sex tourism in developing countries

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Trop Dis Travel Med Vaccines

Sun, sea and sex: a review of the sex tourism literature

Timothy siliang lu.

1 School of Medicine, National University of Ireland Galway, Galway, Ireland

Andrea Holmes

2 Saolta University Hospital Healthcare Group, University Hospital Galway, Galway, Ireland

Chris Noone

3 School of Psychology, National University of Ireland Galway, Galway, Ireland

Gerard Thomas Flaherty

4 School of Medicine, International Medical University, Kuala Lumpur, Malaysia

Associated Data

All material referenced in the preparation of this work are available from the corresponding author.

Sex tourism is defined as travel planned specifically for the purpose of sex, generally to a country where prostitution is legal. While much of the literature on sex tourism relates to the commercial sex worker industry, sex tourism also finds expression in non-transactional sexual encounters. This narrative review explores current concepts related to travel and sex, with a focus on trans-national sex tourism.

The PubMed database was accessed to source relevant literature, using combinations of pertinent search terms. Only articles published in the English language were selected. Reference lists of published articles were also examined for relevant articles.

With regard to preferred destinations, South/Central America and the Caribbean were more likely to receive tourists looking for casual sex. Longer duration of travel, travelling alone or with friends, alcohol or drug use, being younger and being single were factors associated with higher levels of casual sex overseas. The majority of literature retrieved on sex workers focused on risk behaviours, sexually transmitted infections (STI), mobility of sex workers and how these factors affected their lives. Sex tourists require better access to effective methods of preventing HIV, such as pre-exposure prophylaxis, and better education on HIV prevention. Drugs and alcohol play a major role as risk factors for and cofactors in casual sexual behaviour while abroad.

Conclusions

Travellers need to be informed of the increased risks of STI before travel. They should be aware of the local prevalence of STIs and the risks associated with their sexual practices when they travel, including engaging with commercial sex workers, having unprotected sexual intercourse and becoming victims of sexual violence.

Prior to the current pandemic of COVID-19, international travel had reached record levels of activity, with 1.4 billion traveller arrivals recorded in 2018 [ 1 ]. Sex and travel have a long association, dating from the ancient world onwards [ 2 ], and their connection is still apparent today. Sex tourism is defined by the Centre for Disease Control and Prevention (CDC) as “travel planned specifically for the purpose of sex, generally to a country where prostitution is legal” [ 3 ]. Domestic sex tourism implies travel within the same country, while trans-national sex tourism refers to travel across international boundaries.

While much of the literature on sex tourism relates to the commercial sex worker industry, which remains illegal in many jurisdictions, sex tourism also finds expression in non-transactional sexual encounters, typically involving a tourist from an economically developed country seeking sexual experiences in developing host destinations. In some cases, travellers may engage in sex tourism to validate their own sexual identity with greater freedom than would be allowed in their own, more conservative nations. The main source of opposition to sex tourism concerns the troubling phenomenon of child sex tourism, which will be explored later in this review.

The link between travelling and the spread of disease is undeniable, as demonstrated by the current COVID-19 pandemic. As the travel landscape changes in the aftermath of the pandemic, so will the behaviour of travellers. The subject of sex tourism has been neglected to date in the travel medicine literature and receives little attention in the pre-travel health consultation. This narrative review explores current concepts related to travel and sex, with a focus on trans-national sex tourism, while also giving an insight into specific risks and behaviours associated with this activity.

Literature search strategy

The PubMed database was accessed between June 2019 and June 2020 to source relevant literature using combinations of the following search terms: Sex, Tourism, Travel, Migration, Holiday, Abroad, Vacation, Sexually Transmitted Infection, Sexually Transmitted Disease, Human Immunodeficiency Virus, Prostitution, Drugs, Alcohol, Trafficking, Rape, Child, Military, Navy, Defence Forces, Business, Homosexual, Heterosexual, LGBTQ+, Transgender, Asia, North America, South America, Europe, Oceania, Africa. Only articles published in the English language were selected. Articles published within the past 5 years were prioritised. Reference lists of published articles were examined to ensure all relevant articles were included. Relevant sources of grey literature were also retrieved using Google® as a search engine. The legality of prostitution in different international jurisdictions, governmental attempts to regulate the sex tourism industry and the extraterritorial criminalisation of child sex tourism were beyond the scope of the current review.

Epidemiology of sex and travel

In the context of this review, we define casual sex as sexual relations undertaken without serious intent or emotional commitment between individuals who are not established sexual partners or do not know each other well. Men were more likely to seek out or engage in casual or risky sex behaviours (e.g., multiple partners, unprotected intercourse) while travelling [ 4 – 6 ]. As many as 1 in 10 men were recorded as having an overseas partner in a British study [ 6 ], and different categories of male sex tourist have also been proposed in the literature [ 7 ], ranging from the ‘macho lad’ asserting his dominance over foreign women to the ‘white knight’ saving women from commercial sex work. A study from the United States showed that female travellers had a greater preference for travel to European or tropical countries, and that sex was more likely to occur on group tours, sightseeing or backpacking holidays lasting fewer than 14 days [ 8 ]. Female sex tourism has also been described in Caribbean destinations such as Jamaica, with Euro-American women purchasing the services of so-called “Rent-A-Dreads”, local men who seek out relationships with tourist women for economic gain [ 9 ]. Younger women were reported to prefer expatriates and other tourists as sexual partners [ 10 ], while men of all ages and older women were reported to exercise a preference for local partners.

With regards to preferred destinations, a meta-analysis conducted in 2018 showed that South/Central America and the Caribbean were more likely to receive tourists looking for casual sex [ 5 ]. Additionally, Thailand and Cuba also have a prevalent sex tourism industry [ 7 , 11 ]. One study found that 66% of Australian tourists to Thailand were planning on having a sexual encounter while there [ 11 ], while sex tourism in Cuba has been described as “integral to the Cuban experience” [ 12 ]. Traveller subtypes who were more likely to engage in sex included backpackers, travelling businessmen, those visiting friends and relatives (VFR), and those travelling specifically to solicit commercial sex workers [ 5 ]. Factors associated with popular sex tourism destinations are described in Table 1 .

Characteristics of popular sex tourism destinations [ 5 , 13 – 15 ]

STI sexually transmitted infection

Several studies report that longer duration of travel (greater than 1 month), travelling alone or with friends, alcohol or drug use, being younger and being single were factors associated with higher levels of casual sex overseas [ 4 – 6 ]. A study conducted in Sweden reported conflicting data, showing that short term travellers (less than 5 days) were 20 times more likely to engage in casual sex [ 16 ]. While few studies offered information linking different ethnicities to sexual behaviour overseas, one British study found that non-white citizens were more likely to engage in sexual behaviour while travelling [ 6 ]. Migrants and members of the lesbian, gay, bisexual, transgender and queer (LGBTQ+) community are also discussed frequently in the sex tourism literature. A summary of the characteristics associated with sexual risk behaviour is shown in Table 2 . This will be explored further in this review. Studies of travellers engaging in sex with tourism representatives [ 11 ], sex workers and fellow travellers [ 5 ] show that choice of partner while travelling is not limited to any particular demographic.

Summary of the characteristics of a typical sex tourist [ 4 – 6 , 8 , 16 – 23 ]

LGBTQ+ Lesbian, Gay, Bisexual, Transgender and Queer

Commercial sex work and travel

Travellers may engage in planned or opportunistic interactions with commercial sex workers (CSW). The majority of literature we retrieved on sex workers focused on risk behaviours, sexually transmitted infections (STI), mobility of sex workers and how these factors affected their lives. De et al. examined the different categories of sex worker in the region of Bangui in the Central African Republic, and found that 1 in 4 of ‘Pupulenge’, the higher class sex worker more likely to cater to foreigners, had poor regular usage of condoms in the previous 3 months, but better knowledge of their HIV/AIDS risk and status [ 24 ]. There were similar findings among male sex workers in Jamaica, who regarded themselves more as long term romantic partners of female tourists, and as such had low levels of condom usage [ 13 ]. In addition, these men had reported misuse of alcohol and drugs, and were accustomed to having multiple partners.

