Examining the spatial clustering of sex work venues: A comparison of HIV risk in los angeles and New York City

Background: Sex work in Los Angeles and New York City has increasingly moved from the streets into indoor venues, such as massage parlors, acupuncture clinics, hotels and bars, because of heightened enforcement of anti-prostitution ordinances and the internet. This paper examines the characteristics of sex work venues, and the potential spatial clustering of higher HIV risk venues, in Los Angeles County and New York City through a mapping analysis of an online rating website used by male clients to describe Asian and Latina/Hispanic female sex workers. Methods: The popular massage parlor review website we studied boasts 65,000 reviews of 25,000 sex workers. Variables include race/ethnicity, estimated age, sexual services provided, and location of establishment. GIS mapping of worker and establishment characteristics and logistic regression models estimating sexual practices were used to analyze potential clustering of venues and HIV transmission risk in venues by race/ethnicity and age of the female sex workers. Conclusions: Analysis suggests that Chinese women engage in “hand jobs” (lower HIV risk) while Korean and Latina/Hispanic women engage in “full service sex” (vaginal and other sex services, higher HIV risk). There appears to be venue concentrations of lower and higher HIV risk (indicated by differential condom use described in the reviews), varying geographically by region and by ethnicity. Most of the venues are not in the downtown historic “red light” districts but rather in suburban and higher income census tracts. Implications are discussed for HIV prevention interventions in these high risk populations in large metropolitan areas.