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Some months ago a young woman came to see me who had just turned 18 — and had been questioning her sexual orientation for years. She had been attracted to girls since she was at high school, but she had had sex with both girls and boys. She now believed she preferred girls, but how could she be a lesbian when she had also slept with boys? Her friends told her she was bisexual, but she didn't like to be labelled.

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Performed the experiments: CB. Data are available from the Alfred Hospital Ethics Committee for researchers who meet the criteria for access to confidential information, due to restrictions outlined in the consent form.

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Interested researchers may contact Kordula Dunscombe of the Alfred Hospital Ethics Committee if they would like access to the data ua. Fifty-five women working in the indoor sex industry in Melbourne, Australia, were recruited to complete a self-report questionnaire about various aspects of their work, including the impact of sex work on their personal relationships.

Questionnaires were completed anonymously and included both closed and open-ended questions. A small of women reported positive impacts from sex work including improved sexual self-esteem and confidence.

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Seventy-seven percent of single women chose to remain single due to the nature of their work. Many women used mental separation as a coping mechanism to manage the tensions between sex work and their personal relationships. Member checking validated the accuracy of the questionnaire data.

The findings of this study support the need for further studies to be undertaken to determine if the findings are reflected in a larger, more representative sample of Australian sex workers and should be considered in the context of any future intervention and support programs aimed at addressing the tensions sex workers experience between their work and personal relationships. Greater public awareness and education programs aimed at addressing the negative stigma associated with the sex industry may go some way towards easing the issues faced by women in their personal relationships.

Sex work involves one or more services where sex is exchanged for money or goods [ 1 ].

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Sex workers however are not a homogenous group [ 23 ]. Past research has shown both street sex workers and indoor sex workers have commonly experienced high levels of abuse in childhood and adulthood [ 5 — 10 ]. While rates of abuse and trauma are lower for indoor sex workers than street sex workers, they are still higher than the general population [ 10 — 13 ].

Sex workers commonly face ificant stigma related barriers regardless of where they work, due to their perceived violation of gendered norms through sex with multiple partners and strangers, taking sexual initiative and control, inciting male desires, and receiving fees for sex [ 14 — 16 ]. In Victoria, under the Prostitution Control Actindoor sex work in a d brothel, escort agency or private setting is legal, however street based sex work remains illegal [ 21 ].

As part of legislature, indoor sex workers cannot knowingly work with a sexually transmitted infection STI and are required to have three monthly STI testing and provide a certificate to work [ 22 ]. Information from the AIDS Council of NSW a state in Australia suggests approximately 20, legal and illegal sex workers are working in the Australian sex industry at any one time [ 20 ].

It is difficult to provide estimates of the of sex workers due to the transient nature of sex work and sex workers reluctance to report working in the sex industry. This is often due to aspects which remain criminalised which may result in them incriminating themselves or making themselves a target of abuse The stigma surrounding the industry also means they are often reluctant to disclose their work even with family and friends, and the knowledge that in Australia once registered, their name will remain listed in a sex work database regardless of whether they are still working in the industry [ 20 ].

While there are some commonalities between street sex workers and indoor sex workers, generally there are vastly different issues associated with their work and substantially different conditions in which it takes place [ 91018 ]. Indoor sex workers are far less likely to report injecting drug use or issues around poor health compared to outdoor sex workers They are also less likely to report concerns around personal safety or to experience work related violence compared to outdoor workers due to regulations and controls in place in the legal sex industry [ 20 ]. Indoor sex workers are also more likely to view their work as a career than a transient job and remain in the industry long-term and tend to express different concerns in relation to their work including problems surrounding their personal relationships [ 18 ].

While considerable research has been conducted on street sex workers, there is considerably less data on indoor sex workers.

The majority of past research on indoor sex workers has related to condom use and physical health. Past research has found that many sex workers use condoms with clients but are less likely to in their personal lives [ 1925 — 29 ]. The absence of condoms appears to ify security, intimacy and trust between sex workers and their personal partners. Perceived intimacy is the strongest predictor of non-condom use, with condoms serving as an emotional, physical and symbolic barrier between sex workers work and personal lives [ 273031 ]. All of the women reported tensions associated with working in the sex industry and having a private sexual relationship including issues of jealousy, resentment, disapproval and disrespect from partners due to the nature of their work.

A recent study by Bilardi et al. Most participants reported that sex work interfered with their romantic relationships adversely due to issues of jealousy, guilt and safe sex practices. studies that have touched on sex workers personal relationships as part of the broader study have also found sex work negatively affects personal relationships. In a further study by Rossler et al. To cope with these issues, sex workers commonly adopt behaviours to separate their work and personal lives [ 17192932 ]. Work and home lives differ in terms of purpose as well as culture and have specific patterns of attitudes and behaviour for each.

