Home > Drug-using sex workers exposed to multiple risks and harms.

Dunne, Mary (2009) Drug-using sex workers exposed to multiple risks and harms. Drugnet Ireland, Issue 31, Autumn 2009, pp. 20-21.

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A large-scale qualitative study has highlighted the need for adequately resourced support structures to reduce the risk of harm to drug-using sex workers in Ireland. The first of its kind, this study by the National Advisory Committee on Drugs (NACD) explored the local risk environment within which drug-using sex workers in Dublin live and work.1 

The authors conclude that wider social and situational factors, such as poverty, housing, health, educational needs and employment prospects, are as fundamental to reducing risk of harm in this vulnerable group as addressing drug use.

In-depth interviews were conducted with 35 drug users currently or formerly engaged in sex work, and biographical, drug use and offending behaviour data were collected by means of a brief questionnaire. In addition, interviews were held with 40 professionals across community, voluntary and statutory sectors whose work either directly or indirectly impacted on drug-using sex workers. This intensive, qualitative approach revealed that there is a range of behaviours associated with drug use and its accompanying lifestyle which place an individual at particular risk of harm.
For the most part, participants in the study grew up in communities associated with social and economic marginalisation and high levels of unemployment. They moved more or less continually through drug and alcohol services, homeless hostels, the judicial system and other social care agencies.   Participants used a range of strategies to reduce danger, yet their perception of risk was relative to their situation, thus leading them to treat some risks as acceptable or necessary.  Current harm reduction interventions tend to focus on individual risk behaviour, often overlooking the wider social contexts in which members of this group live and work.
Arising from analysis of the research, the NACD recommends: 
·         continued and adequate funding of existing services that deal with this client group;
·         expansion of outreach services (particularly out of hours) to target existing and developing street sex markets, and development of peer outreach to areas of the city with known networks of drug-using sex workers;
·         continued funding of programmes (such as specialist CE schemes for drug users) aimed at getting drug users back to work;
·         provision of flexible hostel accommodation for drug-using sex workers who are homeless, ranging from low-threshold facilities to accommodation that assists recovery and rehabilitation;
·         recognition of the role of drug services in identifying male and female clients involved in sex work and in providing advice on safer sex practices in order to reduce sexual risk in personal intimate relationships and commercial sex transactions.
In terms of policy, the authors recommend that ‘harm reduction be explicitly stated as a guiding principle of the new National Drugs Strategy’ (p.26), and that the strategy must also outline a continuum of harm reduction activities, a ‘model package’ of interventions, minimum standards for services and optimal levels of service coverage.
Speaking at the launch of the report, John Curran TD, Minister with responsibility for drugs strategy, welcomed the research on this key ‘at risk group’, stating that it would inform developments in the new drugs strategy. He said he was committed to achieving real progress in harm reduction and drug rehabilitation, and acknowledged that significant strides forward were needed across several areas, such as medical support, housing, education, employment and family support.
1. Cox G and Whitaker T (2009) Drug use, sex work and the risk environment in Dublin, Dublin: National Advisory Committee on Drugs.

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