Safe sex behaviours were also shown to be highly dependent on the travel destination. A study in Singapore showed that 87.5% of local men used condoms when engaging a sex worker in Singapore, but when travelling the rate dropped to between 44 and 77%, depending on location [ 25 ]. This finding was supported by research from Hong Kong, which also showed that heterosexual men reported lower levels of condom usage when visiting sex workers outside of their own country [ 26 ]. Hsieh et al. [ 27 ] proposed that the clients of sex workers could facilitate the spread of STIs between different nations and networks to a larger degree than sex workers, while also contributing to STI prevalence within their own communities.

An interesting area with limited research evidence is the role sex tourism websites play, with only one paper identified on this subject [ 28 ]. This article analysed various sex tourism websites and found that most displayed sex workers as commodities, to be chosen and paid for by tourists, portraying them as exotic third world women, capable of providing a “total girlfriend experience”, enjoying the company of foreigners and being completely subservient to them. This study proposed that these websites enforce the fiction behind sex tourism and, in doing so, sustain the possible misogynistic views of the sex tourist. It was also noted that any legal or health information on these websites was centred round the tourist, rather than the sex worker.

The risks faced by non-commercial partners of sex workers have also been studied. An examination of CSW in a Mexican border town with high migratory traffic found that unprotected sex was often common in their personal relationships, too [ 29 ]. The literature relating to CSW and travel showed that multiple parties are implicated in commercial sex networks, and the behaviour of any one individual in these networks has implications for many others. Table 3 below summarises these findings.

Summary of commercial sex worker studies

CSW commercial sex workers; STI sexually transmitted infections

Sexually transmitted infections

The association of sex tourism and casual sex during travel with the spread of novel STIs has long been recognised. It has been suggested that Columbus’ sailors were responsible for the epidemic of venereal syphilis in Europe in the late fifteenth century following sexual relations with local Haitian women [ 2 ], while the link between travel and the spread of novel STIs was also established in Thailand in the 1980s [ 30 ], and Trinidad and Tobago in 2012 [ 31 ]. Travellers are also thought to be implicated in the reintroduction of syphilis and lymphogranuloma venereum to parts of North America and Europe [ 25 ]. The risk factors for traveller acquisition of STIs include longer duration of stay, travel to lower income countries, being single, substance abuse, being male, repeat visits to the same area, and a previous history of multiple partners or STIs [ 32 , 33 ]. Crawford et al. identified being female, having a history of fewer sexual partners, and having received pre-travel health advice and vaccinations as being associated with a lower risk of contracting STIs among expatriates and travellers [ 32 ].

While prevalence rates for STIs among CSW vary, rates as high as 88% in Nairobi and 44% in Bangkok have been reported [ 34 ]. In addition to this, high rates of curable STI prevail worldwide, ranging from 5 to 65% in Africa, 20.9% in Brazil and 0–13.6% in Asia [ 10 ]. These findings put sex tourists at very high risk for STIs on a global scale. A diverse range of STIs has been recorded in travellers returning from tropical countries [ 35 ], from frequent detection of genital herpes in sailors returning to China [ 36 ], to the suggested “new” STI Tinea genitalis , found in several individuals with a recent travel sex history in Southeast Asia [ 37 ]. While this type of dermatophyte infection is not primarily an STI, the sudden rise in cases associated with it over a short period highlights how vulnerable travellers are to organisms transferable through intimate contact during travel.

A study examining all cases of gonorrhoea contracted by people living in Nordic nations between 2008 and 2013 showed that 25.5% of all cases were associated with travel [ 14 ]. The rates of travel-associated gonorrhoea increased from year to year and, while the majority of cases involved men, the number of affected women increased from year to year. Among the regions visited, the majority of Nordic travel-associated cases of gonorrhoea were associated with travel to Asia (between December and July) and Europe (from August to November), a third of cases were associated with travel to Thailand, and travel to Thailand, Philippines and Spain accounted for almost half of all travel-related cases. These data imply that specific regions can be considered hotspots for contraction of STIs during travel.

Another important consideration is the acquisition and spread of antimicrobial resistant (AMR) STIs. In recent years, the rise in AMR involving Haemophilus ducreyi has been documented worldwide [ 10 ]. Similarly, beta-lactamase producing strains of Neisseria gonorrhoeae have been detected in Africa, the Caribbean and Asia. In isolates of N. gonorrhoeae from Africa and Southeast Asia, penicillin resistance has been reported in as many as 50% of isolates. Baker et al. also noted the worldwide spread of azithromycin-resistant shigellosis through sexual transmission, from high prevalence regions in Africa and Asia, to lower prevalence nations [ 38 ]. The documented increase in AMR STIs puts travellers engaging in sexual behaviour at high risk of treatment-resistant infection.

Current efforts to advise and change traveller behaviours have been shown to be of limited effectiveness. A study of different efforts to curtail travellers’ risk behaviour showed that providing brief interventions on sexual health during consults for travellers proved minimally more effective than just distributing condoms or not providing additional advice [ 39 ]. This trial showed that the methods employed still resulted in low levels of condom usage. In a study by Croughs et al., extensive motivational training was shown to reduce sexual risk behaviour, and it was also found that written materials on STIs were more effective than having travel health practitioners discuss STI prevention with travellers [ 40 ]. A change in strategy appears necessary to combat the risk-taking behaviours of travellers, especially given the reported difficulty of reaching target audiences [ 41 ].

This is an important area that warrants further research, given poor recorded levels of condom usage in travellers. A meta-analysis of literature on this subject found that the pooled prevalence of unprotected intercourse among travellers who had sex overseas was 49.4% [ 42 ]. Similar results have been shown among sexually active backpackers visiting Ko Tao and Ko Phangan in Thailand, with a third of subjects reporting inconsistent condom use. An online cross-sectional study of travellers was conducted in 2014 [ 15 ], and among the sexually active population 59.7% reported inconsistent condom use. A study of condom usage among Swedish travellers revealed flawed reasoning for decisions around condom usage, such as length of familiarity with partner, the country visited, and asking if their partner had an STI [ 43 ]. This same study also revealed that some travellers succumbed to peer pressure, were more willing to let their partner make the decision, and had a fear of being seen as promiscuous (among heterosexual women) or a fear of ‘ruining the moment’ (among heterosexual men), leading to reduced condom usage. Other factors associated with reduced usage were the belief that foreign condoms were of poorer quality [ 34 ], spontaneous sexual encounters or embarrassment at purchasing condoms [ 43 ], substance use [ 15 , 32 , 43 ], and travel to Latin America or the Caribbean [ 15 ]. An examination of male sex tourists to Thailand also revealed that unprotected sex was seen as more masculine and enjoyable, and there was a general misconception among male sex tourists that unprotected heterosexual intercourse was a low risk activity [ 44 ]. This same study also showed that male heterosexual sex tourists were aware of risks, but due to their own personal or peer experiences being at variance with the warnings they received regarding risky sexual behaviour, they were more likely to engage in unprotected sex with CSW. The low rates of condom usage put sexually active travellers at an obvious risk for contraction of STIs.

It is accepted that contracting an STI increases the risk of HIV transmission, and vice versa [ 45 ]. A Geosentinel analysis from 2013 indicated that, out of a sample of 64,335 travellers, 117 returned home with acute symptoms of HIV transmission [ 46 ]. In addition, links between clusters of HIV acquisition in Belize, Mexico, Guatemala and Honduras have been found. This finding highlighted the role migration and travel play in the transmission of HIV within Central America. This study also found half of Honduran woman sampled with HIV belonged to viral clusters that were linked to international clusters. Memish and Osoba also noted in their paper on STIs and travel that travellers to Sub-Saharan Africa, Southeast Asia and India were most likely to acquire HIV from unprotected sexual encounters [ 2 ]. The voluminous literature relating to STIs and travel indicates that this is an area of key importance to the travel medicine practitioner. While the effectiveness to date of interventions in altering risk behaviours in travellers has been questionable, it is clear that travellers require better access to effective methods of preventing HIV, such as pre-exposure prophylaxis (PrEP), and better education on HIV prevention.

