Harm Red And Sex Work

International Journal of Drug Policy 17 (2006) 3–11

Commentary

Widening the harm reduction agenda: From drug use to sex work Linda Cusick ∗ Institute for Applied Social and Health Research, University of Paisley, The Gardner Building, Paisley PA1 2BE, United Kingdom Received 27 May 2005; received in revised form 3 November 2005; accepted 6 December 2005

Abstract Harm reduction emerged in the 1980s as a public health response to HIV and injecting drug use. This paper reviews the literature to structure the harms associated with sex work and expand the domains of harm reduction. Sex work-related harms are often rooted in debates where moral arguments and health and criminal justice policies compete for priority. Like drug users, sex workers have a social history in which they have been stigmatised, criminalised, pathologised, and on occasion, celebrated. Yet, by focusing on drug-related harm specifically, the ‘harm reduction movement’ is missing opportunities to better promote health among sex workers. Harms associated with sex work include: the vulnerabilities that may lead to sex work; harms that are introduced by sex work; and mutually reinforcing harms such as problematic drug use. These harms are overwhelmingly concentrated in street sex markets and where sex workers’ pre-existing vulnerabilities can be most exploited. They include predation and victimisation, violence and child abuse, trafficking and slavery, stigma, sanctions and penalties, STIs, exposure to mutually reinforcing harms and public nuisance. Existing interventions and policy developments to reduce these harms are discussed. © 2005 Elsevier B.V. All rights reserved. Keywords: Sex work; Prostitution; Harm reduction; Literature review

Introduction Applied to drug use, harm reduction principles aim to reduce individual, community and societal harms including harms to health, social and economic functioning (Newcombe, 1992). Largely developed to prevent the spread of HIV and AIDS, harm reduction is contrasted with drug use prevention and prohibition characterised as the ‘war on drugs’. Riley et al. (1999) describe harm reduction principles as pragmatic, value neutral and focused on prioritising achievable goals. Lenton and Single (1998) define a harm reduction policy or programme as one: ‘(1) where the primary goal is the reduction of drug related harm rather than drug use per se; (2) where abstinence-oriented strategies are included, strategies are also included to reduce the harm to those who continue to use drugs; and (3) strategies are included which aim to demonstrate that, on the balance of probabilities, it is likely to result in a net reduction in drug related harm’. Harm reduction principles are thus synony∗

Tel.: +44 141 848 3449; fax: +44 141 849 4264. E-mail address: [email protected].

0955-3959/$ – see front matter © 2005 Elsevier B.V. All rights reserved. doi:10.1016/j.drugpo.2005.12.002

mous with the reduction of drug-related harm but it may be possible to apply these principles more widely. As Myers, Aggleton, and Kippax (2004, p. 325) argue, ‘public health seeks critical understanding of issues and promotes the use of community empowerment approaches that are well beyond traditional ones, and harm reduction cannot be constructed in isolation from an understanding of the many social processes that affect health today.’ At present, harm reduction is a feature of sex work interventions mainly where sex workers are a sub-set of problematic drug users (Rogers & Ruefli, 2004). As a result, sex workers who are not problematic drug users are relatively neglected by harm reductionists and the wider problems of sex work fall outside their remits. Those interested in sex work as an area for harm reduction in its own right will nevertheless be able to learn much from existing harm reductionists. Drug users and sex workers after all, share similar social and political histories of being stigmatised, criminalised, pathologised and occasionally celebrated (Sloan & Wahab, 2000). A literature review of sex work harms found three types of association: factors thought to predict, explain or cause sex

4

L. Cusick / International Journal of Drug Policy 17 (2006) 3–11

work; harms introduced by sex work; and mutually reinforcing factors. Factors thought to predict, explain or cause sex work In this literature, commercial sex phenomena are described as social problems (Gould, 2001) and in many instances, involvement in sex work is assumed to be a negative experience or an expression of deviance. Background, personal or structural factors are posited to predict, explain or even cause involvement in sex work. This literature tends to be older. In studies of sex work in developed countries, sex work is often depicted as sexual deviance, sexual abuse or the result of ‘a lack’ or ‘failure’ of some kind (Nadon, Koverola, & Schludermann, 1998). Studies of sex work in developing countries draw similar conclusions but also point to explanations for sex work as filial obligation in contexts of cultural acceptance (McCaghy & Hou, 1994). A host of social background and personal factors are associated with entry to sex work and the literature review found no example of a paper that settles on only one explanatory factor. Variously referred to as vulnerabilities, factors, situational and personal variables, characteristics, risks and harms, the list of items thought to lead to sex work includes: pathology, especially mental health (Choicy, 1961); low self-esteem (James & Davis, 1982); childhood neglect or abuse (Dunlap, Golub, & Johnson, 2003; Silbert & Pines, 1981); family (especially maternal) inadequacy (Toby, 1957); moral failing (Denman, 1910) and youth deviance (especially promiscuity in girls) (Davis, 1971; James, 1977). Similarly, a host of structural factors are given to explain sex work and to explain why some individuals become involved in sex work. These include: poverty and a desire to escape it (Muecke, 1992); political instability and war (Richter, 1999); inequality, especially gender inequality (Balos & Fellows, 1999); and lack of education, training or skills for alternative occupations (Rabinovitch & Strega, 2004). Variations on this theme conceive sex work as an outcome of differential association (Sutherland, 1939) and a differential opportunity structure (Cloward & Ohlin, 1960). These sociological theories hold that behaviours and beliefs are learned in specific situations where licit and illicit means to achieving economic success are unevenly distributed. Thus, individuals become sex workers in response to an excess of attitudes favouring sex work which they have learned from others plus relatively good opportunities for doing sex work. Harms introduced by sex work A second type of association indicates harms that are said to be introduced or increased by sex work (Weitzer, 1999). This literature includes articles that may be considered incautious around inferred causality. However, the inferences seem plausible overall. It shows how vulnerability can be exploited

