The organization of sex work in low and high-priced venues with a focus on the experiences of ethnic minority women working in these venues

Abstract

Prior research on female sex workers (FSW) in China, and their risk for HIV and STI, neglects the nuanced experiences of ethnic minority FSW. We conducted participant observations and in-depth interviews with 33 FSW and six venue bosses to describe the experiences of FSW and management structures in high and low-priced sex work venues in Liuzhou, China. In low-priced venues, FSW had more autonomy and stronger relationships with their ethnic minority peers. Mid and high-priced venues had more formal management structures. Ethnic minority FSW working in higher priced venues experienced less support and kinship with their peers. HIV/STI prevention outreach activities occurred in all of the venues, but they were not tailored for different venue types or for ethnic minority FSW. Our findings provide guidance for tailoring public health programs that meet the needs of ethnic minority women working in different types of sex work venues.

INTRODUCTION

The HIV epidemic in China has been concentrated in certain high risk groups. Sex workers, injection drug users, persons with sexually transmitted infections (STI), and men who have sex with men (MSM) are identified as high risk populations for HIV prevention and control in China (¹). HIV has also disproportionately affected ethnic minority groups in China, who constitute 8% of China’s mainland population, yet account for 20% of all HIV cases (²). Little is known about the intersection of ethnic minority status and the other HIV and STI high risk groups in China. Some research has documented that ethnic minorities have fewer opportunities to learn about HIV/AIDS. For example, in Guizhou Province, a cross-sectional study conducted among 246 Han and 173 ethnic minority female sex workers (FSW) showed that ethnic minority FSW had lower proportions of receiving HIV counseling and diagnostic and treatment services for STI than Han FSW (³). More research is required to understand the intersection of ethnic minority status with sex work and access to risk reduction counseling and services in China.

Sex work is illegal in China. FSW thus comprise a large, hidden group. Some sources estimate there are at least 4.4 million FSW across China (⁴); another suggests that there are 2–10 million FSW (⁵). Social and economic changes in China have increased migration and urbanization, which contribute to women entering commercial sex work (⁶). Escaping poverty is one of the primary motivators for women to engage in selling sex (^7,8). FSW have an increased risk both for HIV/STI and have been identified as a “bridge population” responsible for the spread of HIV to the general heterosexual population (⁹). Although the sexual nature of their work makes FSW vulnerable to infections, structural and social factors also influence HIV/STI risk in different sex work settings (^10–12).

Sex work in China is organized according to multiple socio-economic tiers, ranging from low to high (¹⁰). At opposite ends of the spectrum are street-based sex workers and high end personal escorts; in the middle are sex workers employed in a variety of types of service and entertainment venues (¹³). Within this heterogeneous group, venues can be subdivided into low, middle, and high-priced venues based on the monetary value placed on the sale of sex in the establishment (¹⁴). Given concerns about illegality, venues for sex work are often disguised in the form of a club, massage parlor, bathhouse, or karaoke lounge. The price is also affected by a venue’s location, rent, and interior decoration, along with its owner’s connections with local police and even its sex workers. Venue management, clients, monetary policies, the background of the FSW, and sexual health norms within the tiers capture important differences in the organization of workplace safety measures and guidelines that influence STI/HIV risk (^5,8,10,15). These differences are also related to the kinds of information and services available. One study found that less well-educated and older FSW in smaller venues were more likely to say they learned about HIV/AIDS from peer educators, while FSW from large size venues, such as night clubs and karaoke bars, look for health information from websites (¹⁶).

Women account for up to half of all of urban migrants in China. Female migrants are at a disadvantage when it comes to finding employment, and are more likely to be relegated to jobs in the service and retail industries (⁶). Female migrants who are also ethnic minorities are at an added disadvantage in finding urban employment because of their partial fluency in Mandarin, relative lack of education, and unfamiliarity with city life (^2,17). When few other jobs are available, migrant women may turn to selling sex to make a living (¹⁸). There is evidence that ethnic minority women constitute a substantial number of women selling sex in some regions of China (³).

