A summary of evidence relating to how people in prison and on probation may be affected by sex work and how services can improve outcomes for them.
Sex work is associated with a range of negative health outcomes. There are high levels of self-reported substance misuse among those involved in sex work. Experiences of violence and trauma are also common. Many involved in sex work report significant mental and physical health problems. These include Post Traumatic Stress Disorder. Studies report that sex workers identify the stigma they faced as the most challenging barrier to permanently leaving the sex trade,
The majority of research is about women sex workers. A smaller number of studies look at health outcomes of male sex workers. It is recommended that similar advice applies to the provision of services for men.
What do we know works well?
Integrated, holistic, person centred services are effective. These are highly valued by those at risk, and help promote and sustain their engagement. Holistic programmes address individual, varied and complex needs. These services include:
- trauma recovery
- financial management
- independent living
- legal advice
- physical and mental health issues
- drug and alcohol counselling and
- reintegration into the community
Integrated approaches to managing substance abuse and trauma appear to be effective. Compared with sequential or parallel treatment, integrated approaches may be more effective in:
- reducing trauma symptoms
- retaining women in treatment
- reducing risky sexual behaviours and
- improving mental and physical health
What do we know doesn’t work well?
- not treating trauma-related symptoms for sex workers recovering from substance misuse problems - this can place those at high risk of relapse into substance misuse
- not addressing substance misuse for those receiving treatment for trauma-related symptoms - this can impair outcomes and can leave people at risk of further re-victimisation
- services that only signpost to other services - services which don’t help individuals ready themselves for, and then access, relevant services.
Better Outcomes Evidence based guide to working with Former Sex Workers and Victims of Domestic Abuse (HMPPS 2015). A major concern for current and former sex workers that distinguishes them from those who have experienced of domestic abuse is the stigma associated with this work.
Social exclusion of people in the sex industry: review of evidence Independent report by National Inclusion Board shows that people engaged in sex work are subject to high levels of social exclusion. (DoH 2014)
The sexual health of male sex workers in England Analysis of cross-sectional data from genitourinary medicine clinics: Mc Grath-Lone, Marsh, Hughes, Ward (2013).
The Needs and Rights of Male Sex Workers Global Network of Sex Work Projects Briefing Paper
Meaningful Work, Transgender Experiences in the Sex Trade Analysis from the US National Transgender Discrimination Survey (2015)
Sex Work is a LGBTQ issue Survivors against SESTA (Stop Enabling Sex Traffickers Act) US (2018)
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This page summarises the available evidence base and is informed by independent academic peer review. It does not represent Ministry of Justice or Government policy.