and sex workers victimised by predatory pimps, drug dealers, abusers and a host of other players who can profit from controlling sex workers (Williamson & Cluse-Tolar, 2002). The experiences and effects of stigma and of physical, sexual and mental abuse are described (Farley, Baral, Kiremire, & Sezgin, 1998). Opportunities are exposed for the systematic sexual abuse of children through unregulated businesses and statistics are reported on the prevalence of ‘child prostitution’ (Munir & Mohd Yasin, 1997; Willis & Levy, 2002). Trafficking, slavery and debt bondage are linked to health risk, violence and denial of human rights (Cwikel, Ilan, & Chudakov, 2003). The risks, incidence and prevalence of sexually transmitted infection are reported, often alongside recommendations for sex workers and services to prevent their transmission (Mayaud & Mabey, 2004; Nagot et al., 2002). With attention on the potential for sex work to introduce harms to communities, public nuisance is pointed up and a range of measures suggested to reduce or at least displace it ‘elsewhere’ (Benson & Matthews, 1995). The nature and extent of the harm reported in this literature varies with the type of sex market studied. Street sex markets are much more frequently studied and researcher access to study other types of sex market is often described as problematic (Hart & Whitaker, 1994; Shaver, 2005). When sex markets are directly compared, the harms introduced by sex work are overwhelmingly concentrated in street sex markets and where sex workers’ pre-existing vulnerabilities can be most exploited (Church, Henderson, Barnard, & Hart 2001; Pyett & Warr, 1997). Benefits introduced by sex work A relatively small literature exists on the potential benefits that sex work may introduce (Chuen-Juei Ho, 2000). Potentially positive impacts of sex work include positive body image, job satisfaction, autonomy, control of work (Manopaiboon et al., 2003; O’Connell Davidson, 1998) and status especially amongst sex workers and ‘the wise’ (Goffman, 1963). Positive sexual experience is however, almost exclusively discussed by sex working authors or with reference to male sex workers (Minichiello et al., 2001). In the analysis for this paper, sex work benefits are used as ‘negative cases’ (Mays & Pope, 2000) to check and improve on the understanding of associations.

Mutually reinforcing factors This final type of association avoids causal explanations for involvement in sex work but shows connections between sex work and variables that indicate vulnerability (Barnard, 1993). Assumptions about sex workers ‘lacking’ some personal attribute or structural opportunity are less obvious in this literature but ‘spirals of decline’ and the corrosive potential of sex work and its associated variables remain popular themes (Graham & Wish, 1994).

L. Cusick / International Journal of Drug Policy 17 (2006) 3–11

Addiction is frequently associated with sex work and generally discussed in terms of negative consequences for the sex worker’s health, safety when working or risk of becoming trapped by the mutually reinforcing aspects of certain behaviours or substances (Gossop, Powis, Griffiths, & Strang, 1995; Hunter, 2002). Predictably perhaps, drug use is the principal factor of interest here. There is a huge volume of literature providing evidence of the extent of overlap between drug using and sex working populations (Miller & Neaigus, 2002; Morse, Simon, Baus, Balson, & Osofsky, 1992) and the nature of relationships between various types of sex market and drug market (Kwiatkowski & Booth, 2000). Other mutually reinforcing behaviours and attitudes include desire for money to pay for general goods and other lifestyle enhancing expenses (Hwang & Bedford, 2004). By pointing to commitment and the ongoing nature of lifestyle expenses such as mortgage repayments and school fees, the literature here goes further than articles which merely posit desire to escape poverty as a motivation for sex work. Finally, a small proportion of articles deal with the mutually reinforcing potential of rewards that are internal to sex work careers. These include pursuit or enjoyment of sex and the power or status of a successful sex work career (Weinberg, Shaver, & Williams, 1999).

Where do sex work related harms arise? A great variety of types of sex work are revealed in the literature. These are variously distinguished by sex worker demographics, sexual orientation of the client, the physical environment and business operating styles (de Graff, van Zessen, Vanwesenbeeck, Straver, & Visser, 1996; Plumridge, Chetwynd, Reed, & Gifford, 1996). Thus, male/female sex workers, gay/straight clients, indoor/outdoor, and parlour/internet styles emerge as obvious examples of comparative categories. Whether each of these is staffed by a distinct population of sex workers or has a distinct population of clients is not clear (Rissel, Richters, Grulich, de Visser, & Smith, 2003). Nonetheless, sex workers and researchers appear to agree that these categories are meaningful in some way and that they distinguish important features of the various sex markets (Plumridge & Abel, 2001; Rickard & Growney, 2001). Many studies contrast two or more types of sex market. Their overwhelming conclusion is that risk behaviours, harms – and benefits where these are discussed – vary between sex market types (Plumridge & Abel, 2001; Weitzer, 1999). It is clear, therefore, that harms introduced by some kinds of sex work are not introduced to all types of sex work. Violence, for example, is concentrated amongst female sex workers, often soliciting on the streets and providing sex services in isolated and dilapidated environments (Plumridge & Abel, 2001; Surratt, Inciardi, Kurtz, & Kiley, 2004). Similarly, the benefits introduced by some kinds of sex work are not introduced to all types of sex work. The autonomy and control of work-

5

ing conditions enjoyed by home-based internet-entrepreneurs contrasts sharply with the restrictive rules used to manage some parlour based sex workers (Brewis & Linstead, 2002; Sloan & Wahab, 2000). The greatest concentrations of harms introduced by sex work are described in studies of low status, street based, open sex markets (Miller, 1993; Potterat et al., 2004; Surratt et al., 2004). Characterised by their reputations as ‘problem areas’, these sex markets often co-exist with open drug markets and are not effectively controlled so that violence, child abuse, trafficking and pimping are frequently observed (May, Edmunds, & Hough, 1999). Little is known about the clients using these sex markets although it is thought that more respectable clients are most easily displaced by policing (Cameron, 2004; Hubbard, 1998a; Plumridge et al., 1996). The sex workers operating in these sex markets are almost always described as vulnerable and a host of variables reported which indicate their poor circumstances (Green, Day, & Ward, 2000; Williamson, 2003). Sex workers and clients in these sex markets are the key targets for many services (Jeal & Salisbury, 2004) and are much more heavily policed than other sex markets (Benson & Matthews, 2000). This analysis concludes that sex work conditions are the crucial factor for controlling exposure and vulnerability to the harms that sex work may introduce. This conclusion was examined again using the literature review of ‘benefits introduced by sex work’ as a negative case in analytic induction (Denzin, 1978). Although the literature in this area is much more limited, benefits were linked to conditions in which sex workers had strong control over business arrangements and where they were able to operate without penalties or fear (Plumridge & Abel, 2001; Sanders, 2004). The refined conclusion is, therefore, that the harms and benefits of sex work depend on the conditions in which sex is bought and sold. In summary, this analysis indicates that the ways in which sex work is organised determines whether it introduces harm, increases the vulnerability of sex workers or allows sex workers to benefit from sex work.

