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But as a rule, we are all trying to work alone, not make friends. I do not have any acquaintances whatsoever who work for money. I do not ever mention this to anyone. This is something that lives in me and this will never be anyone else's business. Sasha, age 22, MSW Disclosure of sexual identity and involvement in sex work to health care providers was very limited. Negative attitudes from health care professionals were frequently anticipated or reported: Lord, it was such homophobia.

A huge problem is, of course, again due to the hidden community, that in the majority of regions in Russia there are no special services, no legal counseling or psychological services for gay, lesbian and transgender people. But on the other hand, most of them are terribly afraid to contact the police if something happens to them. They are terribly afraid to go the doctors if they are having any health problems, if those are related to their sexuality.

Do you discuss that you work in sex services when seeking medical care? This is ruled out. Once I went to a private clinic and a young, well-groomed guy was before me in line.

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And the doctor simply kicked him out. And that was a private clinic. I can't know for sure what happened there, but I try to hide it all. Because everyone has their own prejudices. And do you also do not tell the doctors that you are gay? No, I do not tell them. Ilya, age 31, MSW3. Regarding interactions with clients, respondents were generally aware of the threats to personal safety.

The concerns that were raised were mostly related to robbery, violence, and group theft by clients.

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Respondents reported both personal experiences with violence by clients in addition to being aware of this happening to other male sex workers. Though some reported that increased protection was an advantage of working for an agency as opposed to working alone, others questioned the extent to which this was actually true. I have one friend who was robbed. He met a boy at a gay club, got drunk, and brought the boy to his place.

The boy gave him some kind of pills that put him to sleep, and the boy took 1, roubles from him.

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A credit card with the PIN-code was also in the bag. Yes, sexual violence and nonsexual violence. They [clients] could simply just beat someone up. Moreover, it is often a question of sexual practices. And then the guy has to get home anyway he can.

Especially, if he doesn't have any money at all, and he just came to earn some. These kinds of things also happened. Men used a variety of strategies to minimise risk, including refusing clients based on character judgments or previous communications on the Internet, meeting clients in apartments or hotels instead of cars, collecting payment prior to sex, working in the daytime, minimising alcohol use, and bringing friends.

There were some unpleasant situations. But, when I invite the person to my place, I at least know that one person will come. But when you go there, there may be a group of five. And you will leave, even without any money. Just to get out alive.

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We agree to meet at some place outside so that I can check and see if the person [client] is shady. I just go up to him and start conversation, and if right away I see any aggressive actions, or I get a negative vibe about him just by chatting, then I just turn around and leave. I try to pretend that I was never even there…. I'm a fairly good judge of people.

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Boris, age 18, MSW6. Perceived risk for HIV was almost universally reported among the male sex workers but in an abstract way: Furthermore, only a small number of the men reported knowing anybody who was HIV-positive. Of course there is [risk for me to get HIV]. Certainly [there is personal risk for HIV infection], but up until now… touch wood'. Situations where condoms were not used included for extra payment, during oral sex, on impulse, with known clients, or with female sex partners. And if they offer a lot of money, but sex without a condom? To be honest, this was the case several times.

Well, there was one such case, that we had sex without a condom. But this was not my first time with this person and we had a good relationship. I already understood that he was not sick with anything.

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So we tried it without a condom. But I always use a condom with those guys that I do not know. I have had sex without a condom. And if it turns out that we don't, then we go to the store. They are available. But unfortunately, there are times when you disappoint yourself and it is too late. Being too drunk was considered a problem both for conducting work as well as for maintaining personal safety.

Use of alcohol by respondents was primarily to relax and help with conversation and was often described in the club environment. You come to the club… you take a shot of vodka for yourself. Well, and also for courage. And you start looking for young men that appear to be well-off, that are more or less okay and don't suffer from some phobias, and you try to meet them. I think alcohol is quite appropriate.

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Before the act, to relax, to create an atmosphere where people are more at ease. Especially when it's the first encounter, when you see a person for the first time, so that you can have closer communication …. I think wine is enough. And, hard liquor — vodka, cognac? I think it's unnecessary. There were some that used drugs, but these were isolated cases. Mostly, they were drinking all kinds of junk, especially in the clubs.

Mikhail, NGO4. Current hard drug use was not reported by any respondents though a small number reported prior use that was described mostly as experimental. Nitrites, commonly referred to as poppers, are recreational club drugs used to enhance sexual pleasure and were often mentioned. Use of poppers was typically not self-use but rather use by client: But I don't need them.

One hard drug that was mentioned was cocaine, with use being either by the client or past experience by respondent. It is obvious why women are working the streets: There are those among the men who work the streets that are there for the dose, but I don't think that the percentage of drug users among MSM is that high.

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