Chicago researchers seek funding and partners to provide better outcomes for an overlooked population
Sex is a way of making a living for some. For others, it's a way of obtaining their most basic needs, like shelter, food and clothing. Survival sex workers, as they are known, are already a marginalized group, but male survival sex workers face unique challenges, including a high prevalence of mental illness and sexually transmitted infections. Little medical research exists on this population, but a group of researchers working at the Illinois Institute of Technology ( IIT ) is trying to learn more.
Culture and stigma make it difficult for male survival sex workers to obtain necessary healthcare, said Scott Noble, an outreach worker who specializes in work with the population. Noble, who worked as a survival sex worker in the past, has spent eight years providing outreach, serving on advisory boards, and conducting HIV testing for the state of Illinois.
He described the attitude surrounding male survival sex workers in the United States as "Suck it up. You're a man." Sensing disapproval, these men often withhold crucial information from doctors, leading to incomplete health checkups and, therefore, incomplete treatment.
Noble is working as the outreach worker for the IIT research team. The project seeks to convene a focus group of 25 male survival sex workers in Chicago. Noble will work with this group to learn about their health challenges and the challenges they experience in getting treatment.
Once the focus group is completed, the research team plans to develop a one-to-two-hour training curriculum for healthcare providers who are likely to serve male survival sex workers. The information gathered in the focus group will provide the team with a clearer direction for the training curriculum, indicating, for example, whether the curriculum should focus primarily on mental healthcare or physical healthcare.
Noble stressed that this particular project is still in its early stages, and the focus group will be the main source of research. It has some precedent though.
The project expands on findings from a survey conducted by Emmaus Ministries, a Christian outreach organization based in Chicago that serves male survival sex workers, explained Lindsay Sheehan, Ph.D., and the head of the IIT research team.
Working in partnership with Sheehan's team through funding from a Patient Centered Outcomes Research Institute ( PCORI ) grant, Emmaus surveyed 195 male sex workers throughout Chicago in 2016.
The survey revealed that 95 percent of the participants had been diagnosed or told they had a mental illness, most commonly bipolar disorder, depression, and addiction. Additionally, 60 percent reported a physical injury, and 65 percent reported experiencing a chronic illness in the past year. But the illnesses were only half the issue; the other half was getting the proper care for those illnesses.
Many participants reported obstacles to obtaining care, including lack of insurance coverage that would cover the treatment. Thirty percent were worried about experiencing judgment from others, preventing them from seeking care, and 39 percent reported having had negative experiences in doctors' offices and hospitals. ( Focus groups that Emmaus conducted stated that these negative experiences included doctors underestimating the patients' experiences as well as misdiagnosing ailments. )
To continue building on this research, the IIT team is currently seeking funding from the community, and is searching for potential healthcare agencies to partner with to test the training curriculum. If the curriculum is successful during its pilot test, the team would like to expand it to other healthcare agencies. They hope that it will increase providers' knowledge of male survival sex workers' needs, and generate more positive attitudes toward the population.
For more information and to donate, visit experiment.com/projects/engaging-male-survival-sex-workers-in-integrated-care-services.