The purpose of our research was to describe the experiences of primarily ethnic minority migrant women who work in different types and price tiers of entertainment venues where sex is sold, within one mid-sized city in China. Sex work venues can be studied as social systems that contribute to health risk and/or promotion through the utilization of established communication models within the organizational structure (¹⁹). In anthropological studies of organizations, there are three root metaphors: the organization as machine, organism, or culture. This study uses the perspective of the organization as a culture, wherein culture acts as a glue to unite people into a functional group that comprises the organization (²⁰). Schein notes that participants in an organization – such as a service or entertainment venue – are likely to share similar values and beliefs (²¹), and that the culture of an organization can be revealed from examining its artifacts, espoused beliefs and values, and the underlying assumptions of its members. Using the theory of organization as culture, we conducted interviews and observations of FSW in different venue types to understand how organizational culture is reflected in the artifacts, beliefs and underlying assumptions of the venue. We use these findings to suggest future avenues for identifying and addressing the health issues of ethnic minority FSW in these settings.

METHODS

This research took place in Liuzhou, a city in Guangxi Zhuang Autonomous Region, which has one of the fastest growing HIV epidemics in China (²²). It is a diverse city; apart from the Han ethnic majority, there are also more than 30 ethnic minority groups, including Zhuang (the largest), Dong, and Miao, which together comprise over 52% of the population. In Liuzhou, the local CDC reports that migrant ethnic minorities comprise approximately half of the FSW working in service venues that double as sex work venues, such as hair salons and massage parlors. These venues are most often sex work venues with ethnic minorities (¹³).

This study consisted of two phases of data collection. In the first phase, we conducted in-depth interviews in October 2009 with 18 FSW to understand the organizational context of sex work in different venues. Six of the FSW worked in three different low-priced venues (A, B, and E), six worked in two middle priced venues (C, D), and six worked at one high priced venue (F). The low-priced venues included one massage parlor and two roadside brothels, where the price of sex was 80–100 RMB ($13–$16). The middle price venues were a SPA (or bathhouse) and a massage parlor in a hotel, where sex typically sold for 220–320 RMB ($35–$51). The one high-priced venue was a luxury KTV (karaoke club) where clients paid 400–500 RMB ($63–$79) for companionship with a woman for one night and an additional 400–600 RMB ($63–$95) for sex. We also interviewed five venue bosses or managers, two each from a low (B) and middle (C) priced venue, and one from a high-priced (F) venue. One low-priced venue boss (E) was also selling sex, but we counted her interview among the 18 FSW.

The local Liuzhou CDC helped us identify venues and recruit bosses who would allow us to conduct the interviews in their venues. Our original intent was to identify venues whose employees were all or mainly from one ethnic minority. As we describe below, the reality was that so-called “ethnic minority venues” often include women from a variety of ethnic groups and also from the Han majority group. Once we received permission to work in a venue, we asked the boss to recommend FSW employees over age 18 for an interview based on their ethnic minority status, including both minority and Han women. In China, some residents can register as a minority while being embedded fully in the majority Han culture. To ensure participants identified as a minority embodied their minority group’s culture, we only included FSW who had grown up in an ethnic minority community outside of Liuzhou and were able to speak the language of the minority group. We used an interview guide comprised of three main topics – initiation into sex work, organization of the sex work venue, and job mobility within and between sex work and other industries. All interviews were conducted by the researchers in Mandarin Chinese, recorded, and transcribed.

For the second phase in April 2010, we conducted observations in three venues where we had already conducted interviews: two low-priced venues (A and B) and one mid-priced venue (C). Venue bosses gave informed consent for the observation. During this phase, we interviewed an additional 15 FSW from the three venues. Table 1 presents the total number of women interviewed at each venue, their ethnic group affiliation, and that of the venue manager. FSW in two of the three low-price venues (A and E) were all from a single minority group (Zhuang). FSW in the others were from Zhuang, Miao, Dong, and Han groups.

Table I.