The LGBTQ+ community and travel sex behaviour

A meta-analysis published in 2018 revealed that gay, bisexual and other men who have sex with men (MSM) travellers were 3 times more likely to have casual sex while travelling [ 5 ]. Travel or migration may allow members of the LGBTQ+ community to escape from societal pressures they face in their home countries and explore their sexuality [ 17 ]. MSM are also more likely than heterosexual men to have multiple partners during their travels. MSM have also shown to be at least twice as likely to pay for sex compared to heterosexual men [ 10 ]. A report on MSM travellers in the United States also found that 19.4% of those surveyed reported that having sex with a new partner was one of their main goals while on vacation [ 18 ]. Further studies in the US on MSM travellers to Key West, a popular destination for LGBTQ+ travellers in Florida, found that of the sexually active participants, 34% had new partners, and 59% had unprotected anal intercourse (UAI) [ 19 ]. Among Swedish MSM travellers, 13.5% reported UAI during their overseas travels, the majority of whom met a new partner abroad [ 20 ]. Additional studies in China involving MSM found that 5% identified as sex tourists, a third of this group identified the purchase of sex as a primary reason for travel, and another third had UAI while travelling [ 21 ].

While limited research exists on other categories of travellers within the LGBTQ+ community, one paper on transgender women in Bangladesh revealed that those who crossed international borders had a greater number of transactional sex partners and reduced use of condoms [ 22 ]. Across all of these studies, regular associations between travel and drug and alcohol use, transactional sex, group sex, a history of STIs and a greater number of past partners were reported [ 18 – 23 ].

Another interesting area of development in LGBTQ+ international travel trends is the resurgence of circuit parties [ 47 ]. These parties involve weekend-long social activities and dance events. Party-goers were found more likely to have a greater number of partners in the previous 6 months, greater use of recreational drugs, more likely to seek transactional sex, and more likely to report a personal history of STI and UAI. A common finding with these parties was attendees travelling from low HIV prevalence countries to high prevalence countries. This finding was replicated among Chinese MSM travellers [ 21 ]. These social events are commonly associated with the use of drugs which heighten sexual arousal, an activity referred to as ‘chemsex’.

Networks of MSM travellers have also been described around the world. A group of MSM referred to as “Geoflexibles” was identified by Gesink et al. in 2018 [ 48 ]. The authors described a group of men who were willing to travel for sex, and who were less particular about where they had sex. Gesink proposed that these travellers could act as a bridge between MSM in Toronto and, although his study did not specifically mention international travel, it is certainly applicable in the travel context. Networks of MSM implicated in the transmission of STIs and HIV have been suggested in the literature. Persson et al. suggested the presence of a network in Sweden with a high prevalence of STI/HIV [ 20 ], and an examination of HIV clusters in Central America found that half of the people living with HIV were MSM, with serotypes closely related to international clusters [ 49 ]. The suggestion of international MSM networks and travel playing a role in the dispersion of STI/HIV was reinforced by Takebe et al. in 2014 [ 50 ]. Their research revealed the worldwide dispersal of the JP.MSM.B1 subtype of HIV, and confirmed the interactions of HIV epidemics between Japan, China and the rest of the world. These networks have also been implicated in Shigella transmission in San Francisco [ 51 ], in addition to an outbreak of Hepatitis A in Northern Italy [ 52 ].

These findings have implications for LGBTQ+ travellers who engage in sexual behaviour while abroad. Mathematical modelling of LGBTQ+ tourists to Key West estimated that 1 in 196.5 MSM who engage in risk behaviour will acquire HIV [ 19 ], roughly equating to 200 new infections per 100,000 tourists, a number which could drop to as low as 45 with consistent condom use. In 77% of sexual interactions in this study, HIV serostatus was not discussed. Studies about MSM travellers in San Francisco showed that, among those who engaged in casual sex, there was a decreased probability of HIV serodisclosure when communication was an issue owing to language barriers [ 53 ]. A follow up study was conducted on the health-seeking behaviour of MSM travellers, revealing that a quarter of those surveyed had not received the Hepatitis B virus vaccine, and of the men living with HIV, a third had not been vaccinated [ 54 ].

Another facet of the intersection between sex tourism and HIV transmission that warrants attention is the relatively new phenomenon of “holiday pre-exposure prophylaxis” (PrEP) for HIV. With PrEP being a relatively new phenomenon, limited literature exists on the subject in relation to travel, but interviews conducted by Underhill et al. suggest that MSM travellers regard themselves as at greater risk for HIV while travelling and are more willing to take PrEP [ 55 ]. However, travel has also been associated with disruption in PrEP regimens due to inconvenience [ 56 , 57 ], so the role it plays in sex tourism warrants further research.

Travel for the purposes of sexual exploration and casual sex among MSM presents a challenge to travel medicine practitioners. Analysis of Swedish MSM travellers in 2015 revealed that there was little HIV or STI prevention information received in Sweden or abroad [ 58 ]. In addition, only 3% of the surveyed population sought out this information before travelling. A further investigation of the knowledge, attitudes and practices of MSM travellers is required to plan successful interventions in this population of international travellers. More research on how sex tourism is experienced by women and gender diverse people within the LGBTQ+ community is also warranted.

The effects of alcohol and drugs on sex tourism

Drugs and alcohol play a major role as risk factors for and cofactors in casual sexual behaviour while abroad. A study of British summer workers in Ibiza found that almost all those surveyed drank alcohol, while 85.3% used drugs during their stay, a high proportion of whom used drugs that they had never tried before [ 59 ]. This study found that the odds of having sex increased with the use of amphetamines or higher frequency of drinking, while the odds of having multiple partners increased with greater frequency of drinking. Unprotected sex was also found to be more likely when alcohol was involved.

Extensive analysis of American students on Spring Break has also been conducted to analyse the role alcohol plays in high risk behaviour during this period. Patrick et al. found that a greater proportion of students drank alcohol before having sex or making risky sexual decisions [ 60 ]. This finding was particularly prevalent among students who travelled abroad. Another study of Spring Break students found that risky behaviours such as unprotected sex or multiple partners were cumulative [ 61 ], such that engaging in one activity increased risk for the other. Almost half of the students in this study reported binge drinking before sex. The role alcohol and drugs play in exposing travellers to risky sexual behaviour is clear, but this appears to be poorly appreciated by the traveller. Travel health practitioners must emphasise the risks travellers expose themselves to when misusing alcohol and drugs.

Sexual assault and violence in travellers

A cross-sectional survey on travellers returning from Mediterranean resorts reported that 1.5% were subject to non-consensual sex during their travels, with gay and bisexual males reporting higher levels [ 62 ]. In this same report, 8.6% of respondents experienced some form of sexual harassment, with females and gay/bisexual males more frequently reporting this. Another finding was that being a gay/bisexual male, using marijuana, and patronising bars where there were opportunities for sex were factors associated with being subject to non-consensual sex. A similar study on the harassment of tourists in Barbados found between 7 and 12% of tourists reported sexual harassment, depending on their country of origin [ 63 ]. Kennedy and Flaherty also asserted that up to 4% of Irish citizens reporting sexual violence experience it while travelling [ 64 ]. A review from Canada of all reported sexual assault cases associated with mass gathering events found a significant association between being overseas and being sexually assaulted at such an event [ 65 ]. Table 4 outlines the pre-travel health advice which should be available to travellers who may engage in sex tourism.

Pre-travel health recommendations

STI sexually transmitted infection; HIV human immunodeficiency virus; PrEP pre-exposure prophylaxis

Child sex tourism

Klain described two main types of child sex tourist, the “elective sex tourist” who travels for leisure or business and makes unplanned use of child sex workers when given the opportunity, and the “core sex tourist”, the purpose of whose trip is solely to engage in sexual contact with a child [ 66 ]. A study of German tourists conducted in 2017 found that 0.4% reported being child sex tourists [ 67 ]. This same study found that these individuals usually had personal experiences of abuse, paedophilic and antisocial behaviours. With an estimated 1.2 million children trafficked worldwide annually [ 67 ], more research is urgently needed on this topic.