The mechanics of deriving harm from sex work A section of the research literature is interested in the actual mechanics or opportunities for harms to be introduced by sex work. With reference to this literature, the question for this paper becomes: what it is about ‘sex work’ that allows these harms to be introduced? From the substantial literature on sexually transmitted infections amongst sex workers we can be confident that these are introduced via the ‘sex’ in sex work. Another substantial literature focuses on drug use or other issues that encourage continuation with sex work: those mutually reinforcing money, status and lifestyle factors. Here, money is the link for reinforcing these harms/benefits. No further harms (or benefits) were identified as arising from the exchange of money and sex. That is, some harms like STIs were introduced by

6

L. Cusick / International Journal of Drug Policy 17 (2006) 3–11

sex, other harms like drug dependency were reinforced by availability of money but no additional harms were introduced by the actions of exchanging sex and money. All of the remaining harms identified in the literature as arising from sex work were limited to and dependent on the specific conditions of some sex markets. Each of these is outlined below. Predation and victimisation such as abusive pimping were found in studies of sex markets where sex workers were fearful of authority, isolated and personally vulnerable (Williamson & Cluse-Tolar, 2002). Children, drug users and migrant sex workers who cannot access indoor sex markets, who do not have the resources or confidence to work as entrepreneurs and who do not know enough about their options are the key targets for sex market predators (Nixon, Tutty, Downe, Gorkoff, & Ursel, 2002; Outshoorn, 2001). Paedophiles, pimps, drug dealers and other individuals, often posing as ‘boyfriends’ (Swann, 1999) control and abuse sex workers in sex markets that are not controlled by a gate keeping colleague. By way of contrast, sex markets run from premises controlled by gatekeepers at least comply with enough local legal and social requirements to remain in business: effectively a guarantee of at least some minimum standards (Whittaker & Hart, 1996). Violence and child abuse were found in many sectors of sex work (Raphael & Shapiro, 2004) but the youngest, the most serious assaults and the greatest number of murders were concentrated in sex markets where sex workers worked alone and where they lack status (Pyett & Warr, 1999). Trafficking, slavery and debt bondage were concentrated in large cities and exist in a system suspended between organised crime on the one hand and policing and immigration controls on the other (Chapkis, 2003; Outshoorn, 2001). Fearful of both criminal gangs and authority figures, these sex workers may be controlled, abused and passed around as chattels in a system that prevents them emerging as free citizens. Some trafficked and enslaved sex workers give accounts of being held prisoner while others describe moving around quite freely in their day to day routines but too fearful to attempt escape from the secretive and deprived conditions of their sex markets. Stigma and negative effects on self-esteem or mental health are said to arise from all types of sex work (Chudakov, Ilan, Belmaker, & Cwikel, 2002; Farley, 2003) but the automatic nature of these relationships has been challenged by both academics (Frable, Wortman, & Joseph, 1997; Link & Phelan, 2001) and sex workers who deny their reach (Taylor, 1991). Stigma, reduced self-esteem and negative mental health effects of sex work may, therefore, be introduced by some sex work experiences more readily than others. More research on this topic will be useful but it seems likely that, as with other harms introduced by sex work, these effects are not universal or evenly distributed. State sanctions, penalties and corrupt levies are disproportionately applied to sex workers and their clients in street and other open sex markets (Benson & Matthews, 2000; Fabre, 2001). Otherwise, official police attention is directed

mainly at those who organise and are suspected of making the most substantial profits from indoor sex markets (Mills, 2004; Narboni, 2004). Sex workers who have the assets, knowledge and organisational skills to work collaboratively or independently mainly do so without coming to the attention of the police, services or tax collectors (West, 2000). Viruses do not respect organisational or social distinctions and thus STIs are found amongst sex workers in almost all sex markets (Desai et al., 2003; The Synergy Project, 2002). There are of course some exceptions as some sex markets do not provide physical sexual contact (Exotic Dancer’s Alliance, 2005). Where genital contact is the norm, condoms are widely used and STIs effectively prevented (Kerrigan et al., 2003; Kunawararak et al., 1995). Indeed, in the UK during an epidemic of STIs amongst the general population, their prevalence fell amongst sex workers attending a London clinic (Ward, Day, Green, Cooper, & Weber, 2004). Explaining these findings, Ward et al. (2004) point out that those sex workers who were best able to use condoms in all commercial sex transactions belonged to peer-networks and used their sex work careers strategically. Even here, it appears that opportunities to control the harms that might be introduced by sex work are dependent on the conditions in which sex workers operate (Agha & Nchima, 2004; Pauw & Brener, 2003; Pyett, Haste, & Snow, 1996). The mutually reinforcing harms of sex work and addiction or dependency have been mentioned above. From the high volume of good quality literature on this topic, it is clear that sex workers who appear to be drug users are most often denied work in indoor and co-operative sex work establishments (Plumridge & Abel, 2001). The open, street-based and low status sex markets thus become the only ones accessible to drug using sex workers. These markets are often so strongly entangled with street drug markets that continued and escalating drug use is virtually guaranteed (Inciardi & Surratt, 2001). Exposure to the reinforcing harms of sex work and problematic drug use therefore arise almost exclusively where sex and drug markets share space (May et al., 1999). Public nuisance is introduced by sex markets that are obvious rather than discrete (McKewon, 2003). These are often busy places also populated by the public who are having a night out, sex workers’ clients, drug dealers, drug purchasers and vigilantes with a mission to halt sex markets (Hubbard, 1997, 1998b). Other sex markets may cause public nuisance where they share space with residential or recently gentrified areas, irrespective of whether the sex market or the gentrified property occupiers were the earlier settlers (Kerkin, 2003). Again, the public nuisance harm introduced by sex work is introduced by sex working conditions that are least private, where the most vulnerable sex workers are concentrated and where they can be fully exposed to legal and illegal measures to displace them. In conclusion, the harms that are introduced by sex work depend on sex work taking place in conditions of vulnerability.

