Now: Mandatory Health Regulations and Mandatory Condom Use

Nevada: The Only State to Legalize and Regulate prostitution 

Nevada is the only state in the United States where prostitution is legal and regulated. Prostitution in Nevada occurs primarily in 20 licensed Brothels—zoned away from major cities, including Las Vegas.[1] In order to license and maintain a Brothel, one must first proceed through an extensive licensing process, consisting of zoning issues (with brothels being legally zoned away from thoroughfares, churches, and schools) and strict background checks.[2] Once licensed, Brothels are subject to inspection by local officials at any point in time. These officials “have the power to revoke licenses for any reason and are free to impose other regulations at will.”[3] Primary to these inspections and most important to my exhibit is legislation regarding public health measures.

The Laws and Practices Surrounding Public Health in Nevada 

The Nevada Administrative Code mandates two mandatory health measures: 1) mandatory STI testing for all registered prostitutes 2) mandatory condom use for all sexual encounters.[4] In 1986, Nevada mandated STI testing for all registered prostitutes.

Before engaging in any sex work, all prostitutes must be tested negative for all STIs; a positive result is grounds for immediate rejection or suspension. Depending on whether the STI is curable, the prostitute could be banned for life from working as a prostitute. If one tests positive, the medical provider must notify the Bureau of Disease Control, the brothel, and the sheriff.[5] Once cleared for STIs, working prostitutes must undergo monthly STI testing.[6]. All of this presents a significant time and monetary burden on the prostitute.

In 1988, the Nevada government passed a law mandating condom use for all brothel customers. This law protects prostitute from STIs and allows for prostitutes to exercise some agency. Prostitutes often follow this law with a specific set of de facto processes that ensure the effectiveness of condom use. First, before a condom is put on, the customer’s penis is visually inspected for gonorrhea, chlamydia, warts, herpes, and crabs.[7] This process is informally passed on from generation to genereation, with older, more experienced prostitutes teaching newer, less experienced prostitutes. Then, the prostitute puts the condom on her customer herself, to ensure that the condom does not break or tear. Throughout sex, the condom is visually checked, and if broken or used for extended periods of time, changed. These de facto measures lead to low rates of condom slippage and breakage.[8]

Health Measures and the AIDS crisis: A Brief History

Both public health laws outlined above were created in direct response to the 1980s AIDS crisis. Following the 1985 AIDS related death of Rock Hudson, actor and Las Vegas heartthrob, public discourse surrounding the safety of brothels proliferated. One brothel owner stated on October 2, 1985, the very same day of Rock Hudson’s death: “Business dropped off in all brothels…In general, people didn’t know whether it was safe or unsafe to go to legal houses. With all the publicity that prostitutes can spread AIDs, people assumed that included legal prostitutes in Nevada.”[9] The next year, 1986, legislation mandated that all prostitutes be regularly checked for HIV/AIDS. It is important to note that the Center for Disease control at the time had not deemed prostitution as a “high risk behavior.” The evidentiary link, at the time, between prostitution and HIV/AIDS was deemed inconclusive.[10] Thus these mandatory health checks did not arise from concrete evidence, but instead from cultural notions of the prostitute as diseased. This served to quell cultural concerns surrounding the protection of society from the diseased prostitute. 

Following this was the introduction of mandatory condom use two years later in 1988. The  measure began in 1986 with new state health administrator, Larry Matheis. Amidst the AIDS epidemic, instead of calling for the shutting down of Brothels, Mattheis supported increasing regulatory measures. Matheis began by convincing several Brothels to enact condom policies. Shortly after, Matheis passed a policy with the Nevada Brothel Association, mandating condom use for all Brothels. This went into affect January 1st, 1988.[11] It is important to note that measures protecting the prostitute from the customer arose two years later after measures protecting the customer from the prostitute.

