&lt;h1 class=&quot;section-header&quot; style=&quot;text-align: center;&quot;&gt;&lt;strong&gt;Travel&amp;nbsp;&amp;amp; Sex&lt;/strong&gt;&lt;/h1&gt;
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&lt;p class=&quot;yb-author-name&quot; style=&quot;text-align: right;&quot;&gt;by &lt;span style=&quot;color: #ff99cc;&quot;&gt;&lt;strong&gt;&lt;a href=&quot;../../pulseteam/2&quot;&gt;Dr.Deyn Natthakhet Yaemim (Founding Director)&lt;/a&gt;&lt;/strong&gt;&lt;/span&gt;&amp;nbsp; on 8 August 2021&lt;/p&gt;
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&lt;p class=&quot;yb-author-name&quot;&gt;&lt;span style=&quot;color: #999999;&quot;&gt;There are many purposes for people to travel. To make it easy we can look at the type of visa offered or categorized by countries.&lt;/span&gt;&lt;br /&gt;&lt;span style=&quot;color: #999999;&quot;&gt;Tourism, visiting friends and family, study, work and business, diplomatic visit. No matter what purpose it is for a person travelling, a good chance is that they have sex during their trips.&amp;nbsp;&lt;/span&gt;&lt;/p&gt;
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&lt;h2&gt;&lt;strong&gt;CASUAL SEX DURING TRAVEL&lt;/strong&gt;&lt;/h2&gt;
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&lt;p&gt;&lt;span style=&quot;color: #999999;&quot;&gt;It is important to distinguish between casual sex and sex tourism. Sex tourism (see below) is travel for the specific purpose of having sex, typically with commercial sex workers. Casual sex during travel, by contrast, describes informal sexual encounters with fellow travelers or locals. Although some travelers may expect to have casual sexual encounters, others who have sex do not.&lt;/span&gt;&lt;/p&gt;
&lt;p&gt;&lt;span style=&quot;color: #999999;&quot;&gt;Two meta-analyses (2010 and 2018) provide a range of how many international travelers engage in casual sex, approximately 20%&amp;ndash;34%. Although crude&amp;mdash;both the 2010 and 2018 pooled prevalence values are based on just a handful of studies, each with considerable variation in their own estimates&amp;mdash;these numbers shed some light on how common casual sex during travel may be. These same studies also provide estimates on the number of travelers engaging in unprotected sex (i.e., sex without a condom). The 2010 report indicates that approximately half (49%) of all travelers participating in casual sex abroad have unprotected intercourse, although in the 2018 report, that number was slightly lower (43%).&lt;/span&gt;&lt;/p&gt;
&lt;p&gt;&lt;span style=&quot;color: #999999;&quot;&gt;Populations less well represented in the literature include female travelers and men who have sex with men (MSM). Limited data on the casual sexual activity of female travelers suggest that such activity occurs almost as frequently as it does in male travelers, and that the incidence of unprotected sex is nearly as high. Existing literature concerning MSM is conflicting. Some studies report MSM are more likely to have new sex partners and unprotected intercourse while abroad. A recent study from California, however, demonstrated that MSM who travel internationally are more likely to use condoms and engage in less risky behavior.&lt;/span&gt;&lt;/p&gt;
&lt;p&gt;&lt;span style=&quot;color: #999999;&quot;&gt;As travelers go places where they are not known, they may no longer feel obligated to observe the same moral standards as at home, or they may desire to create connection with others. The act of travel itself may create the potential for casual sex. Disinhibition resulting from drug and alcohol use, a desire for adventure and excitement, peer pressure, and underlying psychological needs and personality traits may contribute, individually or in combination, to travelers having casual sex.&amp;nbsp;&lt;/span&gt;&lt;/p&gt;
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&lt;h4 style=&quot;text-align: left;&quot;&gt;&lt;strong&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Factors associated with higher frequency of casual or unprotected sex abroad&lt;/span&gt;&lt;/strong&gt;&lt;/h4&gt;
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&lt;li&gt;&lt;span style=&quot;color: #cc99ff;&quot;&gt;Male&lt;/span&gt;&lt;/li&gt;
&lt;li&gt;&lt;span style=&quot;color: #cc99ff;&quot;&gt;Single&lt;/span&gt;&lt;/li&gt;
&lt;li&gt;&lt;span style=&quot;color: #cc99ff;&quot;&gt;Younger age&lt;/span&gt;&lt;/li&gt;
