Study of Brothel Prostitutes Finds Little Venereal Disease : Health: Nevada houses fund research by ex-UCLA professor. Infection has fallen to near zero since condoms were required.
The public health physician and the brothel-keeper were destined to hook up.
Dr. Gary Richwald, a former UCLA professor who directs Los Angeles County’s sexually transmitted disease program, had spent much of the last decade studying what he calls “sex industry workers.”
Russ Reade, a longtime Northern California high school biology and sex-education teacher, had left the classroom in search of riches 10 years ago, buying and managing one of Nevada’s most famed houses of legal prostitution.
The story of how they formed a loose philosophical alliance is a testament to the social upheaval fostered by the AIDS epidemic.
As public concern about AIDS grew in the mid-1980s, Reade, a publicity-conscious entrepreneur, worried about news reports that a growing number of street prostitutes were becoming infected with the human immunodeficiency virus, which causes AIDS.
Reade was convinced that these reports would tarnish the reputation--and the potential profits--of his “Chicken Ranch” brothel, an hour’s drive from Las Vegas, as well as Nevada’s three-dozen other county-regulated brothels.
So two years ago he went looking for evidence to defend his share of the prostitution market.
Reade convinced a number of brothel owners to spend $20,000 for a study he hoped would document low rates of sexually transmitted disease among prostitutes at the Chicken Ranch, which takes its name from a defunct Texas brothel made famous by the play and film “The Best Little Whorehouse in Texas.”
Reade was confident because he had--at some financial risk to his $2.5-million-a-year business--begun requiring customers to wear condoms in 1986. That year business at some brothels dropped by 30% to 40%, according to estimates by Nevada officials, because of mounting fears that AIDS could be spread through heterosexual contact. A number of other brothels began to require condoms, and state health officials in 1986 began requiring brothel prostitutes to be tested monthly for the AIDS virus.
When he first began requiring condoms, “I saw probably 20, 25 clients a week walk back out the door,” Reade said. It was not until 1988 that the Nevada legislature passed a law making condom use mandatory in all brothels. The Chicken Ranch subsequently added AIDS-conscious “house rules” that banned lip-to-lip kissing and anal intercourse.
In talking to a woman who was involved in brothel safety issues in the Philippines, Reade heard about Richwald.
Richwald had attracted attention in the mid-1980s as the principal author of a UCLA school of public health study of gay bath houses. The study, funded by bath house owners, found that a small but potentially significant minority of bath house patrons engaged in unprotected anal intercourse, which carries the highest risk of transmitting the AIDS virus.
Bath house owners contended the findings illustrated the importance of using bath houses as a forum for education about AIDS prevention; critics of bath houses argued the findings bolstered their demand that the houses be shut down.
Richwald, now 42, liked what he heard from Reade, who is 50.
“He is an exemplary brothel owner. He follows the rules,” Richwald said.
There was ample data to survey. Since 1972 Nevada--the only state where legal brothels are permitted--has required pre-employment and periodic medical exams for brothel prostitutes.
Richwald and his fellow researchers surveyed more than 7,000 tests made on 246 Chicken Ranch prostitutes between 1982 and 1989.
They found no cases of the AIDS virus--no Nevada brothel prostitute has ever tested positive for it--and only two cases in which prostitutes tested positive for syphilis, both in 1982.
More striking were the results of gonorrhea tests. Chicken Ranch prostitutes had tested positive on 19 occasions between 1982 and 1985. But since 1986, when condoms were made mandatory there, only one instance of gonorrhea was reported.
Statewide, positive gonorrhea tests at brothels fell from 173 in 1985 to 30 last year.
Preliminary results of the Chicken Ranch study, which Nevada health officials say is the most extensive medical study of brothels undertaken in the AIDS era, were presented at the sixth International Conference on AIDS in San Francisco last year. The final study will be submitted to a medical journal for publication later this year.
Reade, however, is not waiting. More pressure for brothel owners is on the horizon. Nevada health officials plan later this year to start placing “buyer-beware” notices on the front gate of every brothel, explaining that while prostitutes are medically examined, there remains a chance of infection.
This month Reade and one of his “working ladies,” 24-year-old Tabitha, flew first to New England and then to Los Angeles to trumpet the UCLA study on a variety of radio and television talk shows. They also brought with them the Chicken Ranch’s new “Romance of the West” calendar, the brothel’s quarterly newsletter and a hefty Hastings Law Journal article showing how major cities spent an average of $12 million apiece in 1985 on controlling prostitution.
Tabitha said she is bankrolling her earnings to buy a home and set up a clothing business or music-store franchise. She said she was a good student in high school in National City, Calif., and has been frank in telling her mother about her line of work. She said she would never have become a brothel prostitute if the mandatory condom policy had not been in effect.
“We are very tasteful, educated, independent women,” she said.
“My mission has always been to dispel the stereotype” of legalized prostitution, Reade said over lunch last week. “I’m in it for the business but I’m also in it to be an educator. I want to separate legal, licensed prostitution from illegal prostitution.”
It’s a goal that Richwald, who left UCLA to run the county’s sexually transmitted disease program last summer, finds admirable.
“It may be safer to have sex with a licensed prostitute than with anybody else except your wife or your monogamous partner,” he said in his office at the back of an old, cramped county bungalow in Downey.
Richwald, like Reade, believes the Chicken Ranch study should be used to encourage government health agencies to spend more money providing condoms and health advice to street prostitutes, who tend to be less educated, older and more likely to be intravenous drug users than brothel prostitutes. Estimates of the proportion of street prostitutes infected with the AIDS virus have ranged as high as 40% in some communities, but public health experts say there are too many variables to make a reliable estimate.
“It’s hard to measure the extent to which public health regulations have an impact on sexually transmitted diseases,” Richwald said. “But clearly there’s an understated plea in this study for greater regulation of prostitution.”
What happened in the brothel industry, Richwald said, shows that “when it’s in the interest of government and industry to have a rational and effective prevention program--and when politicians are not overly involved in making scientific decisions--programs can work very effectively, even in sensitive areas.”
To Richwald, the ultimate regulatory tactic to curb sexually transmitted disease would be the legalization of prostitution.
“I don’t think I’ll see it in my lifetime,” he said. “I wish the pressure of AIDS would result in a fundamental reassessment of public health policy. But I think we’re very hung up on what’s moral or immoral.”