Description of the sex-work venues and the data collected

Venue	Price-tier	Type	Observation Conducted	Manager Ethnicity	Total # in venue interviewed
A	Low	Massage parlor	Yes	Zhuang	5 Zhuang
B	Low	Roadside brothel	Yes	Miao	6 Mia 2 Zhuang 3 Han
C	Middle	Spa/bathhouse	Yes	Zhuang	3 Zhuang 1 Dong 2 Han
D	Middle	Massage Parlor in a hotel	No	Miao	1 Miao 2 Han
E	Low	Roadside brothel	No	Zhuang	2 Zhuang
F	High	KTV (Karaoke)	No	Zhuang	3 Zhuang 3 Han

For each venue we observed, a female researcher visited for approximately 20 days, spending time in the venue, chatting, cooking and eating with the employees for at least 6 hours per day. The focus of the observation was to examine how FSW expressed the culture of their ethnic group, how the venues functioned in terms of the business practices, and what role ethnic culture played in running and managing the venue. The researchers wrote daily field notes to document what they saw and what they heard among the employees in the venues.

Across the two research phases, 6 venues, 5 venue managers, and 33 migrant FSW were successfully recruited. The research was approved by the Institutional Review Board at Renmin University of China. To protect participants’ identities, pseudonyms were used throughout the process.

For data analysis, the interview and observation data were combined. All members of the research team contributed to the data coding and analysis process. We coded the data according to categories and concepts developed from the research aims, including topics such as how FSW talked about their traditional culture, how FSW became involved with the venues, and how the venues were arranged around clients, working hours, finances, and training. We wrote memos during the analysis process and shared them as a team to further develop our ideas. To identify the relationships among the coded data, the categorized concepts were then organized into an analytical matrix by venue type. The matrix was used to identify patterns and interpret the meaning of these patterns. The characteristics of the two mid-priced venues were more aligned to those of the high-priced venue so, for the purpose of this paper, we describe mid-priced venues together with the high-priced venue unless otherwise noted.

RESULTS

The findings describe how the ethnic culture of migrant FSW intersects with the organizational culture in lower and higher priced venues through the following three themes: initiation into sex work, organization and management of the venues, and strategies to address sexual health risks.

Initiation into sex work

In low-priced venues, sex workers are likely to rely on social networks, especially their kinship connections, to identify opportunities to work in entertainment or service venues. In Venue A (massage parlor) all of the women working there were of the same ethnicity, Zhuang, and came from the same hometown. In venue B (roadside brothel) half of the FSW were of the same ethnic minority group as the boss (Miao), and many seemed to be relatives or introduced by relatives.

There are 6 children in Lily’s (the owner of Venue A) family. Lily’s sister married H’s older brother (H was another FSW in Venue A). Lily’s older sister married my older brother. I used to work there. I moved to a luxury club to be a receptionist. F (another FSW in Venue A) was introduced here by me. I knew her through her younger sister. (FSW J, Zhuang group, Venue A – low-priced massage parlor)

In contrast, in mid- and high-priced venues, there was a relatively rigid process for interviewing and hiring FSW, and fewer instances of getting jobs based on a shared ethnic background. Instead, participants mentioned finding jobs through their social networks, formal interviews, and negotiations. As shown in the remark by a receptionist at a middle price venue, sometimes these norms are revealed when they are violated:

Last time, a girl came to find a job as a XIAOJIE (FSW in Chinese). She said she knows our manager and pretended to dial the manager’s cell phone number. But I found she got the wrong number. And it was strange that she did not ask the price and the commission from the boss. It was not a normal case for me, so I let her leave. (receptionist M, Zhuang group, Venue C – mid-priced Spa)

The receptionist’s report on this “abnormal” example from a job applicant reveals that normally job seekers find the manager and get quotes for payment in mid- and high-priced venues. FSW are a human resource, and market sensibilities and practices are valued. This is reinforced by our finding that all of the participants and managers in the mid-and high-priced venues indicated that they were not aware of nor did they spend time thinking about their own and others’ ethnic identity during FSW recruitment. In contrast, in low-priced venues, sharing an ethnic background was common, and kinship and hometown connections seemed to play an important role in recruiting sex workers.