L. Cusick / International Journal of Drug Policy 17 (2006) 3–11

What can be done to reduce sex work related harm?

7

This commentary provides two lessons for those interested in reducing sex work related harm. First, the literature on personal and structural factors said to predict, cause or explain entry to sex work shows that there are many valid explanations – recognising circumstances, motivations and available options – which impact on individuals becoming sex workers. Second, the literature on the harms said to be introduced or reinforced by sex work shows that these harms are not inherent problems of sex work but of vulnerability. The tasks for harm reductionists in this field may, therefore, be stated as: to reduce existing vulnerability amongst sex work entrants; and to ensure that sex work does not introduce further vulnerability.

book on sex work history in the British Library. Organisations differ in their ambitions to abolish/prohibit sex work with respect to geographic scope (Rouart & Agacinski, 2000; United Nations, 1949) and type of sex work (Holli, 2000; International Programme on the Elimination of Child Labour, 2002). The success of an abolitionist/prohibitionist programme might be measured by its impact on the number of clients, sex workers or sex work premises operating in the area/sector targeted. Since these impacts are notoriously difficult to demonstrate amongst hidden populations, evidence often takes the form of case studies in which individuals ‘are saved’ from sex work (Yahne, Miller, Irvin-Vitela, & Tonigan, 2002). Meanwhile, the wider literature points to a growth in the number of sex workers, clients and premises (Raymond, 1998; Weitzer, 2000).

Reducing existing vulnerability amongst sex work entrants

Can harm reductionists embrace the abolitionist/prohibitionist ideal?

Some harm reduction programmes already exist to address the structural factors underlying sex work careers that begin in the context of poor opportunities to pursue alternatives. Education, training and skills programmes are increasingly considered as appropriate interventions (Norton-Hawk, 2001), and are often developed through sex worker initiatives and campaigns (Arnott, 2004). The task of reducing existing vulnerability amongst sex work entrants is nevertheless a daunting one as identified in the literature on those personal, background and structural factors predicting, explaining or causing sex work. Since these factors include personal pathologies, low self-esteem, childhood neglect and abuse, family dysfunction and youth deviance, the harm reductionists who might work in this area will be a much wider group than those whose interests are specifically with sex work. The pre-existing vulnerabilities found amongst sex workers are not unique to this group (Schissel & Fedec, 1999) and neither is it likely that these vulnerabilities first come to light when the vulnerable person becomes a sex worker (Shaw & Butler, 1998; Zigman, 1999). Social, educational and family policies will all have a part to play and there is already a wide literature on best practice for multi-agency working to support vulnerable people (Christian & Gilvarry, 1999; Shaw & Butler, 1998). Similarly, for global problems like poverty, political instability, war and gender inequality, sex work may be an expression of these problems but the solutions do not rest with sex work.

As with abstinence from drug use, there is no reason for harm reductionists to reject the abolitionist/prohibitionist ideal as an end point. However, with reference to drug related harm, Lenton and Single (1998) specifically argue against extending harm reduction definitions to include abstinence or prohibition programmes. They reason that such a definition would be over-inclusive as abstinence programmes cannot reduce harm to current users. Like drug related harms, the harms that are introduced by sex work are currently affecting many vulnerable people and there is a pressing need to reduce them. In a civilised society, responses that might realistically reduce those harms may be valued for their pragmatic and humane qualities.

Ensure that sex work does not introduce further vulnerability: abolitionist and prohibitionist approaches Some argue that since harms arise from sex work, ideally sex work should be abolished or prohibited using penalties against sex workers, third parties and/or clients to achieve this (Hammer & Maynard, 1987; Jordan, 2002). Such abolitionist and prohibitionist aspirations are mentioned in every

Ensure that sex work does not introduce further vulnerability: challenges for existing harm reduction programmes Sexually transmitted infections, mutually reinforcing aspects of sex work and drug use and public nuisance are all harms which are being tackled by programmes informed by harm reduction principles (Hanslope & Waite, 1994; Smarajit, Basu, Rotherham-Borus, & Newman, 2004). Many of these follow techniques to inform, educate, communicate, reach out and motivate which were developed to reduce drug related harms (WHO, 1995). It is here that those working to apply harm reduction principles to sex work will benefit from the experience of colleagues working to reduce drug related harm (Des Jarlais, 1998; Stimson, 1998). The remaining harms identified in the literature are as follows: predation and victimisation; violence and child abuse; trafficking and slavery; stigma; low self-esteem; mental illness; and the effects of sanctions and penalties. Parallel with the conclusion that these harms arise from the conditions in which sex is bought and sold, they are concentrated where sex work is illicit (Scambler & Scambler, 1995) and have been reduced where it has been decriminalised or in some cases

8

L. Cusick / International Journal of Drug Policy 17 (2006) 3–11

where it has been legalised or licensed (Lewis & MatickaTyndale, 2000; Pyett & Warr, 1997). One explanation for this relationship is that the illicit and immoral status of sex work stigmatises and penalises. Respectable investment and involvement are thereby discouraged and control of sex work left in criminal hands (Brants, 1998). Hence, child abuse, trafficking and slavery are profitable. An extension of this explanation reckons that violence, stigma and fear of authority are used to manipulate vulnerable sex workers to further maximise those profits (Kuo, 2002). If these harms are fostered by the illicit status of sex work, harm reductionists might tackle that illicit status (Castle, 1995; Dasgupta, 2002; Gangoli, 1998). To disentangle sex work from criminal control it will be necessary to decriminalise sex work and, some also argue, for sex workers to campaign for their human and employment rights (Kilvington, Day, & Ward, 2001). Decriminalisation and consistent application of legislation as for other businesses has been demonstrated as effective in reducing harm in Nevada, USA (Brents & Hausbeck, 2005) and in The Netherlands (Outshoorn, 2004). In contrast, in Australia where regulation has been patchy, violence and exploitation have been concentrated wherever sectors of the sex industry remain underground and sex workers are criminalised (West, 2000). Meanwhile in France where recent policy has been influenced by concern about public order, organised gangs increasingly dominate sex work organisation with subsequent negative impacts on public health and the living standards of sex workers (Mathieu, 2004). To conclude, commercial sex is a suitable area for development of the harm reduction agenda. The current focus on drug related harm neglects opportunities to reduce these wider harms.