&lt;li&gt;&lt;span style=&quot;color: #cc99ff;&quot;&gt;Traveling without a partner (either alone or with friends)&lt;/span&gt;&lt;/li&gt;
&lt;li&gt;&lt;span style=&quot;color: #cc99ff;&quot;&gt;&amp;ge;2 sex partners in the last 2 years&lt;/span&gt;&lt;/li&gt;
&lt;li style=&quot;text-align: left;&quot;&gt;&lt;span style=&quot;color: #cc99ff;&quot;&gt;History of previous sexually transmitted infection&lt;/span&gt;&lt;/li&gt;
&lt;li&gt;&lt;span style=&quot;color: #cc99ff;&quot;&gt;Illicit drug use, alcohol abuse, tobacco use&lt;/span&gt;&lt;/li&gt;
&lt;li&gt;&lt;span style=&quot;color: #cc99ff;&quot;&gt;Casual sex at home and during a previous travel experience&lt;/span&gt;&lt;/li&gt;
&lt;li&gt;&lt;span style=&quot;color: #cc99ff;&quot;&gt;Expectation of casual sex while?abroad&lt;/span&gt;&lt;/li&gt;
&lt;li&gt;&lt;span style=&quot;color: #cc99ff;&quot;&gt;Long-term travel (expatriates, military, Peace Corps volunteers)&lt;/span&gt;&lt;/li&gt;
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&lt;h3 class=&quot;travel-for-work-other-reasons&quot;&gt;&amp;nbsp;&lt;/h3&gt;
&lt;h3 class=&quot;travel-for-work-other-reasons&quot;&gt;&lt;strong&gt;SEX TOURISM&lt;/strong&gt;&lt;/h3&gt;
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&lt;p&gt;&lt;span style=&quot;color: #999999;&quot;&gt;&amp;ldquo;Sex tourism&amp;rdquo; is defined as travel planned specifically for the purpose of sex, generally to a country where sex work is legal.&lt;/span&gt;&lt;/p&gt;
&lt;p&gt;&lt;span style=&quot;color: #999999;&quot;&gt;&amp;ldquo;Sex tourism,&amp;rdquo; as defined above, is travel specifically for the purposes of procuring sex. In one study, typical sex tourists were highly educated men, 30&amp;ndash;40 years of age, going to economically disadvantaged countries to pay for sex with commercial sex workers. Fewer than half of these men reported regularly using condoms, even in destinations where the prevalence of STIs (including HIV disease) is?high.&lt;/span&gt;&lt;/p&gt;
&lt;p&gt;&lt;span style=&quot;color: #999999;&quot;&gt;In some countries, commercial sex work is legal and culturally acceptable. In many other places, however, sex tourism supports sex trafficking, among the largest and most lucrative criminal industries in the world.&lt;/span&gt;&lt;/p&gt;
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&lt;h3&gt;&lt;strong&gt;SEXUAL ABUSE, CHILD PORNOGRAPHY, AND THE LAW&lt;/strong&gt;&lt;/h3&gt;
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&lt;p&gt;&lt;span style=&quot;color: #999999;&quot;&gt;Although commercial sex work may be legal in some parts of the world, sex trafficking, sex with a minor, and child pornography are always criminal activities according to US law; travelers can be prosecuted in the United States even if they participated in such activities overseas. The Trafficking Victims Protection Act makes it illegal to recruit, entice, or obtain a person of any age to engage in commercial sex acts or to benefit from such activities.&lt;/span&gt;&lt;/p&gt;
&lt;p&gt;&lt;span style=&quot;color: #999999;&quot;&gt;Federal law bars US residents traveling abroad from having sex with minors. This applies to all travelers, both adult and youth. Travel health providers should inform student travelers (and other young people going abroad) that according to US law, it is illegal for a US resident to have sex with a minor in another country. Bear in mind, however, that the legal age of consent varies around the world, from 11&amp;ndash;21 years. In some countries, there is no legal age of consent: local law forbids all sexual relations outside of marriage.&lt;/span&gt;&lt;/p&gt;
&lt;p&gt;&lt;span style=&quot;color: #999999;&quot;&gt;Regardless of the local age of consent, participation in child pornography anywhere in the world is illegal in the United States. This includes sex with minors, as well as the purchase, procurement, holding, or storage of material depicting such acts. These crimes are subject to prosecution with penalties of up to 30 years in prison. Victims of child pornography suffer multiple forms of abuse (sexual, physical, emotional, and psychological), poverty and homelessness, and health problems, including physical injury, STIs, other infections and illnesses, addiction, and malnourishment.&lt;/span&gt;&lt;/p&gt;