Organization and management of venues

Business management practices within different tier venues

We found major organizational differences across venue price ranges. The low-priced venues were characterized by relatively informal structures and more autonomy for the FSW. The low-priced venues A, B, and E were either a massage parlor or a roadside brothel. The clients went to the venue and chose the FSW they liked. FSW provided sex services and received a cash payment of about 100 RMB ($16), of which 20% commission was given to the boss. FSW relied on an informal organizational structure to define their roles and relations within the workplace. Few rules existed to structure FSW work schedules, so they often worked as much or as little as they wanted, depending on how much money they wanted to earn. Meanwhile venue bosses tried to offer workplace perks, such as providing meals, as incentives to get their workers to come to work.

The boss cooks dinner for us, like sour meat. That is special food from our Miao people. That is delicious and free. Why not come to have it? After that, 7pm to 9pm is busy time. But I still can leave at any point as I like. If there are too many girls that are not staying at the brothel, the boss will complain, as she cannot make money if all of us leave. But she has no way to force us to do anything here, has she? (FSW Ying, Miao group, Venue B – low-priced roadside brothel)

Sex workers in low-priced venues described opportunities to negotiate their services with potential clients and described control over independently setting the price of their services. The bosses also encouraged the clients to choose FSW themselves rather than recommending specific FSW to them.

The client comes to my place. He can choose anyone he likes. If he asks me for advice, I just say all of them are so young and beautiful. It is up to you to take anyone. (Boss R, Miao group, Venue B – low-priced roadside brothel)

The informal management system in low-priced venues served as a draw for FSW who desire autonomy. For some FSW, this trumps the potential for greater earnings at higher-priced venues. The FSW at low price venues can float and not be subject to formal management restraints.

She (NANA, a 17 year old girl in her brothel) will not go to a higher priced place. There are strict regulations in that kind of place. You have to be present on time and be polite to the clients. The clients will give scores to your service … She cannot bear that. She always comes and goes as she likes without informing me. (Boss Xiaoyuan, Venue E – low-priced roadside brothel)

Compared to the low-priced venues, the regulations and management procedures at mid-priced venues such as the SPA bathhouse (venue C) were more rigid. A receptionist took the client’s specifications first and then took him to a special room where he waited. The rooms had beds and other facilities for having sex. The manager would arrange for a few FSW to go to the client’s room for his selection. After the client chose the FSW, the other FSW would leave the room. The manager stood by for any urgent issues or complaints from the client. Afterward, the client paid the receptionist, not the FSW. The typical price for sexual service was 300 RMB ($47). The receptionist would make a record on the account book and the manager would pay the FSW. The FSW received 150 RMB ($24) for each sex service, but only at the end of each day, not case by case. The receptionist was paid a fixed salary and the manager earned a commission for each sex service provided above a base salary. The telephone, reception desk, and accounting book served as management and enforcement materials, or artifacts, in the venue. The following procedure illustrates the order of business.

We are required to stay here from 7:00pm until midnight. The boss bought a punch machine to punch our timecard. But it does not work. We will not be monitored by her. We like freedom, otherwise I would rather move to the luxury place where the price is much higher than this one. But we always stay here after 7:00, otherwise, the manager is not willing to recommend you to the clients, especially kind clients. The logistic staff, for example, managers, receptionists and cleaners have to use their timecard. (FSW L, Zhuang group, Venue C – mid-priced Spa)

High-priced venue F was a luxury karaoke club. The FSW there were dressed in sexy pink gauze skirts, standard working attire in the club, implying standard management through “artifact expression” (²¹). Clients booked a private room as a group, not as individuals. Upon arrival, the receptionist guided clients to their private room, which contained karaoke equipment, tables and chairs. The manager arranged FSW to be chosen by the clients. The FSW worked primarily as waitresses and companions, tending to drinks and offering attentive conversation to the clients. The fee for each FSW was 500RMB ($79) per night. The FSW received commission on the drinks, so they encouraged clients to drink a lot and to order expensive drinks. If a client wanted to have sex with a FSW, he would take her to another private room and pay her directly 400–600 RMB ($63–$95) for sex. The manager was responsible for recruiting and training women in job skills and manners in order to attract more clients to the club.

