Condom use, power and HIV/AIDS risk: sex-workers bargain for survival in Hillbrow/Joubert Park/Berea, Johannesburg

Through interviews with 50 female sex-workers in the Hillbrow/Berea/Joubert Park area of Johannesburg. this paper explores sexual negotiations between men and women in the sex industry. This paper focuses on Factors that affe ct sexual decision-making including safer sex practices. In moving beyond a pproaches that emphasize women's 'powerlessness' in sexual negotiation, thi s article focuses on ways in which sex-workers capitalize on clients' reluc tance to use condoms in sexual exchanges. We emphasize sex-workers agency a nd use a broader, Foucauldian understanding of power, which couples power w ith resistance. Further, this paper examines other elements of the sex indu stry that contribute to unsafe sex such as competition between women for cl ients and violence in the industry. Finally, this paper suggests that HIV-p revention programs take cognizance that power negotiations between men and women cannot be simplistically understood as men having power and women bei ng powerless. Rather, this article contributes to a growing body of literat ure in medical anthropology, which elucidates the complexities of sexual ne gotiations between men and women. This focus on agency is important in tryi ng to lessen the stigma and discrimination that sex-workers face at the han ds of clients, pimps/managers, police and health care workers. (C) 2001 Els evier Science Ltd. All rights reserved.