The effects of wealth and mobility on sex tourism

Aggleton et al. describe in their paper a specific group of travellers, “mobile men with money” [ 68 ]. These men come from diverse backgrounds and various employments, but share two common features, high spending power and high mobility. In the paper, these men were said to frequently use their high spending power and resources to engage in casual and transactional sex encounters. This group of men was found to be at high risk for HIV. The paper proposed that these men lacked social support and were frequently influenced by the behaviour of their peers. While further literature on this sub-group is lacking, travel to lower income countries and the resulting increase in spending power for the traveller have been documented as risk factors for acquisition of STI/HIV [ 32 ]. This would suggest that wealth inequality may have a role in influencing risk behaviours in certain individuals.

Impact of sex tourism on host communities

While a detailed consideration of the impact of sex tourists on sex tourism destinations is beyond the scope of the current work, some key issues are worthy of discussion. Local cultural attitudes towards sex tourism are complex and are influenced by harsh economic conditions, where impoverished families may find themselves with few options for survival and have to resort to sending their children to urban centres visited by sex tourists. There may be an expectation in some cultures that children will share the family’s financial burden. Remittances from a family member engaged in the sex tourism industry may be vital to enable families to improve their quality of life.

Child sex tourism produces a detrimental impact on the children’s capacity to achieve their goals within the education system. Sex tourism may reinforce traditional colonial attitudes towards race and gender, which serve to deepen existing socioeconomic inequalities. Local communities are often reluctant to intervene in cases of child sexual exploitation, given the complex underlying economic precipitants and the greater level of public acceptability of prostitution in some countries. Such attitudes render children far more vulnerable to being absorbed by the adult sex trade and becoming sexually exploited by sex tourists, who may use the anonymity afforded by the dark web as a global networking tool to share information with other sex tourists.

The COVID-19 pandemic has led to school closures and a higher risk of contact between children and online sexual predators. It has isolated victims of child trafficking and sex tourism from available support structures and jeopardised their usual escape routes. The reported 30% increase in consumption of online child pornography during recent periods of pandemic lockdown in Europe, for example, have further increased the demand for child exploitation [ 69 ]. The current restrictions on international travel will undoubtedly influence sex tourism patterns worldwide, leading to greater degrees of domestic child abuse and online sexual exploitation. Further research may shed a light on this and other COVID-related secondary effects on the sex tourism industry.

Future considerations in sex tourism

While the world prepares for a cautious return to routine international travel in a future post-COVID era [ 70 ], we may ponder what constitutes a traveller or a tourist in the modern era. Opperman proposed the idea of a ‘cyberspace tourist’ in his paper on sex tourism [ 71 ]. While we have not found any further literature on this subject, is a person who sits at a computer in his/her home and pays for a voyeuristic virtual reality experience involving a foreigner thousands of miles away a cyber-sex tourist? With the rapid advancements in technology in recent years, we may contemplate whether people even need to leave their home to “travel”. It is conceivable that future sexual experiences will mirror these changes in travel patterns. With PrEP being a recent development, the role it plays in protecting travellers exposed to HIV overseas remains to be seen. This is a potential area of research activity as it becomes established as a mainstay preventive option. Possible areas of unmet need in sex tourism research are presented in Table 5 .

Sex tourism research priorities

PrEP pre-exposure prophylaxis

Limitations of current review

Strengths of our review include its multidisciplinary authorship, its broad coverage of diverse facets of sex tourism, and the focus on the most recent literature on the subject. Limitations of our approach include its restriction to articles published in the English language and the use of a single medical literature database. Accessing literature on sex tourism from Latin America and the Caribbean, using the Latin American and Caribbean Health Sciences Literature virtual library, for example, may have provided deeper insights into the impact of sex tourism on host communities. It is reasonable to assume that relevant literature on sex tourism resides in the social sciences literature such as the Social Sciences Citation Index of the Web of Science. Future reviews on this topic should also consult an appropriate social sciences database and refer to relevant material from the anthropological literature.

In our review of the literature associated with sex and travel, it was clear that the same set of risk behaviours and consequences applied to diverse groups. We recommend that more research be conducted into novel and effective interventions for modifying these high-risk behaviours. Travellers should be informed of the increased risks of STI before they travel. They should be aware of the prevalence of STIs in the area they plan to visit, and the risks associated with their sexual practices when they travel, including engaging with commercial sex workers, practising chemsex, engaging in unprotected sexual intercourse, and becoming the victim of sexual violence. They should also be informed about how to access appropriate medical care overseas and as returned travellers, should they require it.

Acknowledgements

The authors are grateful for the assistance received from Dr. Amy Abrahams and Dr. Stuart MacLeod in identifying appropriate source material for an earlier version of this manuscript.

Authors’ contributions

GTF conceived the idea for the review. GTF and AH planned the literature search strategy. TSL conducted the literature search with assistance from GTF, AH and CN. TSL prepared the first draft of the manuscript, which was edited for significant intellectual content by GTF, AH and CN. All authors read and approved the final version of the manuscript.

None received.

Availability of data and materials

Ethics approval and consent to participate.

Not applicable.

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Competing interests.

The authors state that they have no conflicts of interest to declasre.

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Open access
Published: 27 November 2020

Sun, sea and sex: a review of the sex tourism literature

Timothy Siliang Lu 1 ,
Andrea Holmes 1 , 2 ,
Chris Noone 3 &
Gerard Thomas Flaherty ORCID: orcid.org/0000-0002-5987-1658 1 , 4

Tropical Diseases, Travel Medicine and Vaccines volume 6 , Article number: 24 ( 2020 ) Cite this article

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Conclusions

Literature search strategy

Epidemiology of sex and travel

In the context of this review, we define casual sex as sexual relations undertaken without serious intent or emotional commitment between individuals who are not established sexual partners or do not know each other well. Men were more likely to seek out or engage in casual or risky sex behaviours (e.g., multiple partners, unprotected intercourse) while travelling [ 4 , 5 , 6 ]. As many as 1 in 10 men were recorded as having an overseas partner in a British study [ 6 ], and different categories of male sex tourist have also been proposed in the literature [ 7 ], ranging from the ‘macho lad’ asserting his dominance over foreign women to the ‘white knight’ saving women from commercial sex work. A study from the United States showed that female travellers had a greater preference for travel to European or tropical countries, and that sex was more likely to occur on group tours, sightseeing or backpacking holidays lasting fewer than 14 days [ 8 ]. Female sex tourism has also been described in Caribbean destinations such as Jamaica, with Euro-American women purchasing the services of so-called “Rent-A-Dreads”, local men who seek out relationships with tourist women for economic gain [ 9 ]. Younger women were reported to prefer expatriates and other tourists as sexual partners [ 10 ], while men of all ages and older women were reported to exercise a preference for local partners.

Several studies report that longer duration of travel (greater than 1 month), travelling alone or with friends, alcohol or drug use, being younger and being single were factors associated with higher levels of casual sex overseas [ 4 , 5 , 6 ]. A study conducted in Sweden reported conflicting data, showing that short term travellers (less than 5 days) were 20 times more likely to engage in casual sex [ 16 ]. While few studies offered information linking different ethnicities to sexual behaviour overseas, one British study found that non-white citizens were more likely to engage in sexual behaviour while travelling [ 6 ]. Migrants and members of the lesbian, gay, bisexual, transgender and queer (LGBTQ+) community are also discussed frequently in the sex tourism literature. A summary of the characteristics associated with sexual risk behaviour is shown in Table 2 . This will be explored further in this review. Studies of travellers engaging in sex with tourism representatives [ 11 ], sex workers and fellow travellers [ 5 ] show that choice of partner while travelling is not limited to any particular demographic.

