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1 August 2017
As part of the CLAHRC West feasibility project looking at an intervention to reduce drug use among female street sex workers, we have worked closely with charity One25 to ensure these women can contribute to the project.
Most female street sex workers in the UK are affected by the use of illegal drugs, such as heroin and crack cocaine. For most of these women, heroin and crack use reinforces their dependency on sex work and adds to their health and social problems. The need to finance their drug use, and often that of a partner, frequently underpins their involvement in sex work. Drug intoxication also means they are less able to protect themselves whilst working.
Street sex workers who are drug-dependent find using treatment services difficult and when they do, typically don’t benefit as much as other drug users. Managing problem drug use amongst sex workers is complex. They can experience stigma in drug treatment groups from other drug service users. This prevents them from discussing their sex work, a major factor in their drug use.
There is also evidence that many drug-using street sex workers are affected by post-traumatic stress disorder (PTSD) from their life experiences. They are unlikely to benefit from other treatment unless this trauma is addressed.
Based on recent research, we have developed a plan to improve the results of drug treatment for these women, by organising NHS and voluntary sector services to work together. This new approach involves creating a stigma-free environment for street sex workers to discuss their work in drug treatment groups, as well as addressing trauma as part of the drug treatment.
The project is led by Nikki Jeal who has worked with street sex workers in Bristol since 1998. She got involved in research because she wanted to improve the women’s health and find ways to address their unmet health needs. Nikki has provided care at One25, a voluntary service for female street sex workers, in prison and as a forensic medical examiner. She therefore has longstanding relationships with many of the women through a range of settings.
The women involved have contributed both as advisors and as participants in an earlier qualitative study about poor drug treatment outcomes. Between 10 and 20 women have been involved in advising Nikki on research in this area, as well as in initiatives to improve services. Findings from a previous study led to this project at CLAHRC West.
Public involvement takes place in an advisory group at One25, at meetings where refreshments and vouchers are provided to thank women for their work.
The women have helped with a number of tasks so far:
The women will continue to be involved throughout the project.
The women’s contributions have made a difference to all of the tasks described above. Some of the most important examples are:
The advisory group helps Nikki and the other researchers understand what the women want and what will work.
The project will lead to a patient-focused care package for street sex workers in order to address their longstanding unmet health needs. This project, called the DUSSK (Drug Use in Street Sex Workers) study, is being conducted by the University of Bristol and NIHR CLAHRC West in collaboration with:
For more information contact Nikki Jeal, University of Bristol email: Nikki.Jeal@bristol.ac.uk.