The complex, difficult lives and subsequent health issues of street-based female sex workers are well documented. This paper explores the health needs of a group of sex workers in one geographical locality in the north-west of England. Interviews were conducted with a number of women currently engaged in sex work, with the aim of identifying factors maintaining them in this work and examining their experience of health and health-related services.
A thematic analysis revealed considerable life circumstance complexity, with violence, drugs, alcohol and housing problems being prevalent factors. The combination of such factors compounds the likelihood of the women's social exclusion. Other themes related to the casual perception the women had of their own health needs, their generally poor experience of services and the demonstrable impact of one specific service in supporting a group so reluctant to engage.
The study suggests poor understanding of the complex needs of street-based sex workers by both services and professionals, particularly a failure to engage with the reality of these women's lives and the factors that maintain them in this work.
Street-based sex workers are more likely than many other occupational groups to experience poor health, poverty and social exclusion Costello, Their work often supplements low paid jobs Elmore-Meegan et al. Vulnerability to sex work is more prevalent within areas of economic deprivation and is associated with habitual drug and alcohol use, poor mental health, chaotic lifestyle, homelessness and a background of abusive relationships Belcher and Herr, ; Bellis et al.
Health inequalities and poor health, furthermore, are experienced disproportionately by those living within such areas Wood et al. The main characteristics of social exclusion revolve around persistent drug use, poor access to health and welfare services, low levels of educational attainment, uncertainty of living conditions and high levels of violence Campbell, The ways in which social exclusion, poor mental and physical health interrelate to maintain women in sex work are difficult to determine accurately Melrose, Prostitution and addiction, furthermore, sometimes serve to mask the effects of traumatic life experiences Belcher and Herr, This study looks at the lives of a group of women currently working as sex workers, exploring their experience of health services, particularly the barriers they encounter when trying to access generic health care.