Commercial sex work and travel

Sexually transmitted infections

The LGBTQ+ community and travel sex behaviour

The effects of alcohol and drugs on sex tourism

Sexual assault and violence in travellers

Child sex tourism

The effects of wealth and mobility on sex tourism

Impact of sex tourism on host communities

Future considerations in sex tourism

Limitations of current review

Availability of data and materials

All material referenced in the preparation of this work are available from the corresponding author.

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History, Culture, and Identity

Sex Tourism in Latin America

by Ann Barger Hannum | Dec 22, 2002

Sex tourism—travel to engage in sex for money—shares a lengthy and sometimes colorful history with that of adventure travel and tourism in general. Literature investigating early travel involving sexual encounters includes stories dating to explorations by Columbus in the 15th century. Considerable research supports the theory that, along with potatoes, tobacco, and other commodities, Columbus and his crew also brought the first cases of syphilis to the New World. Among other early journeys abroad that were enhanced by sexual revelries were the “Grand Tours,” trips taken across Europe by young aristocratic men and women during the during the 18th and 19th centuries in order to broaden their understanding of culture and the arts. These adventurous young people often supplemented their cultural experience with that of a sexual nature through liaisons with people they met while traveling.

When travel opportunities opened up to a growing segment of the middle class in the mid-19th century, including that of the United States, sex tourism evolved into a common activity. As many European countries became wealthier, clients expanded their search for sex into other regions, such as the Caribbean and northern Africa, where prices for sex were more moderate. The growth of sex tourism has also had a strong correlation with military conquest and the presence of foreign military bases. Prostitution proliferated near British military bases worldwide during the latter part of the 18th century and emerged more recently near US military bases in Korea, the Philippines, Thailand, and Vietnam, establishing these areas as preferred destinations for sex. In the 1940s and 1950s, Cuba was the destination of large numbers of American male sex tourists. Prostitution became illegal after the revolution but started to flourish again in the 1990s, when economic conditions forced Castro to reopen the tourism industry.

The expansion of sex tourism has continued unabated, in part as a result of the promotion of tourism as a development strategy, particularly in the developing world, where poverty forces people into sex work. Resource-scarce regions, including many Latin American countries, where tourism has experienced considerable support from the government, have proven to be fertile areas for the growth of sex tourism. Until the tragic events of September 11, tourism had been increasing steadily worldwide, with Latin American countries among those enjoying rising figures. The World Tourism Organization (WTO) reports that the total number of visitors to Latin America and the Caribbean grew by 6.1 percent last year to 57.6 million. Research indicates that as countries such as Guatemala, El Salvador, Costa Rica, and Nicaragua have increased efforts to promote tourism on a wide scale, sex tourism has risen proportionately.

Today, sex tourism is a multibillion dollar industry that supports an international workforce estimated to number in the millions. Because prostitution is illegal in most countries, exact statistics about sex workers, their international clients, and the money generated within the industry itself are unavailable. Employees benefiting from the sex tourism industry include female and male sex workers as well as—directly or indirectly—members of the entire travel and tourism sectors, from taxi drivers to airline, hotel, and restaurant employees. Sex tourism most commonly involves female prostitution, but, most disturbingly, increasingly involves the sexual exploitation of children, which is outlawed universally. Whether sex tourism among consenting adults is a “victimless crime” remains a point of contention. Excluding some “escorts” working for elite agencies and high wages, sex workers almost always suffer from poverty, marginalization, violence, disease, and sexual and substance abuse.

Sex tourism is increasing worldwide, but particularly in Latin American, especially in Central America. In part, the shift in destinations can be attributed to the crackdown in Asia by organizations such as the WTO, End Child Prostitution, Child Pornography and Trafficking of Children for Sexual Purposes (ECPAT), and the United Nations. Sex tourism—especially that involving exploitation of children—sought areas where laws are less restrictive and government surveillance less diligent.

Brazil has long been thought of as the region’s leader in sex tourism, but recent evidence highlights emerging business in Costa Rica, Guatemala, and Honduras. Julia O’Connell Davidson, one of the most knowledgeable experts on the subject of sex tourism, cites a 1994 study estimating that more than 30,000 Americans and several thousand more Canadians had retired to Costa Rica. Many of the single men among them were described as “sex-pats,” expatriates who retired there not just for the climate, tax breaks, and other advantages but also for the “easy and cheap sexual access to their preferred sexual objects.” “What we are seeing is the dark side of tourism,” said Heimo Laakkonen, head of UNICEF in Costa Rica, where tourism is the most profitable industry in the country.

While views of sex-for-sale between consenting adults vary considerably, the arena of child sex tourism is disturbing to all. ECPAT estimates that more than one million children worldwide enter the sex trade annually, many of them from Latin American countries. The organization estimated, for example, that in 1994, 500,000 children in Brazil were involved in the sex industry, and more recently, the Colombian Ministry of Justice reported at least 25,000 child prostitutes in that country. The UN Human Rights Committee recently expressed concern over the “high incidence of commercial sexual exploitation of children in Costa Rica related to tourism”. Casa Alianza, a non-profit advocacy group for street children in Mexico and Central America, estimates that some 5,000 street children in Honduras are involved in sex tourism. Similar problems exist in Paraguay, the Dominican Republic, and Venezuela.

The reasons for the growth in the child sex tourism trade in Latin America and elsewhere are numerous and often mirror those in the adult sex tourism industry. According to the Preda Foundation, prostitution among the estimated 40 million street children in Latin America has long been a consequence of the region’s poverty. A recent study of 300 street children by Nicaragua’s Family Ministry revealed that more than 80 percent of them had started working as prostitutes that year to support themselves and to buy drugs. Typically, many thousands of these children have fled abusive homes.

The increase in the child sex trade is also commonly attributed to the mistaken impression that younger sex workers are less likely to be infected with sexually transmitted diseases such as HIV or AIDS, although figures often dispute this belief.

Another possible reason for the rise in child sex tourism is that clients often feel less inhibited outside the constraints of their home countries and may be attracted by what they feel to be less restrictive social taboos in other countries. Like their adult counterparts, child sex workers are also frequently lured into the trade by advertisements for lucrative jobs, travel, and an exciting lifestyle. One of the greatest boosts to sex tourism overall has been the availability of information on the Internet related to the sex industry. Some Web sites are accessible to the general public, while others, such as the World Sex Archives Web page, require membership and dues to access their database of photos and bulletin boards of messages from other sex tourists. Child pornography and prostitution of any kind are illegal on the Internet, and international efforts to shut down related Web sites have been reasonably successful. However, lawmakers have been unable to agree on whether and how to prohibit the advertisement of adult sex tours, especially since prostitution is legal in many countries, such as Costa Rica.

Since the 1990s, ECPAT and other members of the nongovernmental, governmental, and private sectors worldwide have been collaborating to raise awareness about sex tourism and to take steps toward eradicating child sex tourism. These groups have initiated campaigns that include the use of luggage tags, ticket pouches, and educational brochures, along with the development of courses in tourism training schools and in-flight videos. In 1997, Brazil launched a “No Child Sex Tourism” campaign, since adopted by the WTO, to curtail sex tourism and enforce laws imposing jail sentences on foreigners caught purchasing sex from children. In January 2000, Mexico enacted an amendment of the federal penal code and code procedures that declared sex tourism to be a punishable crime.

Latin American countries share with others in the international community the enormous and complex challenges posed by the growing sex tourism industry. Even if they are united in their determination to eliminate all forms of exploitation of children, countries nevertheless need to agree on more effective and expedient means of regulating the entire sex tourism industry. Sex tourism among adults remains a complex topic involving issues of privacy, consent, religious and ethical beliefs, and human rights. Only through international cooperation can the sex tourism industry be regulated successfully and millions of children be protected against exploitation.

Winter 2002 , Volume I, Number 2

Ann Barger Hannum , project manager and consultant, has been affiliated with Harvard for the past ten years, most recently at the Harvard AIDS Institute. The author thanks Julia M. Green, project associate for the Community Research Initiative of New England, for her collaboration with this article.