Acknowledgements The author is grateful for positive feedback on an oral presentation of this paper at the sixteenth International Conference on the Reduction of Drug Related Harm, Belfast 2005. Additional thanks are expressed to Prof. Avril Taylor, Dr Susan Sherman and Dr Marina Barnard for their comments on the drafts of this paper.

References Agha, S., & Nchima, M. C. (2004). Life-circumstances, working conditions and HIV risk among street and nightclub-based sex workers in Lusaka, Zambia. Culture, Health and Sexuality, 6, 283–299. Allwood, G. (2003). Sarkozy’s Domestic Security Bill: A war on prostitutes not on prostitution? Actualite: Modern & Contemporary France, 11, 205–212. Arnott, J. (2004). Bangkok 2004: Sex workers and law reform in South Africa. Canadian HIV AIDS Policy Law Review, 9, 78–80. Bagley, C. (1999). Adolescent prostitution in Canada and the Philippines: Statistical comparisons, an ethnographic account and policy options. International Social Work, 42, 445–454.

Balos, B., & Fellows, M. L. (1999). A matter of prostitution: Becoming respectable. New York Law Review, 74, 1220–1303. Barnard, M. (1993). Violence and vulnerability: Conditions of work for streetworking prostitutes. Sociology of Health and Illness, 15, 683–705. Barry, K. (1995). The prostitution of sexuality. New York: New York University Press. Benson, C., & Matthews, R. (1995). Street prostitution: Ten facts in search of a policy. International Journal of the Sociology of Law, 23, 395–415. Benson, C., & Matthews, R. (2000). Police and prostitution: Vice squads in Britain. In R. Weitzer (Ed.), Sex for sale: Prostitution, pornography and the sex industry. New York: Routledge. Bittle, S. (2002, July). When protection is punishment; neo-liberalism and secure care approaches to youth prostitution. Canadian Journal of Criminology, 317–350. Brants, C. (1998). The fine art of regulated tolerance: Prostitution in Amsterdam. Journal of Law and Society, 25, 621–635. Brents, B. G., & Hausbeck, K. (2005). Violence and legalized brothel prostitution in Nevada: Examining safety, risk and prostitution policy. Journal of Interpersonal Violence, 20, 270–295. Brewis, J., & Linstead, S. (2002). Managing the sex industry. Culture and Organisation, 8, 307–326. Cameron, S. (2004). Space, risk and opportunity: The evolution of paid sex markets. Urban Studies, 41, 1643–1657. Castle, C. (1995). Summary of Xth international conference on AIDS in Yokohama, Japan: Sex workers. AIDS Care, 7, 93–95. Chapkis, W. (2003). Trafficking, migration, and the law—Protecting innocents, punishing immigrants. Gender and Society, 17, 923– 937. Choicy, M. (1961). Psychoanalysis of the prostitute. New York: Philosophical Library. Christian, J., & Gilvarry, E. (1999). Specialist services: The need for multi-agency partnership. Drug and Alcohol Dependence, 55, 265–274. Chudakov, B., Ilan, K., Belmaker, R. H., & Cwikel, J. (2002). The motivation and mental health of sex workers. Journal of Sex and Marital Therapy, 28, 305–315. Chuen-Juei Ho, J. (2000). Self-empowerment and ‘professionalism’: Conversations with Taiwanese sex workers. Inter-Asia Cultural Studies, 1, 283–299. Church, S., Henderson, M., Barnard, M., & Hart, G. (2001). Violence by clients towards prostitutes in different work settings: Questionnaire survey. British Medical Journal, 322, 524–525. Cloward, R. A., & Ohlin, L. E. (1960). Delinquency and opportunity. New York: Free Press. Cusick, L. (1998). Female prostitution in Glasgow: Drug use and occupational sector. Addiction Research, 6, 115–130. Cwikel, J., Ilan, K., & Chudakov, B. (2003). Women brothel workers and occupational health risks. Journal of Epidemiology and Community Health, 57, 809–815. Dalla, R. L. (2002). Night moves: A qualitative investigation of streetlevel sex work. Psychology of Women Quarterly, 26, 63–73. Dasgupta, M. (2002). Social action for women? Public interest litigation in India’s supreme court. Law, Social Justice and Global Development Journal. Available at http://http://www2.warwick.ac.uk/fac/soc/ law/elj/lgd/2002 1/dasgupta/. Davis, N. J. (1971). The prostitute: Developing a deviant identity. In J. Henslin (Ed.), Studies in the sociology of sex. New York: AppletonCentury-Crofts. de Graff, R., van Zessen, G., Vanwesenbeeck, I., Straver, C. J., & Visser, J. H. (1996). Segmentation of heterosexual prostitution into various forms: A barrier to the potential transmission of HIV. AIDS Care, 8, 417–431. Denman, W. (1910). San Francisco Committee on the Causes of Municipal Corruption Report on the Causes of Municipal Corruption. San Francisco: Rincon.

