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Our chapter on clients who use the services of MSWs improves our understanding of this topic, although obvious gaps in our knowledge remain. Studies must go beyond finding out who clients are and explore the reasons they use male escorts, and we should advance our understanding of how such sexual relationships fit into these people’s lives. We urgently need to chronicle the real-life stories of both the male and female clients of male escorts so we can learn more through their experiences about the complex relationships between sexual fantasies, identity, and power. From a public health perspective, the exchange of fluid during sex represents not just intimacy but a health risk, yet we cannot accurately predict the desires and fantasies of clients and workers or what motivates them to engage in unprotected sex. Romance and sex are at the core of the human experience, and clients’ need for intimacy and fulfilment can sometimes overpower their need for protection. Moreover, some MSWs need to express their masculinity and dominance by penetrating a client without protection. By dint of such action, they gain control over a client, which enhances their sense of masculine pride and satisfaction.
The male sex industry has never been exclusive to Western society, and it definitely is not a phenomenon arising from the decadence of capitalism. The chapters in this volume have shown that MSWs are found in a range of sociopolitical and geographic contexts or situations. These include rural and urban environments, developing and developed countries, and countries with capitalist, communist, and dictatorial governments. MSWs are found in China, Russia, South America, Africa, and even the Middle East. However, how male sex work appears in the public view and how it unfolds as a commercial business differs between countries and cultures. Needless to say, the services of MSWs in every country and culture are sought by both men and women.
The existence of MSWs around the globe offers extensive opportunities for further research: What explains the similarities and differences in how the male sex industry is regulated in various countries? How do clients and sex workers view themselves and go about their business? How do men in different societies and cultures negotiate and reconcile contradictions in pleasuring themselves sexually? How is such behavior interpreted symbolically and politically? What are the consequences of male sex work? Studies of these and other topics would also shed light on the roles culture and religion play in shaping the sale of sex by men to men, and by male escorts to women. Such research would also provide further insights not only into the male sex trade but into the phenomena of sexualities, gender, and men’s health.
Finally, public health is of enormous and sometime even life-or-death importance. As shown in this book, the health of MSWs and their clients is intimately bound up with social attitudes toward sex work and same-sex desire. We therefore refer to health in the broadest sense and include issues of behavior, such as homophobic violence or other psychological or physical abuse of MSWs and their clients. The regulation of sex work often puts sex workers and their clients at risk of violence and other horrific health outcomes—behavioral, physical, and social. Ill-considered regulation can also discourage sex workers and their clients from using preventative aids to maintain good health. Research shows that countries that have decriminalized or legalized the sex industry have much lower incidence of HIV and sexually transmitted infections and more positive health outcomes for both MSWs and their clients (Ashford, 2009; Scott et al., 2006; Scoular & O’Neil, 2007). However, any changes to existing laws need to take into account the wide diversity of the sex work experience, including the many contexts in which sex work occurs.
Existing HIV prevention programs succeed in changing behavior only in highly motivated individuals. The AIDS epidemic is moving relentlessly into its next phase (Parsons & Bimbi, 2007), and intervention approaches are now urgently needed for men who intentionally engage in unsafe commercial sex. Internet and computer-mediated communications facilitate the growth of subcultural sexual behaviors, such as HIV-negative individuals seeking out HIV-positive partners (Tewksbury, 2003). Public health programs need to maximize their reach by understanding more fully how the Internet is used to promote harm-reduction strategies (Bauermeister, Giuere, Carballo-Dieguez, Ventuneac, & Eisenberg, 2010).In terms of public health, the explosion of social networking offers opportunities for collaborating, generating, and sharing interactive Internet content that relates to people’s lived experiences and encourages a participatory rather than a delivery model of health care.
Other challenges emerge from online interactions between MSWs and their clients. For example, some of the messages found on the website
Rentboy.com
hint at the willingness of some MSWs to consider having unsafe sex under certain circumstances with particular partners. We recognize that MSWs are marketing a range of services they think may bring in additional income and thus may be ambiguous about their willingness to have sex without condoms to attract clients who will pay more for such services. To be clear, implying that such sexual activity may occur does not necessarily reflect what actually will actually occur; thus this type of sexual service may be overemphasized at a time when people appear less concerned about unsafe sex. Nevertheless, there is an urgent need for studies that explore and explain individual MSWs’ motivations for offering and/or practicing unsafe sex or being ambiguous about their intentions, including studies of the circumstances of people’s most private lives. Successful public health campaigns need to understand the nuances of MSWs’ intentions or premeditation about safe-sex practices, and use health promotion and sexual messages that speak to the realities of MSWs’ complex and socially fueled but ultimately personal decision-making processes. And the fact remains that urgent advice about using a condom simply may not work with all people.
The male sex industry is a topic that provides both opportunities and challenges for researchers and society. Consistent, reliable data will help us understand more fully the demographic diversity of MSWs and their clients. Additional study will enable society to openly acknowledge that the male sex industry is larger and more widespread than heretofore believed, and that enormously diverse sexualities and sexual practices prevail. Increasing our knowledge of MSWs will help us learn more about the meaning of masculinity in the context of transactional sex and may have a critical impact on our understanding of sexual relations in the context of gender roles. The male sex industry will continue to create considerable challenges in the broader society, and some policymakers are responding creatively to issues related to public health, homosexuality, and the professionalization and commercialization of the male sex industry. One thing is certain: we can confidently say, as this book attests, that the male sex industry—which includes highly diverse men of all colors, shapes, and sizes who sell sexual services—deserves significantly increased funding for future research on the basis of public health alone. We hope this book will open new doorways to that future.
References
 
