ hands regularly placed on their hips, arms, or their chest. “It’s a necessary component of dance and my work,” said the dancer. Backing out physically means losing out on tips financially, especially with business already slowing down in recent months.

So “I haven’t really done anything different” as cases of monkeypox increase, said Devine, who is non-binary and asked to be identified by his stage name. The 23-year-old is worried about what would happen if they contract the virus, suffer sores, and end up with scars. “I’m exposing my body in a semi-naked bikini. … It would definitely strain my confidence as a dancer.”

Selena, who works at a strip club in Los Angeles, lamented that “screening clients can be difficult because the club’s lighting is so low. … What should I do if the customer has monkeypox while I am dancing?”

“There’s not a lot of literacy about it, so I wouldn’t be surprised if a customer was carrying it and was completely unaware,” Selena said in an email.

Another dancer working in Los Angeles and Las Vegas, who requested anonymity due to concerns about employer retaliation, said skin contact is inevitable in jobs that involve pole dancing and laps topless or in lingerie. dance is included. The activist, who is non-binary, said his pleas for club managers to better clean and remove the VIP rooms had been turned down.

“It’s as if we are seen as disposable,” said the dancer. Trying to avoid touching would mean “I will lose 95% of my income.”

Fuentes said his group wrestled with how to make recommendations that were relevant and useful to a wide range of sex workers., For example, Lady Kay has contemplated the idea of ​​manipulating the space to be neat and tidy before meeting a polite client.

As a dominatrix, she doesn’t do anything that involves penetrating or touching her genitals. But she knows that some other sex workers “generally can’t say much about how their bodies are touched and how exposed their skin is – which puts them in a more dangerous position than me.”

After waiting in line outside the Crenshaw Boulevard clinic for hours in a long-sleeved shirt on a hot day, Lady Kay gets her first dose of the Genos vaccine to protect herself from monkeypox. Project She’s Marbury said it can be difficult for many sex workers to find time to get a monkeypox shot, especially if they sleep during the day and work through the night.

“It’s not like a COVID vaccine, where you can just go to CVS,” Marbury said.

Until recently, many sex workers in Los Angeles County were not eligible for the vaccine, which was determined Criteria Concerns about the short supply of the vaccine to offer them limited people – mainly gay and bisexual men or transgender people with other risk factors.

LA County public health officials said even after distributing the dose To increase the supply, they only have enough vaccine for a fraction of the people who are believed to be most at risk. The Jynneos vaccine is given in two shots spaced several weeks apart.

As of mid-August, a county health department spokesman said the current supply could only fully vaccinate about 5% of the estimated at-risk population and give the first dose to about a third of that group — including men. Defined as having sex with men who are either HIV positive or eligible for medication to prevent HIV.

With a limited supply of vaccines, “you have to prioritize the highest-risk populations,” said Dr. D., clinical professor of population and public health sciences at USC’s Keck School of Medicine. Jeffrey Klausner said. In Sex Workers, “these are male sex workers and transgender female sex workers.”

LA County updated its guidelines on Monday, however, adding that the vaccine can be given to anyone who has engaged in a commercial or transaction in the past two weeks — regardless of gender or sexual orientation.

Although men make up the vast majority of reported cases so far—98% in LA County as of Friday—”we know it’s only a matter of time before we see a more diverse population being affected,” Susie Baldwin, medical director of the Office of Women’s Health at the Los Angeles County Department of Public Health.

The county has worked with groups that organize and advocate to help provide sex workers with information about the virus and how it spreads, but “the challenge, of course, is that many people in this population are hiding.” Has happened.”

“We are concerned about people who are not listening to the message,” Baldwin said.

The move to expand vaccine eligibility in LA County was praised by Performer Availability Screening Service Inc., an organization focused on the health and safety of workers in the adult industry, which has argued that sex workers regardless of gender are at risk.

Because jobs in the industry often involve skin-to-skin contact, “it is very important that all genders who do such work in order to survive have the health resources (namely vaccines) necessary to stay safe as much as possible.” have access to it.” Pass spokesman Siouxi Q said in an email.

The group has prepared guidelines Partnered with the Los Angeles LGBT Center to reduce the risk of monkeypox during the shooting of adult films and more recently to provide vaccinations to sex workers. Among those who were able to get a shot was Daddy Ann Lee, a Dominatrix working in Los Angeles.

“Often, the people I see are men who secretly have sex with men,” said Domintrix, who identifies as gendered, meaning there’s fluidity in her gender identity. . “I understand you want to go for the most at-risk population — but to assume that gay men and trans people only stick to their corner of the population seems out of date to me.”

Some have argued that vaccination rules should be relaxed to remove the stigma about getting the shot.

Artist and activist Soma Snekoil fears “people are being targeted as if they are trans or sex workers to get the shot” and has urged health officials to offer other vaccines at each site, so It is not clear whether one is to get the monkeypox vaccine.

“When you target people who are already criminalized or marginalized for public health, you really increase the stigma about infectious disease and our communities are to blame,” said Soma Snekoil, who leads the Sidewalk Project. Key, which assists sex workers, which helps homeless people who use drugs. And people are facing crisis regarding their mental or physical health. “And then the violence against people escalates.”

“Most people – especially non-domesticated people – are doing sex work for survival,” she said. “They can’t stop doing sex work just because a disease strikes.”

Times staff writer Rong-Gong Lin II contributed to this report.

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