L. Cusick / International Journal of Drug Policy 17 (2006) 3–11 Denzin, N. K. (1978). The Research Act (2nd ed.). New York: McGrawHill. Desai, V. K., Kosambiya, J. K., Thakor, H. G., Umrigar, D. D., Khandwala, B. R., & Bhuyan, K. K. (2003). Prevalence of sexually transmitted infections and performance of STI syndromes against aetiological diagnosis, in female sex workers of red light area in Surat, India. Sexually Transmitted Infections, 79, 111–115. Des Jarlais, D. (1998). Fifteen years of research on preventing HIV infection among injecting drug users: What we have learned, what we have not learned, what we have done, what we have not done. Public Health Reports, 113(Suppl. 1), 182–188. Dunlap, E., Golub, A., & Johnson, B. D. (2003). Girls’ sexual development in the inner city: From compelled childhood sexual contact to sex-for-things exchanges. Journal of Child Sexual Abuse, 12, 73–96. Dwyer, R., Richardson, D., Ross, M. W., Wodak, A., Miller, M. E., & Gold, J. (1994). A comparison of HIV risk between women and men who inject drugs. AIDS Education and Prevention, 6, 379–389. Exotic Dancers Alliance at St James Infirmary. (2005). Available at http://www.iusw.org/links/index.html. Fabre, G. (2001). Drugs and the state: State corruption and criminalisation in China. International Social Science Journal, 53, 459–466. Farley, M. (2003). Prostitution and the invisibility of harm. Women and Therapy, 26, 247–280. Farley, M., Baral, I., Kiremire, M., & Sezgin, U. (1998). Prostitution in five countries: Violence and post-traumatic stress disorder (South Africa, Thailand, Turkey, USA, Zambia). Feminism & Psychology, 8, 405–426. Ford, K., Wirawan, D. N., Fajans, P., Meliawan, P., MacDonald, K., & Thorpe, L. (1996). Behavioural interventions for reduction of sexually transmitted disease HIV transmission among female commercial sex workers and clients in Bali, Indonesia. AIDS, 10, 213–222. Frable, D. E. S., Wortman, C., & Joseph, J. (1997). Predicting self-esteem, well-being and distress in a cohort of gay men: The importance of cultural stigma, personal visibility, community networks and positive identity. Journal of Personality, 65, 599–624. Gangoli, G. (1998, March). Prostitution, legislation and decriminalisation. Economic and Political Weekly, 504–505. Gilchrist, G., Taylor, A., Goldberg, D., Mackie, C., Denovan, A., & Green, S. T. (2001). Behavioural and lifestyle study of women using a drop-in centre for female street sex workers in Glasgow, Scotland: A 10-year comparative study. Addiction Research and Theory, 9, 43–58. Goffman, E. (1963). Stigma: Notes on the management of spoiled identity. New York: Simon & Shuster. Gossop, M., Powis, B., Griffiths, P., & Strang, J. (1995). Female prostitutes in South London: Use of heroin, cocaine and alcohol, and their relationship to health risk behaviours. AIDS Care, 7, 253–260. Gould, A. (2001). The criminalisation of buying sex: The politics of prostitution in Sweden. Journal of Social Policy, 30, 437–456. Graham, N., & Wish, E. D. (1994). Drug use among female arrestees: Onset, patterns and relationships to prostitution. Journal of Drug Issues, 24, 315–319. Green, A., Day, S., & Ward, H. (2000). Crack cocaine and prostitution in London in the 1990s. Sociology of Health and Illness, 22, 27–39. Green, M. B. (1993). Chronic exposure to violence and poverty: Interventions that work for youth. Crime and Delinquency, 39, 106–124. Hammer, J., & Maynard, M. (1987). Women, violence and social control. London: Macmillan. Hanslope, J., & Waite, M. (1994, March). Safer on the streets. Healthlines, 20–21. Hart, G., & Whitaker, D. (1994). Sex workers and HIV. AIDS Care, 6, 267–268. Holli, A.M. (2000, April). The fall of innocence and the rise of a new prohibitionism: Prostitution, policies and women’s policy machinery in Finland. European Consortium for Political Research (ECPR): Prostitution and Trafficking as Political Issues, Copenhagen. Hubbard, P. (1997). Red light districts and toleration zones: Geographies of female street prostitution in England and Wales. Area, 29, 129–140.

9

Hubbard, P. (1998a). Community action and the displacement of street prostitution: Evidence from British cities. Geoforum, 29, 269–286. Hubbard, P. (1998b). Sexuality, immorality and the city: Red-light districts and the marginalisation of female street prostitutes. Gender, Place and Culture: A Journal of Feminist Geography, 5, 55–76. Hunter, M. (2002). The materiality of everyday sex: Thinking beyond prostitution. African Studies, 61, 99–120. Husak, D. N. (2004). Guns and drugs: Case studies on the principled limits of the criminal sanction. Law and Philosophy, 23(5), 437–493. Hwang, S., & Bedford, O. (2004). Juveniles’ motivations for remaining in prostitution. Psychology of Women Quarterly, 28, 136–146. Inciardi, J. A., & Surratt, H. L. (2001). Drug use, street crime and sex trading among cocaine-dependent women: Implications for public health and criminal justice policy. Journal of Psychoactive Drugs, 33, 379–389. International Programme on the Elimination of Child Labour. (2002). Combating child labour. Geneva: International Labour Organization. www.ilo.org/childlabour. James, J. (1977). Early sexual experiences as a factor in prostitution. Archives of Sexual Behaviour, 17, 31–42. James, J., & Davis, N. J. (1982). Contingencies in female sexual role deviance: The case of prostitution. Human Organisation, 41, 345–350. Jeal, N., & Salisbury, C. (2004). Self-reported experiences of health services among female street-based prostitutes: A cross-sectional survey. British Journal of General Practice, 54, 515–519. Jordan, A. D. (2002). Human rights or wrongs? The struggle for a rights-based response to trafficking in human beings. Gender and Development, 10, 28–37. Kerkin, K. (2003). Re-placing difference: Planning and street sex work in a gentrifying area. Urban Policy and Research, 21, 137–149. Kerrigan, D., Ellen, J. A., Moreno, L., Rosario, S., Katz, J., Celentano, D. D., et al. (2003). Environmental-structural factors significantly associated with consistent condom use among female sex workers in the Dominican Republic. AIDS, 17, 415–423. Kilvington, J., Day, S., & Ward, H. (2001). Prostitution policy in Europe: A time for change? Feminist Review, 67, 78–93. Kunawararak, P., Beyrer, C., Natpratan, C., Feng, W., Celentano, D. D., Deboer, M., et al. (1995). The epidemiology of HIV and syphilis among male commercial sex workers in Northern Thailand. AIDS, 9, 517–521. Kuo, L. (2002). Prostitution policy: Revolutionizing practice through a gendered perspective. New York: New York University Press. Kwiatkowski, C. F., & Booth, R. E. (2000). Differences in HIV risk behaviours among women who exchange sex for drugs, money or both drugs and money. AIDS and Behaviour, 4, 233–240. Lazaridis, G. (2001). Trafficking and prostitution: The growing exploitation of migrant women in Greece. European Journal of Women’s Studies, 8, 67–102. Lenton, S., & Single, E. (1998). The definition of harm reduction. Drug and Alcohol Review, 17, 213–220. Lewis, J., & Maticka-Tyndale, E. (2000). Licensing sex work: Public policy and women’s lives. Canadian Public Policy—Analyse de Politiques, XXVI, 437–449. Link, B. G., & Phelan, J. C. (2001). Conceptualizing stigma. Annual Review of Sociology, 27, 363–385. Manopaiboon, C., Bunnell, R. E., Kilmarx, S., Chaikummao, S., Limpakarnjanarat, K., Supawitkul, S., et al. (2003). Leaving sex work: Barriers, facilitating factors and consequences for female sex workers in Northern Thailand. AIDS Care, 15, 39–52. Mathieu, L. (2004). The debate on prostitution in France: A conflict between abolitionism, regulation and prohibition. Journal of Contemporary European Studies, 12, 153–163. May, T., Edmunds, M., & Hough, M. (1999). Street business: The links between sex and drug markets. Home Office Policing and Reducing Crime Unit Research, Development and Statistics Directorate, Policing and Reducing Crime Unit: Police Research Series paper 118.

