The Wisdom of Whores

Looking over the environmental forces influencing a topic, such as socio-cultural and economic factors, reminded me of a book that I read called "The Wisdom of Whores," by Elizabeth Pisani. Despite the mildly vulgar name, it was very informative on formative research and qualitative analysis used to gather quantitative data. The book is written by an epidemiologist who studies the AIDS epidemic worldwide. As an epidemiologist she mentions how she initially disliked qualitative research because it seems so 'fluffy' and not based on hard numbers. But, for her work, she needed to figure out what type of programs would be most effective for the growing number of HIV infected persons, what programs had worked best in the past, as well as why HIV was spreading so quickly in some areas. An interesting point that she brought up, that I never had really thought of before (also because I was not yet super engaged in public health when I read it) was that HIV in Africa is spread differently than HIV in America which is spread differently than HIV in Asia. Pisani spends a lot of time in Africa and Asia talking to the locals, exotic dancers, prostitutes, brothel owners (madams), and many other gatekeepers throughout the two continents. She learns about how in Africa, younger girls are dating older men, who are more likely to have HIV than boys their own age. She also mentioned that many girls and boys more often have multiple partners at a younger age compared to a lot of other places, one of the reasons along with the former, that Africa has the highest prevalence of HIV. Contrary, in Thailand, a lot of travelers come through, and a lot of prostitutes are readily available. One of the reasons that there are so many prostitutes (there, as well as other places) is because sex sells...and sells well. And it beats working in a sweat shop for two cents an hour. Prostitutes are a populous vector for HIV.

After many pages of other differing ways that HIV is transmitted throughout the world, Pisani talks about a convention on HIV/AIDS that she attends addressing how to subdue the HIV virus. She talks about her irritation with the convention-because of her research, she knows that the epidemic cannot be addressed the same way in each country. Each country's intervention plan must parallel its own cultural beliefs. Religion even must play a big role: HIV programs worked best in communist and buddhist countries, while not so well in Christian and Muslim countries. Clearly, to combat such a disease in incredibly different countries, the same program will not work for all.

This lecture, as well as reading the mentioned book, really made me interested in qualitative research and evaluation. I am doing my thesis on exotic dancers, a topic that is mostly written about in a qualitative fashion, but I am analyzing it quantitatively, which is very interesting. Reading over the survey that was given, and looking at my results, I can now see how this research can be made more specific to health issues and risks that exotic dancers are exposed to, and what type of program could possibly help them.