Ashford, C. (2009). Male sex work and the Internet effect: Time to re-evaluate the criminal law?
Journal for Criminal Law, 73
, 258-280.
Bauermeister, J. A., Giuere, R., Carballo-Dieguez, A., Ventuneac, A., & Eisenberg, A. (2010). Perceived risks and protective strategies employed by young men who have sex with men (YMSM) when seeking online sexual partners.
Journal of Health Communication, 15
, 679-690.
Han, C.-S. (2006). Geisha of a different kind: Gay Asian men and the gendering of sexual identity.
Sexuality & Culture, 10
(3), 3-28.
Logan, T. D. (2010). Personal characteristics, sexual behaviors, and male sex work: A quantitative approach.
American Sociological Review, 75
, 679-704.
Minichiello, V., Scott, J., & Saifur, R. (2012).
Safer sex intention in the male sex industry: New public health challenges?
Manuscript under review.
Parsons, J. T., & Bimbi, D. S. (2007). Intentional unprotected anal intercourse among men who have sex with men: Barebacking. From behavior to identity.
AIDS and Behavior, 11
, 277-287.
Scoular, J., & O’Neil, M. (2007). Regulating prostitution: Social inclusion, responsibilization and the politics of prostitution reform,
British Journal of Criminology, 47
, 764-778.
Scott, J., Minichiello, V., Marino, R., Harvey, G., Jamieson, M., & Brown, J. (2006). Understanding the new context of the male sex industry.
Journal of Interpersonal Violence, 20
, 320-342.
Solorio, R., Swendenman, D., & Rotheram-Borus, M. J. (2003). Risk among young gay and bisexual men living with HIV.
AIDS Education and Prevention, 15
(Suppl. A), 80-90.
Tewksbury, R. (2003). Bareback sex and the quest for HIV: Assessing the relationship in Internet personal advertisements of men who have sex with men.
Deviant Behavior, 24
, 467-483.
Walby, K. (2012).
Touching encounters: Sex, work and male-for male Internet escorting
. Chicago: University of Chicago Press.
Wilson, P. A., Valera, P., Ventuneac, A., Balan, I., Rowe, M., & Carballo-Dieguez, A. (2009). Race-based sexual stereotyping and sexual partnering.
Journal of Sex Research, 46
, 399-413.
Endnotes
 
1
      Symbolic interaction theory is a major sociological current of thought that originated at the University of Chicago in the social-psychological writings of Blumer, whose school of thought and its offshoot, social constructionism, have furnished qualitative sociology with a useful and now widespread perspective on social problems. Interactionists focus on the subjective meanings that people give to objects, events, and human behavior. They give priority to subjective meanings because they assume that people behave on the basis of what they believe or claim, rather than what might be objectively true.
David S. Bimbi
is an Associate Professor of Health Sciences at LaGuardia Community College and a Faculty Affiliate of the Center for HIV/AIDS Educational Studies & Training (CHEST) of the City University of New York. He is a social psychologist specializing in behavioral health, specifically among lesbian, gay, bisexual, and transgender populations. Dr. Bimbi was inducted into the International Academy of Sex Researchers in 2011.
Paul Boyce
is a lecturer in the Department of Anthropology at the University of Sussex School of Global Studies. He works internationally on issues of sexuality, health, and rights. His particular interest is in ethno-graphic approaches to sexual subjectivity, intimate life worlds, and sex work.
Denton Callander
is a research officer at the University of New England and a project coordinator at the University of New South Wales. His work explores the areas of sex, sexuality, and sexual health using complementary qualitative, quantitative, and mixed methodologies.
Heide Castañeda
is Associate Professor in the Department of Anthropology at the University of South Florida. Her research focuses on health inequalities related to unauthorized migration, especially the analysis of legal status and constructs of citizenship. Her work has appeared in numerous journals, including
Social Science & Medicine, Journal of Health Care for the Poor and Underserved
, and the
American Journal of Health Behavior
, and several collected volumes.
Thomas Crofts
is Associate Professor of Law and Criminology and Director of the Sydney Institute of Criminology at The University of Sydney. His research in criminal law, criminology, and criminal justice centers on criminalization and criminal responsibility, with a particular interest in the criminal responsibility of, and for, children, comparative criminal law and law reform, and the relevance and role of labeling. In 2011 he was awarded the Australia and New Zealand Society of Criminology’s inaugural Adam Sutton Crime Prevention Award.
Carlos Disogra
is an Adjunct Professor of Introductory Psychology in the Faculty of Psychology at the National University of Cordoba in Argentina. His research on male sex workers and the general population is focused on understanding condom use and HIV prevention.
Tinashe Dune
is a lecturer in interprofessional health sciences in the University of Western Sydney’s School of Science and Health, and an Honorary Research Associate with the Australian ICF Disability and Rehabilitation Research Program at the University of Sydney and the Collaborative Research Network Mental Health and Well-Being at the University of New England. Her work focuses on sexual marginalization and health inequities, including the phenomenological experiences of sexual health and cross-cultural understandings of sexuality.
Graham Ellison
is a reader in criminology at the Queen’s University School of Law in Belfast, Northern Ireland. He is currently heading a research study funded by the British Academy to investigate the policing and regulation of prostitution/sex work in four EU jurisdictions, including Belfast, Prague, Manchester, and Berlin. He is the coauthor of
The Crowned Harp: Policing Northern Ireland
(with J. Smyth) and
Policing in an Age of Austerity: A Post-Colonial Perspective
(with M. Brogden).

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