10

L. Cusick / International Journal of Drug Policy 17 (2006) 3–11

Mayaud, P., & Mabey, D. (2004). Approaches to the control of sexually transmitted infections in developing countries: Old problems and modern challenges. Sexually Transmitted Infections, 80, 174–182. Mays, N., & Pope, C. (2000). Assessing quality in qualitative research. British Medical Journal, 320, 50–52. McCaghy, C. H., & Hou, C. (1994). Family affiliation and prostitution in a cultural context: Career onsets of Taiwanese prostitutes. Archives of Sexual Behaviour, 23, 251–265. McKewon, E. (2003). The historical geography of prostitution in Perth, Western Australia. Australian Geographer, 34, 297–310. Miller, J. (1993). ‘Your life is on the line every night you’re on the streets’: Victimisation and the resistance among street prostitutes. Humanity and Society, 17, 422–446. Miller, J. (1995). Gender and power on the streets: Street prostitution in the era of crack cocaine. Journal of Contemporary Ethnography, 23, 427–452. Miller, M., & Neaigus, A. (2002). An economy of risk: Resource acquisition strategies of inner city women who use drugs. International Journal of Drug Policy, 13, 409–418. Mills, K. (2004, July). Operation Rampart. The Association of Chief Police Officers (ACPO) for England, Wales and Northern Ireland, Vice Conference, Cheltenham, England. Minichiello, V., Marino, R., Browne, J., Jamieson, M., Peterson, K., Reuter, B., et al. (2001). Male sex workers in three Australian Cities: Socio-demographic and sex work characteristics. Journal of Homosexuality, 42, 29–51. Monto, M. A. (2004). Female prostitution, customers and violence. Violence Against Women, 10, 160–188. Morse, E. V., Simon, P. M., Baus, S. A., Balson, P. M., & Osofsky, H. J. (1992). Cofactors of substance use among male street prostitutes. Journal of Drug Issues, 22, 977–994. Muecke, M. A. (1992). Mother sold food, daughter sells body: The cultural continuity of prostitution. Social Science and Medicine, 35, 891–901. Munir, A. B., & Mohd Yasin, S. H. (1997). National and international legal responses to child prostitution and child pornography. Child Abuse Review, 6, 147–153. Myers, T., Aggleton, P., & Kippax, S. (2004). Perspectives on harm reduction: Editorial introduction. Critical Public Health, 14, 325–328. Nadon, S. M., Koverola, C., & Schludermann, E. H. (1998). Antecedents to prostitution: Childhood victimisation. Journal of Interpersonal Violence, 13, 206–221. Nagot, N., Ouangre, A., Ouedraogo, A., Cartoux, M., Huygens, P., Defer, M. C., et al. (2002). Spectrum of commercial sex activity in Burkina Faso: Classification model and risk of exposure to HIV. Journal of Acquired Immune Deficiency Syndromes, 29, 517–521. Narboni, C. (2004, July). Operation Pabail. The Association of Chief Police Officers (ACPO) for England, Wales and Northern Ireland, Vice Conference, Cheltenham, England. Newcombe, R. (1992). The reduction of drug related harm: A conceptual framework for theory, practice and research. In P. O’Hare, R. Newcombe, A. Matthews, E. Buning, & E. Drucker (Eds.), The reduction of drug related harm. London: Routledge. Nixon, K., Tutty, L., Downe, P., Gorkoff, K., & Ursel, J. (2002). The everyday occurrence: Violence in the lives of girls exploited through prostitution. Violence Against Women, 8, 1016–1043. Norton-Hawk, M. (2001). The counterproductivity of incarcerating female street prostitutes. Deviant Behaviour, 22, 403–417. Norton-Hawk, M. (2004). A comparison of pimp- and non-pimpcontrolled women. Violence Against Women, 10, 189–194. O’Connell Davidson, J. (1998). Prostitution, power and freedom. Cambridge: Polity Press. Outshoorn, J. (2001). Debating prostitution in parliament: A feminist analysis. European Journal of Women’s Studies, 8, 472–490. Outshoorn, J. (2004). Pragmatism in the Polder: Changing prostitution policy in The Netherlands. Journal of contemporary European Studies, 12, 165–176.