In mid- and high-priced venues, connections to other staff and mangers were more likely to be imposed by the management and organizational structure, although shared cultural practices, such as speaking in a local dialect and going home for ethnic festivals, were also present in these venues. Higher-priced venues typically had more formal business management systems in place to guide the procedures for selling sex.

At the same time, FSW and bosses from all venues are strongly concerned with making money. This shared assumption across different venues drives Han and ethnic group FSW to work together. In mid and high-priced venues, Han and ethnic minority FSW are on the same working schedule and do not seem to differentiate when they call each other. In low-priced venues, Han FSW can tell the ethnic groups of other girls from their backgrounds and attendance at various ethnic festivals, but this did not seem to concern them.

“I know they belong to which ethnic groups, because they will be absent during their festival. For example, Zhuang will spend Qingming Festival in April. Miao families will gather together to celebrate New Year in spring. During this period, they will go home. So I know their festival. But this difference is not important for me. We come here just for money. That is it.” (FSW Ting, Han group, Venue B – low-priced roadside brothel)

Orientation, training and education

We did not find much evidence of formal training on how to be a sex worker in the low-priced venues. FSW are expected to figure that out themselves, are briefed by the boss about the price, and observe and interact with other FSW. They are allowed to speak and behave as they want, such as keeping the accent from their hometown, leaving for home whenever they want, going to their traditional festivals, or chatting with their people from home in the venues or through the internet or cell phones.

Training? No. We do not have any. We do not need to be trained to have sex, do we? We are just briefed about the price and how much is the commission by the boss when we got here. (FSW Hui, Zhuang group, Venue B – low-priced roadside brothel)

In the mid- and high-priced venues, the management expects the FSW to represent the venue in a professional manner and provides trainings on the skills to do so. Those who do not learn the required sex skills will either be denied the opportunity to work as an FSW or will only be called upon when there is no other FSW available.

The manager will give us training when we get here. She will demonstrate the service by herself. She used to be the best FSW here. Taking another FSW as a model, we practice the skill. Then the manager will give us a test. We will be required to practice the skills on her body. For example, a service named Kousha requires us to give massages to the client with our tongue and lips. When we try on the manager’s body, she will tell if the movement of the lips and tongue is comfortable and decide if we can pass the test. If I cannot pass the exam, I will be in last place to serve the clients. The manager worried that experienced clients would complain about my poor skill. (FSW L, Miao group, Venue D – mid-priced massage parlor)

At the same time, training and orientation programs modify and standardize their employees’ appearance, behavior, and style to meet the requirement of clients, and non-standard accents and customs are intentionally erased.

We will give training to the girls. Last time, we employed an etiquette service company to give a lecture to the girls. We will teach the FSW how to use make up, how to speak politely, and what is elegant sitting posture, etc. You know, some of the girls come from the village with accents and behave inelegantly. We have to train them to provide better service to the clients. (Manager T, Zhuang group, Venue F – high-priced KTV)

For the health information promotion in these different venue settings, FSW indicated that the most important point was to distribute condoms and to remind people to use them. The health workers were not aware of the ethnic status of the FSW in the venues. For the high end venues, the FSW indicated there is no need for health workers to differentiate ethnicity among FSW.

I know them (health workers). I happened to see them two times when I was staying here. Every time, they came to distribute condoms and reminded us to use condoms. They are not very clear about which ethnic group we are from. That’s all. (FSW Xi, Miao group, Venue B – low-priced roadside brothel)

The health workers come to our place every week or every 10 days. The health information is good and useful. I don’t think the health workers should address FSW by our ethnic groups. We all are here for money. We are the same on this point. (FSW Z, Zhuang group, Venue F – high-priced KTV)

Trust and support within the venues

Schein points out that there must be shared regulation, beliefs, and assumptions among the participants in an organization. The leader must have the authority to lead the team to fulfill the function of the organization (²¹). We found that in the low-priced venues, ethnic culture seemed to be the key force uniting FSW. That is, sharing similar customs, languages, and identities made FSW feel safe and maintained trust within the venue.

