Hillis, A (2022) Sex tourism in an era of globalisation, technology, harm reduction and disease migration. Doctoral thesis, Liverpool John Moores University.

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Abstract

Background There is a well-developed body of literature on sex tourism, a phenomenon that is experienced in almost every corner of the world. While extant literature depicts the complexity of sex tourism, it does not acknowledge the extent to which globalisation has irrevocably changed the industry. To date, there is a distinct lack of examination and understanding of the theoretical aspects of sex tourism that effectively conceptualise the intricate phenomenon within a contemporary worldview. For clarity, this thesis defines sex tourism as a phenomenon involving tourists, planned or spontaneously purchasing sexual services or experiences. Aim Sex tourism is a multifaceted and complex phenomenon. Using existing visual and theoretical frameworks and extensive analyses of literature, a model was created to depict the contemporary realities of those involved in the sex tourism industry. Using the country specific context of Thailand, this research took a public health and social science approach to map out sex tourism by drawing on the situation of sex workers, tourists, healthcare professionals, and community workers, as well as wider global forces such as technology, human rights, law enforcement, sexual health, and healthcare provision. Methodology The research consisted of four stages. Stage 1 was a critical analysis of extant literature, resulting in the development of an initial, conceptual sex tourism model. Stage 2 was an empirical, pragmatic, qualitative study, using unstructured and then semi-structured interviews with community workers, healthcare professionals, tourists, and sex workers. The interviews explored the unmet needs of stakeholders involved in sex tourism. Following this, the interviews sought to understand increased risky sexual behaviour in the context of globalisation; analyse the impact of technology on relationships between tourists and sex workers in Thailand; and discuss required changes to UK public health and social policy, clinical practice, and sexual health programmes. Stage 3 analysed and compared findings generated from Stages 1 and 2. Stage 4 scrutinised and refined the contemporary sex tourism model based on the combined findings from the previous stages, as well as presenting a sexual health patient pathway for tourists before travel and upon return to the UK. Results and future research To date, the holistic conceptual model is unique as it was built upon existing bodies of work whilst incorporating distinctive aspects of the industry that have not yet been considered in the field. The model consists of interacting, multi-level associations. Whilst the separate micro, contextual, meso, and macro levels are versatile, decision- makers and practitioners will be equipped to understand sex tourism in its entirety. The model should be used to inform international public health policy, practice and investments in country specific contexts. Following acceptance of the conceptual model, further empirical research should be undertaken to prove the validity and reliability of the model, adapt it where necessary, and expand the scope of the current research.

Item Type:	Thesis (Doctoral)
Uncontrolled Keywords:	Sex tourism; Sexual health; HIV; Disease migration; Globalisation; Service provision; Harm reduction; Conceptual model; STIs
Subjects:	H Social Sciences > H Social Sciences (General) R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine T Technology > T Technology (General)
Divisions:	Public Health Institute
Date Deposited:	17 Mar 2022 09:30
Last Modified:	30 Aug 2022 15:23
DOI or ID number:	10.24377/LJMU.t.00016473
Supervisors:	Van Hout, MC, Leavey, C and Kewley, S
URI:	https://researchonline.ljmu.ac.uk/id/eprint/16473

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