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Brandy Bang 6 ,
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Sex tourism is the complicated nexus of prostitution and tourism. Sex tourism is a sector of the international tourism trade. More specifically, offenders utilize the tourist industry to travel to different countries for the explicit purpose of engaging in sexual acts with minors in nations where child prostitution and exploitation laws are more lax than those in the United States. Essentially, it links global offenders with local victims to facilitate sexual exploitation of minors without the threat of prosecution. Sex tourism is often present in countries that offer lower ages of sexual consent, legalized prostitution, and where extradition laws are absent. Research has identified Asia, Central America, and South America as primary hubs for sex tourism. Offenders can either be preferential or situational abusers. Similar to the mechanism of prostitution, sex tourism includes both procurers and facilitators. Sex tours can be booked and planned in a manner similar to typical family vacations. Tourists can independently plan their vacations via the Internet, or sex tours can be organized by travel agencies. Unlike previously discussed CSEC crimes, the actual exploitation and fiscal exchange occurs in foreign countries with foreign-born children. Victims of sex tourism are characterized by the same vulnerability factors as other CSEC victims but by definition are not United States citizens. Lack of education, poverty, disintegrated or neglectful families, and physical or sexual abuse are common risk factors for children coerced into sex tourism.

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Bang, B., Baker, P.L., Carpinteri, A., Van Hasselt, V.B. (2014). Sex Tourism. In: Commercial Sexual Exploitation of Children. SpringerBriefs in Psychology(). Springer, Cham. https://doi.org/10.1007/978-3-319-01878-2_7

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Notice to US citizens: Your actions abroad may have serious consequences

WASHINGTON – American tourists, with twisted overseas travel plans to engage in child sex tourism, may think they are beyond the reach of U.S. law enforcement. However, they should know that it is a priority for U.S. Immigration and Customs Enforcement's (ICE) Homeland Security Investigations (HSI) to apprehend and prosecute U.S. citizens who engage in sexual acts with minors in foreign countries.

Millions of American citizens travel abroad on a regular basis. While the vast majority of them are law abiding, some commit sexual crimes against minors in foreign countries. Each year, over a million children are exploited in the global commercial sex trade. Child sex tourism involves people who travel from their home country to another and engage in commercial sex acts with children. Child sex tourism is a shameful assault on the dignity of children and a form of child abuse and violence. For the minors involved, these acts have devastating consequences, which may include long-lasting physical and psychological trauma, disease, drug addiction, unwanted pregnancy, malnutrition, social ostracism and possibly death.

Tourists engaging in child sex tourism often travel to developing countries looking for anonymity and the availability of children in prostitution. The crime is typically fueled by weak local law enforcement, corruption, the Internet, ease of travel and poverty. These sexual offenders come from all socio-economic backgrounds and may hold positions of trust. Previous arrests for child sex tourism involving U.S. citizens have included: a pediatrician, a retired Army sergeant, a dentist, a Peace Corps volunteer and a university professor.

In 2003, the United States strengthened its ability to fight child sex tourism by passing the Prosecutorial Remedies and Other Tools to End the Exploitation of Children Today Act (PROTECT Act) and the Trafficking Victim's Protection Reauthorization Act. These laws carry penalties of up to 30 years in prison for engaging in child sex tourism. In the nine years since these laws were strengthened, HSI special agents have arrested 93 suspects on child sex tourism charges.

HSI has 73 offices in 47 foreign countries around the world that serve as the agency's liaison to counterparts in local government and law enforcement. HSI's attachés abroad are critical in investigating these crimes.

Just last week, Jesse Osmun, 33, a former Peace Corps volunteer, was sentenced in Hartford, Conn., to 15 years in prison for sexually abusing four girls, all under the age of 6, while he was a volunteer in South Africa. He never expected that HSI special agents would arrest him for crimes he committed nearly 8,000 miles away from his Connecticut home. HSI's office in Connecticut – working collaboratively with the U.S. Attorney's Office for the District of Connecticut – has had two other recent cases involving child sex tourism. Edgardo Sensi was sentenced in January to 85 years in prison for production of child pornography and sexual tourism offenses related to his sexual abuse of minor girls in the United States and Nicaragua. Douglas Perlitz was sentenced in December 2010 to nearly 20 years in prison for sexually abusing 16 minor victims over the course of a decade in Haiti.

"I am proud to partner with HSI in prosecuting U.S. citizens who abuse children abroad," said U.S. Attorney David B. Fein, District of Connecticut. "I am hopeful that the cases we have successfully prosecuted in Connecticut will serve as a deterrent to others who would partake in these illegal acts. The Department of Justice will continue to devote resources to protecting children worldwide."

HSI's Child Exploitation Investigations Unit investigates the trans-border, large-scale production and distribution of images of child abuse, as well as individuals who travel abroad to engage in sex with minors. The unit employs the latest technology to collect evidence and track the activities of individuals and organized groups who sexually exploit children through the use of websites, chat rooms, newsgroups and peer-to-peer trading. These investigative activities are organized under Operation Predator, a program managed by the Child Exploitation Investigations Unit.

"If you are molesting children, I advise you to turn yourself in and get help," added Vincent. "The law will catch up to you no matter where you are. If you continue your crimes against children, you should always be looking over your shoulder because we will hunt you down to the ends of the earth in order to protect innocent children from being violated. There will be no refuge for child sexual predators who believe that they may victimize children outside the United States. No place is too distant or too remote to escape the attention of HSI."

To learn more about HSI, visit www.ICE.gov/HSI .

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Sex Tourism

Sex tourism is travel for the specific purpose of having sex, typically with commercial sex workers. It is different from having casual sex during travel with fellow travelers or locals.

Condoms Help Prevent Sexually Transmitted Infections

Both sex tourism and casual sex can lead to the transmission of HIV and other sexually transmitted infections (STIs), because these infections may be common among sex workers.

Some common STIs, such as gonorrhea, have become resistant to medications for treatment in some parts of the world. International travelers having sex with new partners while abroad are exposed to different “sexual networks” than at home, which may lead to the importation of drug-resistant STIs.

Always use a condom when having sex.

Things to Know Before Traveling for Sex Tourism

In some countries, commercial sex work is legal and culturally acceptable. In some countries sex tourism supports sex trafficking, one of the largest criminal industries in the world.

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 laws.

Someone who engages in these activities in a foreign country can be prosecuted under that country’s law while abroad and under US law after returning to the United States.

Having Sex with Minors is a Crime

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 also often suffer health problems including physical injury, STIs, other infections and illnesses, addiction, and malnourishment.

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.

How to Prevent Human Trafficking

To combat human trafficking and child sexual abuse, some international hotels and other tourism services have voluntarily adopted a code of conduct that includes training and reporting of suspicious activities. Tourist establishments supporting this initiative to protect children from sex tourism are  listed online .

Providers and travelers who suspect child sexual exploitation or other trafficking activities occurring overseas can report tips anonymously by:

Using the Operation Predator smartphone app .
Calling the Homeland Security Investigations Tip Line (866-347-2423).
Completing an ICE submission online
The International Centre for Missing & Exploited Children

In the United States, the National Center for Missing & Exploited Children’s CyberTipline collects reports of child prostitution and other crimes against children (toll-free at 800-843-5678).

Additional human trafficking resources include:

HHS National Human Trafficking Hotline ,
ACF National Human Trafficking Hotline
Department of State: “ 20 Ways You Can Help Fight Human Trafficking ”

Since 2003, when Congress passed the PROTECT Act, at least 8,000 Americans have been arrested – for child sex tourism and exploitation. The PROTECT Act strengthens the US government’s ability to prosecute and punish crimes related to sex tourism, including incarceration of up to 30 years for acts committed at home or abroad. Cooperation of the host country is required to open an investigation of criminal activity.

After Travel

When you return from your trip, make an appointment with a healthcare provider to get a medical checkup. This should include STI testing, including an HIV test.