FSW in low-priced venues reported that it was easier to trust someone from their own ethnic group or whom they had known from their hometown.

I will not move to another place. Here, the boss is my aunt. Her daughter is running another brothel on this street. We have known each other since our childhood. I cannot trust others, especially in urgent cases. ….. Last time, when I was with a client upstairs, a policeman came to crack down. AZI (my cousin) passed a warning to me loudly in the Miao language from downstairs. The client and I dressed quickly and threw away the condom. Then the policeman could not find any evidence and had to leave. You know, we are in a high risk industry. We must trust and rely on relatives and people from our hometown here. (FSW Y, Miao group, Venue B – low-priced roadside brothel)

That day, W (another FSW who was FSW J’s close friend, or Zuotong¹) was tired and wanted to get off work at midnight. A drunk guy came and wanted her. W refused, but the man intended to push her. I stepped out and beat him away with a stove stick. (FSW J, Zhuang group, Venue E – low-priced roadside brothel)

In these cases, rather than being barriers to communication or assimilation, language and customs served as important weapons to deal with threats from police and aggressive clients.

In contrast, in the mid- and high-priced venues, the role of manager is a direct and crucial support for the FSW. While managers in these venues may also depend on tapping into the shared cultural backgrounds to engender a commitment to the venue, they are also concerned that this might create divisions between FSW from different cultures.

We would like to chat in Zhuang language. You know there are various dialects in Zhuang. The girls around me can understand each other, because our hometowns are not a long way off from each other… (but) I must lead a team and absorb more girls to run the business. Otherwise if you only have few girls on hand, how can you make money? (Manager T, Zhuang group, Venue F – high-priced KTV)

Thus, while culture in low-priced venues is a basic foundation for trust-building among FSW and bosses, in mid- and high-priced venues, it tends to be suppressed via the management procedures and organizational structure. The manager stands by to solve problems rather than relying on specific ethnic group subcultures or language sharing to build trust.

Last time, a client wanted oral sex without a condom. I could not persuade him to put one on. Then, I called Manager W from the guest room. The client argued with the manager and said he can get the service in another brothel. Manager W insisted that wearing a condom is regulation here and asked the client to leave politely. (FSW W, Han group, Venue C – spa)

Strategies to address sexual health risks within venues

The FSW in different-priced sex work venues used different strategies to protect themselves and deal with the potential for STI. FSW in both low- and higher- priced venues indicated that before entering the sex industry, they got very superficial knowledge about sexual health from their conservative ethnic cultures. In lower-priced venues, health protection depends more on individuals rather than management practice.

The new girls are blank about HIV/STI. I have to tell them to protect herself. Last time a girl was infected by gonorrhea. I lent her some money to see a doctor, but she never came back to me. (Boss R., Miao Group, Venue B – low-priced roadside hotel)

Last time, I put on a condom for a client. But he took it off under the table. Angry, I refused to continue sex with him. I put on my clothes and went downstairs. I know the boss will protect and support me, so I dared to refuse him. (Qiong, Zhuang group, Venue B – low-priced roadside hotel)

The boss is vital for health information sharing and protection in the low price venues. However, it happens on an individual basis. The boss would lend FSW money to see a doctor. Qiong would seek protection from the boss because she trusts the boss.

In higher-priced venues, the management staff have created systems to protect their employees by developing and enforcing policies to protect sexual health, even at the expense of losing customers.

We have special flower decorations on the girls’ uniform if she is having her period or has problems with her urinary system. When the clients want to take the girl out, the girl can communicate with him to refuse. If there is conflict, I will go to solve it. I can tell the client the meaning of the flower decoration symbol and ask for understanding from the clients. (Manager T, Zhuang group, Venue F – high-priced KTV)

The flower decoration on the work uniform is an artifact or symbol of standard management practices in the high priced venue. The manager dealt with clients and provided health protection as part of the management procedure. This procedure, rigid for the clients and FSW in the venue, is a shared regulation there.

