Case Studies: Joe Zunt

Sam Clark    |    Jonathan Gorstein - Abstract    |    Jonathan Gorstein - Outline    |    Anne Marie Kimbal    |    Ann Kurth
Martina Morris    |    Beth Rivin    |    Bettina Shell-Duncan    |    Clarence Spigner    |    Joe Zunt    |    Combined

Sex (workers) and the city

Abstract

Under's criminal legislation, prostitution is not classified as an offense for persons who engage in it and are eighteen years of age or older. However, any person promoting or favoring the prostitution of another will be sentenced to a prison term of not less than two nor more than five years. The Barton Clinic in, is one of four reference centers for sexually transmitted infections (STI) in the metropolitan area. Under a national program organized by the Peruvian Ministry of Health’s Program for the Control of STI and AIDS (PROCETSS), the Clinic provides free periodic medical attention to female sex workers, including clinical evaluation, diagnostic testing and counseling services every 28 days.Each woman receives an official stamp on her carnet after each screening that she is required to show the brothel owner prior to renting a room for the day. The ability of the Clinic to offer diagnostic and treatment services depends upon availability of laboratory reagents, antibiotics and equipment from the Ministry of Health. Periodic shortages can limit the Clinic’s ability to provide some diagnostic services. The laboratory staff at the Clinic has adapted to deficiencies of equipment: lack of an ELISA reader for HIV testing means that ELISA results are interpreted manually; a broken incubator means that diagnosis of gonorrheal infection is based on Gram stain rather than culture.The centrifuge in use no longer functions correctly.

After an afternoon of screening female sex workers for STI in the public health clinic, the social worker, physician and laboratory technologist have just enough time to grab an Inca cola and snack from a street vendor before loading up the mobile medical van with educational brochures and supplies before heading out to set up a temporary examination room in a nearby hostel.The social worker approaches a young woman standing on the corner outside a bar. Once the social worker identifies herself as part of a public health team providing healthcare to female sex workers, the young woman accepts an invitation to discuss STI and receive a gynecologic examination. The young woman is 16 years old and has heard of HIV and syphilis, but is unable to name any other STI or note what symptoms such infections may produce. She states she tries to use condoms with clients when condoms are available and the client is willing. Sometimes she’ll have sex without a condom if the client agrees to pay a higher price. She is the third of five children and completed grade school; her siblings earn money by selling newspapers and toys on the street corners. Her father is away most of the year working in the copper mines but occasionally sends money home to buy food. The examination does not reveal an STI, but her pregnancy test is positive.

Disciplinary perspectives:

Public health, Public policy, International law, Medicine, Social work

Objectives:

• Discuss effective approaches to surveillance and treatment of sexually transmitted infections in high risk populations and their clients.
• Evaluate the impact of Peruvian law on access to care for commercial sex workers.
• Examine how Peru has adopted aspects International law regarding sex workers.
• Identify impediments to health care access for adolescent sex workers.
• Explore how social service agencies and NGOs could provide useful services to CSW