Can the mining boom be blamed for the rising rates of sexually transmitted infections (STIs) in some states? The Australian Medical Association thinks so, with its Queensland president Dr Richard Kidd attributing rising rates of gonorrhoea, syphilis and chlamydia in Queensland and Western Australia to bored and cashed-up miners.
Kidd is not an isolated voice. Queensland Health Minister Lawrence Springborg recently blamed sex workers operating in mining regions for the doubling of HIV diagnoses in Queensland – from 2.7 per 100,000 population in 2001 to 5.4 in 2010.
These claims have been disputed by sex industry advocates who say commentators have got it wrong. Fly in fly out (FIFO) sex workers aren’t contributing to the problem – they’re part of the solution.
So who should you believe: the medical professionals and politicians or the sex worker advocates?
Double standards
Concern over sex workers and the spread of STIs has historically climaxed in periods of national crisis. During the second World War, for instance, the spread of venereal disease from sex workers was deemed “race suicide”: a threat to national security because of its capacity to diminish pools of fighting men.
Sex workers have since been regulated and punished in order to prevent the spread of STIs, while their clients escaped scrutiny. At the height of public concern over the HIV epidemic in 1985, the Sydney Morning Herald ran the headline “AIDS spread linked to prostitutes”. These claims were supported by some health professionals and resulted in widespread public concern and legislative changes, despite research at the time indicating most sex workers used condoms.
The latest available data (from 2005) shows HIV has not transmitted in a sex industry setting in Australia. In fact, Australian sex workers have very low rates of HIV and STI infection and high rates of condom usage.
Fit in, or f**k off
Fly-in-fly-out (FIFO) work has been blamed for a range of social problems in rural communities, ranging from increased littering, to violent crime. The social impact from the current mining boom appears to be mixed, however, with official crime rates falling in some communities.
But if offensive behaviour or crime has not increased, concern and fear has. FIFO workers often present as an outsider population, who have invaded once peaceful and harmonious rural communities. Worse still, they appear to contribute little to the community and make no effort to integrate. This situation is no better captured by the inversion of FIFO by locals to the slogan “fit in or fuck off”.
The open presence of sex in the neighbourhood represents a potential challenge to the moral fabric of generally conservative communities. In many ways, female sex workers come to symbolise a range of concerns associated with rapid change in regions affected by the mining boom. Concern is only furthered by reports that some FIFO sex workers may be based in foreign locations.
Rural sex work
When we think of sex workers we tend to think of urban settings. Despite this, sex workers have a strong association with mining communities.
When largely male populations first settled the frontiers in places such as Australia and the United States, sex workers were with them or closely followed them. As these places became more settled with the establishment of families and long-term residential patterns, the sex industry became less visible, moving from the main street to the margins of the community, becoming less visible in rural settings.
While brothels were the mainstay of the rural sex industry up until the 1990s, the introduction of the mobile telephone increased numbers of escorts working in rural locations as this technology allowed for sex workers to live outside of the small communities where they worked. The ability to work in diverse locations at relatively short notice, such as motels, mobile vans, also appealed to a small town clientele to whom discretion and anonymity were important.
Few sex workers conform to the stereotype of exploited, drug-addicted opportunists who work the streets. Those working on the streets account for approximately 10% of the sex worker population, with escort and brothel workers making up the bulk of the market.
For those entering into sex work on a full-time or long-term basis, contracting an STI or HIV is bad for business. Discretion is also important to success, especially in smaller regional communities.
Rising rates of STI and HIV
Increases in rates of STIs and HIV often pre-date the current mining boom and are not restricted to regions with mining growth.
Research shows safe sex compliance among both gay and heterosexual populations began to decline in the last decade, a phenomena witnessed in a number of western countries, with or without the mining boom. After twenty years of safe-sex education, researchers have noted a sense of information fatigue in some communities and disillusionment with safe sex cultures.
The growth of the internet also saw an explosion of subgroups seeking partners to intentionally engage in unsafe sex, a practice referred to as bare-backing. Such phenomenon has led researchers to re-evaluate traditional public health strategies.
Reversing the trend
Sex workers in regional and rural areas face a number of challenges due to isolation, occupational discrimination and confidentiality.
Sexual health clinics, if they exist at all, are likely to have highly restricted hours of operation. Access to condoms can be restricted by lack of an all-night chemist. Seeking help from a health professional might also be difficult because of a desire for discretion among both sex workers and their clients.
So it’s important not to stigmatise these sex workers, which may result in them being further isolated from resources and support services.
Of course, isolation, discrimination and confidentiality aren’t restricted to sex workers; these are problems for all members of the community. We need to be wary of presenting a narrow view of sexual health, which isolates broader community problems to subgroups within the population.