What this Mechanism Achieves

Since the introduction of the condom policy, no legally employed prostitute in Nevada has tested positive for HIV.[12] The same cannot be said for prostitutes working in non-legalized areas. This   may provide us a model for prostitution that does not have negative health consequence. Furthermore, the condom policy allows for a set of highly specific practices that put the prostitute in control of their own safety (i.e. the practices of inspecting the penis, putting on the condom, etc.,).  Instead of leaving the issue up to the state, the brothel owner, or the customer, the prostitute is able to exercise some agency. These practices enable the prostitute to independently and proactively protect themselves.

What this Mechanism does not Achieve 

Mandatory health checks, while promoting the safety of the prostitute, does so in a way that limits the prostitute’s agency and marks the prostitute as diseased. Mandatory health checks fundamentally put the control of one’s body up to the state. Every month, the prostitute must undergo some form of invasive test that includes vaginal swabs, mouth swabs, blood tests, etc., One might argue that this is done in order to protect the customer; however, since condoms are also mandated, one might find this practice to be redundant. Additionally, in many other markets, the risk of an activity or service falls on the customer and not on the service. According to this logic, in mitigating risk for the customer, the prostitute must shift the questions of her health from that of an individual level to that of a state level. In other words, the question of a woman’s health is put in the hands of the state rather than in her own hands.

Symbolically these mandatory STI tests reinforce the prostitute as diseased. It has been argued that “the testing policy was, by all accounts, ineffectual and, at first, merely symbolic.”[13] When viewed historically as a response to the AIDS epidemic, one can see how the policies were created out of a climate of cultural panic. Brent writes, In the State of Sex, “Larry Matheis argued that the state had to have an immediate visible response [to the AIDS epidemic] even if it was largely ineffective in stemming the spread of HIV/AIDS.”[14] Furthermore, it can be seen that the mandatory health checks were put into place before the CDC tied prostitution to HIV/AIDS. Therefore these laws did not draw on concrete evidence, but instead drew on stereotypes that posited the prostitute as a diseased body. This law functioned to pacify the public hysteria surrounding HIV/AIDS and ostensibly ensured the safety of men from that of the “diseased prostitute.” In the State of Sex, Brents writes: “By playing on the public perception, the state lowers both its fiscal and political accountability.”[15] This law, however, while possibly preventing the spread of HIV from prostitute to client did not prevent the spread of HIV from client to prostitute (mandatory health checks only protected the client because the client was still able to have unprotected sex with the prostitute). Condom use, the only effective measure in preventing the spread of HIV from client to prostitute, was not, as already mentioned, mandated until two years later. Culturally this shows how the client’s health is viewed of as more important than the prostitute’s health. These laws continually reinforce the cultural stereotype of the prostitute as diseased.


[1] Brents, Barbara G., Crystal A. Jackson, and Kathryn Hausbeck. The state of sex: Tourism, sex and sin in the new American heartland. Routledge, 2010.

[2] Ibid, 8-9.

[3] Ibid, 9.

[4] Ibid, 8.

[5] Albert, Alexa. Brothel: Mustang Ranch and its women. Random House Digital, Inc., 2002, 58.

[6] [6] Brents, Barbara G., Crystal A. Jackson, and Kathryn Hausbeck. The state of sex: Tourism, sex and sin in the new American heartland. Routledge, 2010, 10.

[7] Brents, Barbara G., Crystal A. Jackson, and Kathryn Hausbeck. The state of sex: Tourism, sex and sin in the new American heartland. Routledge, 2010, 10, 59.

[8] Ibid, 5.

[9] Brents, Barbara G., Crystal A. Jackson, and Kathryn Hausbeck. The state of sex: Tourism, sex and sin in the new American heartland. Routledge, 2010, 10, 81.

[10] Ibid, 82.

[11] Ibid, 84.

[12] Ibid 85.

[13] Ibid, 85.

[14] Ibid, 84.

[15] Ibid, 84. 

Now: Mandatory Health Regulations and Mandatory Condom Use