If you become ill after travel, see a healthcare provider immediately and tell them about your recent travel and sexual activities.

More Information

CDC Yellow Book: Sex & Travel
Traveler Factsheet: STDs

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A billboard poster depicting missiles, Tehran, Iran, on 19 April.

In this shadow war between Iran and Israel, the outline of a different future is visible

Both seem keen to limit hostilities, and key Arab states are ready to resist Tehran. But real change will require new Israeli leadership

When it comes to the Middle East, it’s the pessimists who look smartest. Predict the worst and you’ll rarely be proved wrong. If you are, it’s usually because your forecast was insufficiently bleak.

So put on your gloom-tinted spectacles and assess the events of the last week. You’ll see the dawn of a grim new era, in which the region’s two strongest powers, Israel and Iran, trade blows directly. Last weekend, Iran crossed what had previously been a red line, aiming a barrage of missiles and drones directly at Israeli territory for the first time. In the early hours of Friday morning, Israel responded with a series of drone strikes on targets inside Iran, including Isfahan, site of an airbase and the country’s burgeoning nuclear programme. You don’t have to be Clausewitz to know that two regional powers, one an aspirant nuclear state, the other already there, engaged in a tit-for-tat exchange of fire aimed at each other’s sovereign terrain spells danger.

The pessimist draws little comfort from those who insist that both sides are clearly trying to avoid a major escalation into all-out war. The Iranian assault on Israel involved 170 drones, more than 30 cruise missiles and more than 120 ballistic missiles – about three times the number of projectiles unloaded on Ukraine in the first shock-and-awe night of the Russian invasion in February 2022 . It was only Israel’s ability to defend itself, and the support of its allies in that effort, that prevented devastating loss of life.

As for Israel’s response, it may look like it was carefully calibrated to send nothing more lethal than a message – even if that message was, as a former Israeli intelligence officer put it , “that, if we want to, we can send a stronger message”. The details are still murky, with neither country in a hurry to spell out exactly what happened, but reports suggest that Israel may have unleashed previously dormant, remote-controlled “quadcopters” – apparently already secreted inside Iran itself – on some of the country’s most sensitive and highly valued military installations. The objective may have been no more than an Israeli desire to tell the Iranian military they know where they live – and can reach them – but even that is a move fraught with risk. Because things can so easily go wrong. Both sides are playing with some serious matches in a neighbourhood built from tinder.

So, yes, the authorities in both countries may brief, in their different fashion, that they’ve got things under control, with the Iranians adamant that the Israeli attack was a humiliating failure that left barely a scratch, and the Israelis confident that Iran is now deterred. But the peoples of the region, anxiously looking up at the sky, have good reason to be sceptical.

Recall that it was the supposedly all-seeing experts of Israeli military intelligence, and their political masters, who promised that Hamas was deterred before 7 October – and Israelis know all too well how that worked out. And it was those same Israeli sages who similarly thought there would be no major Iranian reaction to Israel’s assassination of a senior commander of the Iranian Revolutionary Guards Corps (IRGC), along with his deputy, in Damascus on 1 April – when it was that incident that prompted last weekend’s massive retaliation.

The Iranians, too, are capable of misreading the signs, judging by the conduct of their proxies in the region. There is good evidence that Hamas massively underestimated Israel’s response to the 7 October attacks – which were always going to bring a terrible retribution – and that it believed months of street protests against Benjamin Netanyahu’s judicial coup would leave the country too debilitated to hit back. The price for that miscalculation continues to be paid by the Palestinian civilians of Gaza, who have lost so much and so many.

It doesn’t help that the leaderships in both Iran and Israel are under constant pressure from elements that are even more bellicose. At odds though it might be with his global image, Netanyahu was among the more moderate voices in the room as Israel weighed its options after the Iranian fusillade. It was not just the ultra-nationalist extremists Bezalel Smotrich and Itamar Ben-Gvir who were demanding Israel punch back hard, with the latter denouncing Friday’s yesterday’s operation as “feeble”. Benny Gantz, an opposition leader drafted into Netanyahu’s war cabinet, was urging the prime minister to order an instant response last weekend. In Tehran, the supreme leader, Ali Khamenei, who turned 85 on Friday, is the theocratic face of a military dictatorship that, in the IRGC, includes those who harbour imperial ambitions for Iran – an aspiration that is hardly the stuff of fantasy, given Iran’s control, mainly through proxies, of large parts of Syria, Lebanon, Yemen, Iraq and Gaza. (As the New York Times columnist Thomas Friedman puts it, the Iranian general killed by Israel in Syria earlier this month “was not there on a tourist visa ”.)

All of these are reasons to be fearful about the lines that have been crossed and the taboos that have been broken, as the decades-long standoff between these two powers turns direct. And yet, if you put down the gloom goggles and replace them with glasses of a rosier tint, you can, if you squint a bit, see a more hopeful picture.

Of course, the risk of escalation, even in error, is real. And yet, it’s significant that both sides are at least taking steps to avoid that outcome, even as they try to satisfy internal pressure for robust action. Both the Israeli attack, and Iran’s efforts to play down its impact, were partly about saving face, but also about containing a situation that could otherwise spiral. It is a small mercy, but we should be grateful for it all the same.

Perhaps more surprising is this: you can glimpse in this shadow war the outline of a different, more peaceful future for the region. Because Iran targeting Israeli territory directly was not the only historic first last weekend. Also unprecedented was the fact that Israel kept out those missiles thanks to an alliance of, yes, the US along with the UK and France, but also Jordan and, reportedly, the United Arab Emirates and Saudi Arabia. That’s right: Israel was protected from Iranian fire by a group of Arab states.

This is a big deal. It means the hitherto crypto-alliance of Israel and those Sunni states that fear Tehran more than they fear Tel Aviv has stepped into the light. Last weekend, it became something real. That represents an enormous diplomatic opportunity, one that could give Israel the thing it has lacked since its founding: an accepted place in the Middle East. “The prize of a different relationship between Israel and its region is still there on the table, despite what’s been happening in Gaza,” Tom Fletcher, a former Downing Street foreign policy adviser, told the BBC on Friday morning .

To grasp that prize, Israel would have to do what the US and others are asking: offer the Palestinians a political horizon, one that holds out the prospect of an eventual Palestinian state. That will not be easy for Israelis to stomach, not after 7 October, when so many fear any such state would soon become a launchpad for further, similar attacks against them. But if Israelis can make that move, an entirely new future could be unlocked – one that would see Iran finally hemmed in by a coalition of countries united in their resolve to stop Tehran wreaking regional havoc via the militias and regimes it controls. It’s achievable, but not without the replacement of Netanyahu by a leader ready and able to seize the opportunity that this week has revealed. Will that happen? Remember: the quickest way to lose money is to bet on hope for the Middle East. But hope, like gambling, is a hard habit to break.

Jonathan Freedland is a Guardian columnist

Guardian Newsroom: Crisis in the Middle East On Tuesday 30 April, 7-8.15pm BST, join Devika Bhat, Peter Beaumont, Emma Graham-Harrison and Ghaith Abdul-Ahad as they discuss the fast-developing crisis in the Middle East. Book tickets here or at theguardian.live

Do you have an opinion on the issues raised in this article? If you would like to submit a response of up to 300 words by email to be considered for publication in our letters section, please click here .

