UK plans to cut street prostitution will threaten sex workers' health

Editorial: Sex workers to pay the price; BMJ Volume 332, pp 190-1

Plans to cut street prostitution, set out by the UK government last week, will threaten sex workers' health, warn experts in this week's BMJ.

The Home Office strategy aims to challenge the view that street prostitution is inevitable; achieve an overall reduction in street prostitution; improve the safety and quality of life of communities affected by prostitution; and reduce all forms of commercial sex exploitation.

But the strategy does not explicitly tackle health and human rights and will not, therefore, do enough to reduce vulnerability and exploitation, argue the authors.

For instance, the proposed strategy rejects calls to licence premises, which could ensure that children were not employed, employees were not in possession of drugs, and foreign nationals had work permits.

Instead the strategy focuses on disrupting sex markets. Kerb crawling will be policed in established red light areas, despite evidence that this can lead to increased violence, pressure to abandon safer sex practices, and increased public disorder.

Specialist healthcare services in red light areas, such as provision of condoms and needle exchange schemes, could also be compromised if this strategy is enforced, they warn. This could have profound consequences both for sex workers and the wider population.

Furthermore, collaborative work by healthcare professionals, social services, and sex workers will be disrupted if red light areas are phased out, as the strategists intend, they add. Collaborative working gives sex workers the support and confidence to report violent clients and other predators who aim to coerce and control them.

"The lack of detail in the strategy about implementing the new approaches, especially regarding indoor sex work, leaves most of the sex workers we have spoken to feeling uneasy that they will have to wait and see how the strategy affects their access to health care and their contact with the criminal justice system," conclude the authors.

Disappointment about the UK government not going further towards legalisation is reflected in a personal view by Juliet, a prostitute based in London. She believes that the government has "failed enormously" and argues that neither having sex nor getting paid are inherently degrading, abusive, exploitative, or harmful. The problems, she says, are the associated coercion, drug dependency, and lack of choices, not prostitution itself.

BMJ Editor, Fiona Godlee also supports the idea of legalisation. "It is surely time for an end to the arguments of moral opprobrium and for some bolder steps towards legalisation if we are to improve public health and human rights," she writes.

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Last reviewed: By John M. Grohol, Psy.D. on 21 Feb 2009
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