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NCBI Bookshelf. In the beginning stages of the AIDS epidemic, many people feared that female prostitutes would become widely infected and spread the AIDS virus to their male clients. The evidence instead suggests that prostitutes' risk of transmission is more closely associated with drug use than with multiple sexual clients. The evidence also indicates that the risk of transmission through sexual contact is greater in the personal relationships of female prostitutes than in their paying ones.
For this reason, and because the future dynamics of the epidemic are still unclear, there is a continuing need to monitor any future role that prostitution may play in transmitting HIV. As is the case for other individuals believed to be at-risk for HIV infection, the design of effective intervention strategies should be informed by an understanding of the risk-associated behaviors of the prostitute and her partners, as well as the conditions under which the behaviors occur.
Unfortunately, information about women who work as prostitutes is scant, and knowledge of their clients is sketchier still. Moreover, such studies cannot provide an accurate estimate of the number of women who work as prostitutes. Little is known about the occupational histories of prostitutes, but anecdotal evidence suggests that this is a dynamic population.
In the following section, the committee reviews the literature on prostitution as it relates to the AIDS epidemic in the United States. In presenting this overview, the committee wishes to emphasize that our understanding of this population is far from complete and our knowledge of the widely varied contexts in which its members work is limited.
Caution must thus be exercised in deriving generalizations from the findings presented below. Although all prostitutes share the common characteristic of exchanging sexual acts for some kind of payment, there is in fact great diversity in all aspects of the social organization of prostitution and its relations to the larger society in which it is embedded.