A physical border defines where these take place, temporal borders define when the behaviours take place and psychological borders are defined by the individual, dictating when behaviours, thinking patterns and emotions are appropriate for each.

The more flexible a border is, the more an individual can think about work while at home and home while at work. When domains are very different it can be more difficult to juggle the conflicting demands and an individual can experience confusion about their identity and purpose [ 34 ]. In a study by Wolffers et al. Another important aspect was maintaining emotional distance at work while being emotionally involved at home.

Other strategies sex workers commonly use to cope with the demands of sex work are taking regular breaks at work, physical boundaries between work and home, keeping to time during consults, hiding appearance and avoiding emotional relationships with clients [ 1719 ]. Similarly, Sanders [ 19 ] found indoor sex workers constructed a manufactured identity in order to maintain a sense of self by limiting certain feelings to work, and certain feelings to their personal lives.

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Women had certain rituals surrounding clothing, behaviour and appearance to separate their identities, with some women even referring to their work persona in the third person. The romantic relationships of indoor sex workers, outside of work, has not been studied extensively despite being raised as a concern by many women in the sex industry [ 252937 ].

It could be argued that psychologically, activities at work and home are very different for sex workers and therefore strong borders between the two would be required in order for a person to cope with the very differing demands. This study developed from findings of an earlier study by Bilardi et al. This exploratory study allowed for preliminary investigation in an area in which very limited data is currently available.

The impact of sex work on women’s personal romantic relationships and the mental separation of their work and personal lives: a mixed-methods study

Exploratory studies aims to explore the research questions, gain greater understanding of an issue and lay the groundwork for further investigation into the area of study [ 38 ]. A mixed-methods approach was used as it allowed for the use of multiple methods to explore, identify and confirm findings within the study. Mixed method studies commonly employ both qualitative and quantitative approaches to allow for greater breadth and depth of understanding and are useful in exploratory de studies [ 39 ]. To be eligible for the study women had to be over the age of 18, have a good understanding of English, and work in a d brothel, massage parlour or as a private escort in Victoria, Australia.

Participants were recruited between June and August from the Melbourne Sexual Health Centre MSHCthe largest sexual health clinic in Victoria, Australia, where they attended for their three monthly check up and certificate to work. This study reports only on the 31 questions relating specifically to work characteristics, personal relationships, rates of abuse, condom use, and the levels of mental separation between sex work and personal relationships.

Three questions measuring the separation of work and personal relationships were developed based on a scale of work-family conflict [ 41 ]. An additional two questions were developed by study investigators and related specifically to sex work and personal relationships.

Questions included both closed and open ended responses. Member checking can be undertaken for a variety of reasons, including as a means of validating study findings and ensuring the credibility of [ 42 ].

Associated data

Participants were first asked to describe their background in the sex industry before they were verbally presented with the major findings of the study and asked to comment on whether the findings reflected their personal and broader experience of working in the indoor sex industry. Women were opportunistically recruited to the study during a routine three monthly clinical appointment for sexually transmitted infection testing to obtain their certificate to work.

Women were identified through CPMS. During the consultation a nurse briefly explained the study to eligible women and invited them to participate. Women interested in participating were offered a plain language statement and questionnaire at the end of their consultation and given the option to complete the questionnaire privately onsite or complete the questionnaire off-site and return it in a reply paid envelope.

The questionnaire was anonymous with no identifying information collected. Women involved in the member checking interviews were recruited by the same method and interviewed either face to face or by telephone, depending on their preference. Questionnaires were entered into SPSS and analysed using descriptive and frequency analysis. Open-ended questions were transcribed verbatim and thematic analysis applied. Thematic analysis is a method of identifying, analysing and reporting patterns in qualitative data, which are commonly referred to as themes, to organise the data and convey important and relevant meanings [ 43 ].

Open-ended responses were firstly read and re-read by CB to identify the major themes and arising from the data. Themes were developed based on relevant background literature, questions derived from the aims of the study and issues raised by women. Once identified, themes and were coded and text responses grouped according to similarities and differences.

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Responses were re-read again by CB to further revise, refine and confirm. To ensure consistency and reliability of data analysis, two secondary researchers JB and SC examined a subset of qualitative questionnaire responses to cross check themes and. No further themes or differences in interpretations were identified by either secondary researcher. Member checking interviews were digitally recorded, transcribed verbatim and the same thematic analysis process applied. A total of 55 women completed the questionnaire. In addition, one woman started and returned the questionnaire but only completed the initial demographic questions and her were therefore not included in the study.

For pragmatic reasons and due to the anonymous nature of the questionnaire we were unable to keep a record of all the women who accepted a questionnaire and did not complete and return it, or the reasons for non-completion.