&lt;p&gt;&lt;span style=&quot;color: #999999;&quot;&gt;A report published in 2016 by End Child Prostitution, Child Pornography, and Trafficking of Children for Sexual Purposes International (ECPAT) identified that most perpetrators of child pornography are &amp;ldquo;situational&amp;rdquo; offenders, people who may have never considered sexually exploiting a child until given the opportunity to do so. Americans and US permanent residents account for an estimated 25% of child sex tourists worldwide and up to 80% in Latin America. They are typically white men aged &amp;ge;40 who have been traced visiting Mexico, Central and South America (Brazil, Colombia, Costa Rica, Dominican Republic), Southeast Asia (Cambodia, India, Laos, Philippines, Thailand), Eastern Europe (Estonia, Latvia, Lithuania, Russia), and other regions.&lt;/span&gt;&lt;/p&gt;
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&lt;h1&gt;&lt;strong&gt;Be Aware&lt;/strong&gt;&lt;/h1&gt;
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&lt;h2&gt;Infections &amp;amp; Diseases&lt;/h2&gt;
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&lt;p&gt;&lt;span style=&quot;color: #999999;&quot;&gt;HIV and other sexually transmitted infections (STIs) may be common among sex workers. Some common STIs, such as gonorrhea, have become extensively drug-resistant in some parts of the world. Make&amp;nbsp;&lt;strong&gt;sure you ALWAYS use protection when having sex with a new partner.&lt;/strong&gt;&lt;/span&gt;&lt;/p&gt;
&lt;p&gt;&lt;span style=&quot;color: #999999;&quot;&gt;The World Health Organization estimates approximately 357 million infections with curable sexually transmitted pathogens (chlamydia, gonorrhea, trichomoniasis, and syphilis) per year, or nearly 1 million new infections per day. More than 30 different sexually transmitted infections (STIs) are caused by a range of pathogens, not all of which are curable or vaccine preventable. Travel health providers have a responsibility to educate their patients about what they can do to reduce the chances of acquiring an STI during travel. Targeted teaching and messaging to travelers at highest risk is a prudent approach.&lt;/span&gt;&lt;/p&gt;
&lt;p&gt;&lt;span style=&quot;color: #999999;&quot;&gt;Global distribution of sexually transmitted pathogens and their sensitivity to available treatment varies. International travelers having sex with new partners while abroad are exposed to different &amp;ldquo;sexual networks&amp;rdquo; than at home and can serve as a conduit for importation of novel or drug-resistant STIs into parts of the world where they are unknown or rare. Gonorrhea, for example, among the more common STIs globally (with an estimated 85 million new cases in 2012), has become extensively drug resistant in some parts of the world. Patients presenting with antimicrobial-resistant gonococcal infections should prompt providers to inquire about their travel history and the travel history of their sex partners.&lt;/span&gt;&lt;/p&gt;
&lt;h2&gt;Legality&lt;/h2&gt;
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&lt;p&gt;&lt;span style=&quot;color: #999999;&quot;&gt;Sex tourism supports human trafficking (slavery), one of the largest criminal industries in the world. Even if prostitution is legal in a country, human trafficking, sex with a minor, and child pornography are&amp;nbsp;&lt;strong&gt;ALWAYS&lt;/strong&gt;&amp;nbsp;crimes. Millions of children around the world are victims of commercial sexual exploitation. Children abused by sex tourists suffer not only sexual abuse but also physical, emotional, and psychological abuse, as well as poverty and homelessness. They suffer from health problems including addiction, malnourishment, injuries, STIs and emotional trauma.&lt;/span&gt;&lt;/p&gt;
&lt;p&gt;&lt;span style=&quot;color: #999999;&quot;&gt;&lt;strong&gt;Someone who engages in these activities in a foreign country can be prosecuted under that county&amp;rsquo;s law while abroad and under US law after returning to the United States.&lt;/strong&gt;&lt;/span&gt;&lt;/p&gt;
&lt;p&gt;&lt;span style=&quot;color: #999999;&quot;&gt;Although the age at which someone is considered a minor may vary by country, federal law makes it a crime for US residents to engage in sexual or pornographic activities with a child younger than 18 years anywhere in the world. It is also illegal to travel abroad for the purpose of having sex with a minor.&lt;/span&gt;&lt;/p&gt;

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