Middle East and north Africa
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COMMENTS

Sex tourism
Sex tourism is commonly regarded as a transnational challenge, as it can be seen to target marginalised demographics in developing nations, such as countries in the Americas or Southeast Asia. The chief ethical concerns arise from: the economic gap between tourists and residents, the sexual trafficking of children and women and the parties ...
Sun, sea and sex: a review of the sex tourism literature
Background. Prior to the current pandemic of COVID-19, international travel had reached record levels of activity, with 1.4 billion traveller arrivals recorded in 2018 [].Sex and travel have a long association, dating from the ancient world onwards [], and their connection is still apparent today.Sex tourism is defined by the Centre for Disease Control and Prevention (CDC) as "travel planned ...
Sun, sea and sex: a review of the sex tourism literature
Sex tourism is defined as travel planned specifically for the purpose of sex, generally to a country where prostitution is legal. While much of the literature on sex tourism relates to the commercial sex worker industry, sex tourism also finds expression in non-transactional sexual encounters. This narrative review explores current concepts related to travel and sex, with a focus on trans ...
A paradigm shift in sex tourism research
Whatever research has been done on sex tourism in the 70s and 80s, scholars have emphasized how male sex tourist flows from the developed to the developing countries are responsible for bringing negative changes to host communities. One such issue is tourism and HIV/AIDS, and how women from these developing countries have become victims of sex ...
Sex tourism
Sex tourism within developing and developed destinations has also received very little attention (Harrison 1998), perhaps partly because it is difficult to place it in a dependency perspective ... Data and reports from tourist-prostitute interactions in developing countries suggest that sex seekers often do not see themselves as sex tourists ...
Sex Tourism in Latin America
The World Tourism Organization (WTO) reports that the total number of visitors to Latin America and the Caribbean grew by 6.1 percent last year to 57.6 million. Research indicates that as countries such as Guatemala, El Salvador, Costa Rica, and Nicaragua have increased efforts to promote tourism on a wide scale, sex tourism has risen ...
Sex tourism in the Dominican Republic and other developing countries: a
Sex tourism in the Dominican Republic and other developing countries: a study of political, economic, and social determinants @inproceedings{Rivera2015SexTI, title={Sex tourism in the Dominican Republic and other developing countries: a study of political, economic, and social determinants}, author={Melissa Rivera}, year={2015}, url={https ...
Sex Tourism
The relationship between tourism and sex is well established. A pioneering ethnography of tourism in The Gambia identified female, Swedish tourists searching for romance and sex with young, local men looking to earn money (Wagner 1977).This study is typical of the connections between sex and tourism in that it highlights the commodification of an exoticized and eroticized cultural Other.
Sex Tourism
Sex tourism is a phenomenon that occurs in various parts of the world, most visibly in Southeast Asian countries such as Thailand and the Philippines, as well as Latin American and Caribbean countries such as the Dominican Republic, Cuba, Colombia, and Brazil. ... European or North American men who travel to developing countries to have sexual ...
Sex tourism
Much writing has focused on sex tourism in developing countries, especially Southeast Asia, parts of the Caribbean, and Kenya. Economies may benefit, but the moral and social consequences are problematic, particularly where children are involved (though official ages of consent vary). Ways of countering child sex tourism have justifiably ...
PDF The Global Impact of the Sex Tourism Industry: Issues of Legalization
The key is to identify the countries which have legalized sex tourism against those countries that are not legal to evaluate any potential impacts. Research Limitations ... with tourists originating from developed countries and traveling to developing countries. Although, most individuals do not travel with intent to engage in sex, there are ...
Sex tourism in the Dominican Republic and other developing countries
This study also includes a broader statistical analysis of secondary data on sex tourism in developing countries around the world, which aimed at identifying the main political, economic and social determinants. Findings from both the qualitative and quantitative arms of this research will shed light on this important social problem and can ...
Sex Tourism
Sex tourism is the complicated nexus of prostitution and tourism. Sex tourism is a sector of the international tourism trade. More specifically, offenders utilize the tourist industry to travel to different countries for the explicit purpose of engaging in sexual acts with minors in nations where child prostitution and exploitation laws are more lax than those in the United States.
Sex in tourism: Reflections and potential future ...
The existing knowledge regarding the experiences of men who pay for sex as part of their tourist experience draws mainly on ethnographic studies of sex tourists in developing countries (Carr, 2016 ...
Exploring the male Chinese tourists' motivation for commercial sex when
However, much existing literature in this area has been situated within a postcolonial conceptual framework that is generally grounded in either north-south power relations, or exploitation of the developing countries by the developed ones (Carr, 2016; Oppermann, 1999). Accordingly, commercial sex tourism in the existing literature has often ...
Countries: a Study of Political, Economic and Social Determinants a
for sex tourist can aid its competitive advantage against other countries. Sex tourism has often been linked to sex trafficking; the coercion and exploitation of women and children. While literature exists on trafficking, very little is known about ... tourism has been used by developing countries as an alternative economic strategy (Kempadoo ...
'Gender and Political Economy of Sex Tourism in Kenya ...
Sex tourism is very complex and has been defined as tourism for which the main motivation, or at least part of the main aim of the trip, is to consummate or engage in commercial sexual relations ...
PDF Tourism and Human Trafficking
The tourism and travel industries are by nature a global industry, which leads to increased opportunities for labor trafficking and exploitative practices, especially in regions. 77% of labor trafficking in the U.S. hotel industry reported from 2007-2015. of the world with weak labor protections and welfare.
The Context of Sexual Exploitation of Children by Tourists and
Sexual exploitation of children in the context of travel and tourism (SECTT), also known as "child sex tourism," 1 is a global problem that has received growing policy attention over the years. The typical image is that of an offender traveling from a wealthy country of origin to a poorer country where the child is sexually abused (the so-called "destination country").
Notice to US citizens: Your actions abroad may have serious
Tourists engaging in child sex tourism often travel to developing countries looking for anonymity and the availability of children in prostitution. The crime is typically fueled by weak local law enforcement, corruption, the Internet, ease of travel and poverty.
Sex Tourism
International travelers having sex with new partners while abroad are exposed to different "sexual networks" than at home, which may lead to the importation of drug-resistant STIs. Always use a condom when having sex. Things to Know Before Traveling for Sex Tourism. In some countries, commercial sex work is legal and culturally acceptable.
FAO at the Forum of the Countries of Latin America and the Caribbean on
Elevated national food prices, weak currencies and lower economic growth prospects continue to constrain access to food for many net-food-importing developing countries and vulnerable communities. As an average, Latin America and the Caribbean recorded the highest cost of a healthy diet compared to other world's regions in 2021.
Sex Tourism
Sex Tourism. Child sex tourism (CST) is defined as travel abroad to engage in the commercial sexual exploitation of a child under the age of 18years. ... The phenomenon of women travelling in search of relationships with local men in developing countries has been studied for the last 20 years. However, it appears little known in travel medicine
In this shadow war between Iran and Israel, the outline of a different
But if Israelis can make that move, an entirely new future could be unlocked - one that would see Iran finally hemmed in by a coalition of countries united in their resolve to stop Tehran ...

Sun, sea and sex: a review of the sex tourism literature

Andrea Holmes

Chris Noone

Gerard Thomas Flaherty

Associated Data

Conclusions

Literature search strategy

Epidemiology of sex and travel

Commercial sex work and travel

Sexually transmitted infections

The LGBTQ+ community and travel sex behaviour

The effects of alcohol and drugs on sex tourism

Sexual assault and violence in travellers

Child sex tourism

The effects of wealth and mobility on sex tourism

Impact of sex tourism on host communities

Future considerations in sex tourism

Limitations of current review

Acknowledgements

Authors’ contributions

Availability of data and materials

Consent for publication

Sun, sea and sex: a review of the sex tourism literature

Conclusions

Literature search strategy

Epidemiology of sex and travel

Commercial sex work and travel

The LGBTQ+ community and travel sex behaviour

The effects of alcohol and drugs on sex tourism

Sexual assault and violence in travellers

Child sex tourism

The effects of wealth and mobility on sex tourism

Impact of sex tourism on host communities

Future considerations in sex tourism

Limitations of current review

Availability of data and materials

Acknowledgements

Author information

Contributions

Corresponding author

Ethics declarations

Consent for publication

Additional information

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About this article

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Sex Tourism in Latin America

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ICE Check-in for Noncitizens

Notice to US citizens: Your actions abroad may have serious consequences

Sex Tourism

Condoms Help Prevent Sexually Transmitted Infections

Things to Know Before Traveling for Sex Tourism

Having Sex with Minors is a Crime

How to Prevent Human Trafficking

After Travel

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In this shadow war between Iran and Israel, the outline of a different future is visible

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