The relationships between female sex workers and their non-commercial male partners are typically viewed as sites of HIV risk rather than meaningful unions.
This ethnographic case study presents a nuanced portrayal of the relationship between Cindy and Beto, a female sex worker who injects drugs and her intimate, non-commercial partner who live in Tijuana, Mexico.
What life really like for sex workers heroin brought a couple of chairs outside so we could sit comfortably in the shade of their front yard while she anxiously joined Beto on the street corner to connect. Black tar heroin and crystal methamphetamine are wrapped in small plastic packages and encased in colored balloons to indicate drug type — blue and red balloons are 50 pesos of heroin, while yellow, pink, green, and sometimes black are 50 pesos of crystal.
We humbly entered their home that Beto built himself. It is modest with simple functional furniture. As we settled in, Beto was already stirring the heroin and water in a cooker bottom of a soda can using the butt of a syringe plunger. Beto prepared the injections on the floor in the light of the single window; without electricity and even in the daytime, it can be difficult to see. On the floor near the cooker, I noted that the heroin balloons were blue that day.
After they each had their loaded syringes in hand, they started the injection process. We all grew quiet to concentrate, they on injecting, and we on observing them injecting. The drug mixture appeared black and thick inside their syringes. They each What life really like for sex workers heroin multiple sites of injection on their bodies in a struggle to find relief from their malilla.
Several times throughout the arduous process, which lasted about 45 minutes, they held their syringe up to the light of the window, flicked it with a thumb and middle finger to knock the air out, and licked the needle as part of an injection ritual that also attempted to avoid wasting any precious drops. Cindy sat down on the floor and looked intently for veins in her right foot. Beto estimated that she has taken up to five hours to inject.
But this What life really like for sex workers heroin, she was sick and resorted to injecting herself in the muscle in her upper left arm.
She slowly and precisely inserted and withdrew the needle from her flesh. She explained that while the rush is not as intense, it nonetheless provides immediate relief from her symptoms of malilla.
Meanwhile, Beto tied a tourniquet a strip of a material on his arm and attempted injection inside his upper left arm. She relayed that she too used to inject in her armpit and underneath her arm, but that she can no longer find veins there.
He tried again and missed, but this time the burning was worse. He pulled the needle out, but his arm was already starting to swell and he appeared to be developing bright red hives. His arm, face, and chest turned red and glistened with sweat. He appeared to be in pain. His hand swelled to nearly twice its size.
He held his hand out to us and instructed us to feel it—it was rock hard to the touch and he could barely grasp his fingers into a fist. Attentive to his discomfort, Cindy then tried to help him inject. They propped a mirror up in the light of the windowsill and she first tried to inject him into his left collarbone area.
She tried a few times and he grimaced during the process. She apologized for hurting him. She sat down on the floor, and almost by chance observed a potential opportunity in his leg.
She instructed him to stand still as she examined his right calf and quickly affirmed her luck. She tied the tourniquet at his knee, loudly slapped his right calf to fully engorge the vein, and patiently injected the rest of the contents of his syringe into the vein in the back of his calf.
She injected him relatively easily, at least compared to their other injection attempts. Once they were finished, she stood up, and they embraced and kissed. The process was complete. This ethnographic case study explores the emotional dimensions of HIV risk between Cindy and Beto, a female sex worker who injects drugs and her intimate, noncommercial partner who live in Tijuana, Mexico.
Although Tijuana is a cosmopolitan city of more than 1. Sex work is technically regulated in Tijuana. However, much of it occurs under the radar of the municipal registration system, particularly among street-based sex workers who use drugs and are at highest risk for infectious diseases Sirotin, et al.
Drug abuse, including injection drug use, has increased in Tijuana in recent years Instituto Nacional de Salud Publica in part due to its location on a major U. Mexican black tar heroin and crystal methamphetamine dominate the local drug trade Bucardo, et al.