DISCUSSION

This research describes the experience of migrant FSW in different types of sex work venues in Liuzhou, China. Our results reveal different business practices associated with different priced tiers of sex work venues. Although FSW in the brothels all share the experiences of participating in the underground commercial sex trade, the role of ethnic subculture expressions in low compared to mid- and high-priced venues are different. In low-priced venues, kinship connections are the main source of recruitment into the venue, while in mid- and high-priced venues, FSW mostly rely on the market to search for and find a venue job. In the organization and management of the low-priced venues, ethnic group subculture is a basic foundation for establishing trust. The social interactions, health protection, and even coping with police, happens mainly on the individual level, via sharing language, customs, and food. The mid- and high-priced venues practice more rigid business models with salient physical or material evidence, such as a reception desk, an accounting book, and standard working attire. Regulations and the role of the manager are clear and consistent for all of the FSW for each element of venue management, such as recruitment, training, solving problems with clients and health protection. Expressions of ethnic subculture can be found in these mid- and high-end venues, but appears subordinate to the rules of the business culture. In low-priced venues, women seem bonded together by respect for ethnic traditions that form their identity, and many of the women in these venues value these bonds. They value the autonomy they have over their schedules and the roles and guidelines that loosely structure their work. Women working in mid- and high-priced venues are organized by more standard and commercial management procedures. Drawing upon these findings of different organizational cultures, it seems likely that different venues would require different strategies for health information dissemination.

We found evidence of outreach activities in each of the six venues we visited. There is, however, no evidence that these outreach programs are tailored for different types of venues or different types of women in the venues. This research revealed that among the three types of venue pricing tiers, kinship and ethnicity play an important role among sex workers in low-priced venues. Thus HIV prevention programs in low-priced venues should develop messages in ethnic minority languages and use culturally meaningful strategies to disseminate information. This includes taking advantage of the kinship networks in low-priced venues, identifying the key authority in these kinship connections, and using the trust maintained through kinship connections to promote risk reduction strategies among relatives engaged in commercial sex work. For the mid- and high-priced venues, the central role of management indicates that health messages can be promoted and enhanced through the management process. The roles of the manager and receptionist can be taken into account to help disseminate health information and enforce condom use with clients.

The study is not without limitations. First, this study used a small sample of women interviewed and venues observed, and as such, should be understood as exploratory research. The purpose of the data collection was to explore how ethnicity, sex work, and venue structure interacted among a small group of female sex workers in a few sex work venues. More empirical data are needed for a comparison of women from different ethnic groups, including the Han, to conduct an in-depth comparison of ethnicity. We were not able to interview women from all ethnic groups, or in sufficient numbers so that we could develop comparisons that are relevant to ethnic minority FSW. Nor were we able to interview enough Han FSW to draw comparisons between their experiences and that of ethnic minorities. Second, all the interview and communication in this study were conducted in Mandarin. Even though all of the FSW could communicate in Mandarin, there were still language barriers encountered, particularly in expressing their ethnic culture. Third, because all of the women we interviewed were migrants to Liuzhou, it was not possible to separate the experience of being a migrant, sometimes from the same or nearby hometowns, from that of being an ethnic minority. Fourth, the profile and characteristics of the clients are likely to be a vital force in shaping the organizational culture in the venues, but we did not investigate it in this study. Finally, we were limited by our access to high-priced venues in which the experience of sex workers is very likely different from lower priced venues. We did not find a high-priced venue that would allow us to conduct observations, so we have fewer results to share about the internal structure of high-priced venues beyond the information that we received from sex workers and a venue boss during interviews. Despite these limitations, we join an increasing number of scholars and researchers who have described the considerable heterogeneity among female sex workers and the venues and other locations where they work (^10,13,16). These descriptions are critical for the development of targeted, appropriate and effective HIV/STI interventions.