Sex workers - good practice examples
We are highlighting examples of good practice. Some of these are described in (sometimes hard to find) documents. Others have been provided by nurses working with excluded groups.
You might also like to refer to the guidance, policy and voices sections for further information on sex workers.
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Sex Workers Into Sexual Health (Swish) Project, Terrence Higgins Trust
Hillfields is a densely populated area adjacent to Coventry city centre. It is home to a multicultural community that includes many asylum seekers waiting a decision on their refugee status. It was the site of one of the first Community Development Projects in 1970 which, like many subsequent area based initiatives, was abandoned.
A key issue affecting the quality of life of Hillfields' residents is the extent of prostitution and drug dealing that has earned the area a reputation as a high-crime neighbourhood. The Terrence Higgins Trust research into the lives of women sex workers in Coventry examined how drug use and housing conditions affect the risks they take with their sexual health. Economic need was the main factor in starting sex work. All women interviewed were using drugs with three quarters using crack cocaine or heroin every day.
All the women who worked on the streets in the study had been homeless and a third had been in prison at some point in their lives. Street sex workers were more likely to take risks than women working indoors who were more likely to be in control of their personal and working lives (Terrence Higgins Trust 2006).
Swish is a mobile outreach service (using a bus) to encourage sex workers into sexual health. It receives funding from the Drug Action Team and Community Safety Partnership. The service currently concentrates on street workers, but is being expanded to incorporate parlours, saunas etc.
The service provides health services such as access to drug treatment services, auricular acupuncture to reduce cravings for crack, a sexual health clinic, awareness training of sexual health issues, condom distribution and safer sex materials, needle exchange and hepatitis vaccinations.
Swish works alongside other agencies whose staff also travel on the outreach bus at certain times. This includes a Community Drug Team nurse to administer hepatitis B vaccinations and a nurse from the Anchor Centre, a primary care centre for people who are homeless, have mental health issues and substance misuse problems.
The project is part of the Court Diversion scheme whereby sex workers can avoid prison sentences if they sign up to working with Swish. This means the client is given a two week adjournment in the expectation that she will attend at least one appointment with Swishto complete an assessment and refer to other agencies if needed. When the client returns to court the sitting magistrates are updated as to the progress. The expectation is that the client would not receive a fine and a conditional or absolute discharge would be given thus breaking the arrest/fine cycle.
Swish also provides support and advice for those who wish to exit from sex work and refers clients to the Community Drugs Team to reduce injecting and safer alternatives to injecting. The project has increased the numbers of women accessing services and leaving the sex industry. It reduced offending, homelessness and the number of nuisance complaints to the police.
The key learning points according to Swish are that services should be delivered "on site", at times that are accessible to the client group; other organisations must be involved in outreach and drop-ins for a "one stop shop" approach; the service needs to ensure boundaries are clear for clients and staff and that local residents are to be involved at every opportunity.
Sources:
The items below are available online. They were last accessed on 2 November 2010. One item is in PDF - see how to access PDF files.
Audit Commission (2006) Neighbourhood crime and anti-social behaviour. Making places safer through improved local working. London: Audit Commission.
Audit Commission (2006) West Midlands Police and Coventry City Council: Hillfields neighbourhood plan. London: Audit Commission.
Local Government Improvement and Development (2008) Sex Workers into Sexual Health scheme and the Street Outreach Service. London: Local Government Improvement and Development.
Terrence Higgins Trust (2006) Terrence Higgins Trust report investigates the health needs of sex workers in Coventry. London: Terrence Higgins Trust.