Importantly, drug addiction must be understood within the broader HIV risk environment of Tijuana, including the everyday violence of limited economic opportunities, discrimination, and stigma that characterize the experiences of many socially marginalized individuals on the border Beletsky, et al. While researchers have frequently characterized the social and physical conditions of drug addiction, recent scholarship has turned to the emotional dimensions of this illness.
Angela Garcia explored intergenerational addiction as an expression of longing for connection to familial emotional and geographic territories Garcia Our analysis is guided by a critical phenomenology approach Desjarlaiswhich combines concern over lived What life really like for sex workers heroin with political economy perspectives that highlight the historical and structural production of risk.
Our approach examines HIV risk behaviors through the lens of love, which connotes intimacy, commitment, trust, and emotional connection between partners. As a holistic construct, love is a useful medium through which to link emotional, social, and structural dimensions What life really like for sex workers heroin personal experience Padilla, et al. Structural conditions bring partners together into emotionally intimate relationships and shape their private risk behaviors as ways to hold onto each other amidst uncertainty Rhodes and Cusick ; Sobo The story of Cindy and Beto illustrates how love and other emotions are enacted and embodied within broader structures of HIV risk.
The lead author first met Cindy, age 29, in the Zona Norte project office in One year later, Cindy and her partner Beto were the first couple to enroll. Although the authors had interacted with each participant in the project offices, it was not until they engaged in individual life history interviews that the extent of hardship and emotional turmoil that Cindy and Beto have experienced became apparent.
Cindy has long, impossibly thick black hair and curves that she often showcased in tight jeans. She was frank, outgoing, funny, and often emotionally charged in her interviews: Her strained relationship with her mother, who was mostly absent from her life, and the influence of an ex-boyfriend pushed her to first try drugs.
She was heavily involved in drugs and selling large quantities of heroin when she was deported from the United States for robbing an ice cream shop at gunpoint.
Estranged from her family, she relied on help from another deportee after arriving in Tijuana. She was introduced to a man with whom she could stay in exchange for cleaning his house. Soon after, she moved in with a boyfriend who sold methamphetamine.
He was often violent, including the day he killed her kitten Gemini in a fit of rage. Born and raised in Tijuana, Beto, age 33, completed school through the third grade. He used drugs and went to prison at a young age, and eventually got married but never felt connected to his non-drug using wife with whom he had two children.
During his marriage, he navigated a period of sobriety and held a regular job, but he was not content. At one point, he lived on the streets with a small group of drug users who engaged in elaborate schemes to steal merchandise and evade the police to survive.
He was caught, however, and after serving time in prison, he was released only to find that his companions had all died from AIDS and other drug-related causes. Beto hardly fits the stereotypical image of a long-time drug user with a prison record.
He has a slight build, friendly brown eyes, and a shaved head often hidden under a baseball hat.
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Sometimes his skin is scabbed from smoking methamphetamine and picking at it, as users often do to quell the crawling sensation under their skin. He steals bikes, stereos, wiring in houses, and other opportune goods as well as works odd mechanic jobs to hustle for drugs and support his life with Cindy.
Beto was soft spoken in his individual interviews and he became deeply emotional when describing the importance of his relationship with Cindy over the past two years. He recounted a period of heavy methamphetamine use when he incessantly picked at his skin all over his body to the point that his clothes uncomfortably stuck to him and he felt ashamed. Beto said Cindy remained with him, did not judge, and instead offered her support.
He became deeply reflective as he described his feelings for Cindy, which also revealed his own emotional comportment: Cindy always wanted children but could not get pregnant; her intense attachment to her dog partially fills that void.
Early in their relationship, Cindy asked Beto if Lucia could live with them and she was prepared to leave if he said no. Yet he tolerated it for Cindy and has gradually come to accept the dog and her subsequent litters of puppies, one of which he has grown particularly attached to. Cindy said that Lucia has had the same father for all three litters of puppies, and this dog always comes back to check on her after she gives birth.