Pauw, I., & Brener, L. (2003). ‘You are just whores—You can’t be raped’: Barriers to safer sex practices among street sex workers in Cape Town. Culture, Health and Sexuality, 5, 465–481. Plumridge, E. W., Chetwynd, S. J., Reed, A., & Gifford, S. J. (1996). Patrons of the sex industry: Perceptions of risk. AIDS Care, 8, 405–416. Plumridge, L., & Abel, G. (2001). A ‘segmented’ sex industry in New Zealand: Sexual and personal safety of female sex workers. Australian and New Zealand Journal of Public Health, 25, 78–83. Potterat, J. J., Brewer, D. D., Muth, S. Q., Rothenberg, R. B., Woodhouse, D. E., Muth, J. B., et al. (2004). Mortality in a long-term open cohort of prostitute women. American Journal of Epidemiology, 159, 778–785. Pyett, P., & Warr, D. (1999). Women at risk in sex work: Strategies for survival. Journal of Sociology, 35, 183–197. Pyett, P. M., Haste, B. R., & Snow, J. (1996). Risk practices for HIV infection and other STDs amongst female prostitutes working in legalised brothels. AIDS Care, 8, 85–94. Pyett, P. M., & Warr, D. J. (1997). Vulnerability on the streets: Female sex workers and HIV risk. AIDS Care, 9, 539–547. Rabinovitch, J., & Strega, S. (2004). The PEERS story: Effective services sidestep the controversies. Violence Against Women, 10, 140–159. Raphael, J., & Shapiro, D. L. (2004). Violence in indoor and outdoor prostitution venues. Violence Against Women, 10, 126–139. Raymond, J. G. (1998). Prostitution as violence against women—Trends and statistics. Women’s Studies International Forum, 21, 1–9. Richter, L. K. (1999). After political turmoil: The lessons of rebuilding tourism in three Asian countries. Journal of Travel Research, 38, 41–45. Rickard, W., & Growney, T. (2001). Occupational health and safety among sex workers: A pilot peer education resource. Health Education Research, 16, 321–333. Riley, D., Sawka, E., Conley, P., Hewitt, D., Mitic, W., Poulin, C., et al. (1999). Harm reduction: Concepts and practice, a policy discussion paper by The Canadian Foundation for Drug Policy, Toronto, Ontario. Substance Use & Misuse, 34, 9–24. Rio, L. M. (1991). Psychological and sociological research and the decriminalisation or legalization of prostitution. Archives of Sexual Behaviour, 20, 205–218. Rissel, C. E., Richters, J., Grulich, A. E., de Visser, R. O., & Smith, A. M. A. (2003). Sex in Australia: Experiences of commercial sex in a representative sample of adults. Australian and New Zealand Journal of Public Health, 27, 191–197. Rogers, S. J., & Ruefli, T. (2004). Does harm reduction programming make a difference in highly marginalised, at-risk drug users? Harm Reduction Journal, 1, 7., http://www.pubmedcentral. nih.gov/articlerender.fcgi?artid=420490. Rouart, M., & Agacinski, S. (2000). People of the Abyss, prostitution today. Foundation Seal Conference, France. Sanders, T. (2004). A continuum of risk? The management of health, physical and emotional risks by female sex workers. Sociology of Health and Illness, 26, 557–574. Scambler, G., & Scambler, A. (1995). Social change and health promotion among women sex workers in London. Health Promotion International, 10, 17–24. Schissel, B., & Fedec, K. (1999, January). The selling of innocence: The gestalt of danger in the lives of youth prostitutes. Canadian Journal of Criminology, 33–56. Shaver, F. M. (2005). Sex work research: Methodological and ethical challenges. Journal of Interpersonal Violence, 20, 296–319. Shaw, I., & Butler, I. (1998). Understanding young people and prostitution: A foundation for practice? British Journal of Social Work, 28, 177–196. Silbert, M., & Pines, A. (1981). Sexual child abuse as an antecedent to prostitution. Child Abuse and Neglect, 5, 407–411. Silver, R. (1993). The girl in scarlet heels: Women in the sex business speak out. London: Century Random House.

L. Cusick / International Journal of Drug Policy 17 (2006) 3–11 Sloan, L., & Wahab, S. (2000). Feminist voices on sex work: Implications for social work. Affilia, 15, 457–479. Smarajit, J., Basu, I., Rotherham-Borus, M. J., & Newman, P. A. (2004). The Sonagachi project: A sustainable community intervention program. AIDS Education and Prevention, 16, 405–414. Stimson, G. V. (1998). Harm reduction in action: Putting theory into practice. International Journal of Drug Policy, 9, 401–409. Surratt, H. L., Inciardi, J. A., Kurtz, S. P., & Kiley, M. C. (2004). Sex work and drug use in a subculture of violence. Crime and Delinquency, 50, 43–59. Sutherland, E. (1939). Principles of criminology (3rd ed.). Philadelphia: Lippincott. Swann, S. (1999). Children involved in prostitution: The government’s draft guidance. Childright, 154, 15–16. The Synergy Project (funded by USAID). (2002). Room for change: Preventing HIV transmission in brothels. University of Washington Center for Health Education and Research. A research-based field resource supported by The Synergy APDIME Toolkit http://www.synergyaids.com. Available at http://www. synergyaids.com/documents/sub module brothel1 hh edit.pdf. Taylor, A. (1991). Prostitution: What’s love got to do with it? London: Optima. Toby, J. (1957). The differential impact of family disorganisation. American Sociological Review, 22, 505–512. United Nations. (1949, December 2). Resolution 317 (IV) for suppression of the traffic in persons and of the exploitation of the prostitution of others, 264th plenary meeting. http://daccessdds.un.org/doc/ RESOLUTION/GEN/NR0/051/36/IMG/NR005136.pdf?OpenElement. Walker, K. E. (2002). Exploitation of children and young people through prostitution. Journal of Child Health Care, 6, 182–188.

11

Ward, H., Day, S., Green, A., Cooper, K., & Weber, J. (2004). Declining prevalence of STI in the London sex industry, 1985 to 2002. Sexually Transmitted Infections, 80, 374–378. Weinberg, M. S., Shaver, F. M., & Williams, C. J. (1999). Gendered sex work in the San Francisco Tenderloin. Archives of Sexual Behaviour, 28, 503–521. Weitzer, R. (1999). Prostitution control in America: Rethinking public policy. Crime, Law and Social Change, 32, 83–102. Weitzer, R. (2000). Sex for sale. London and New York: Routledge. West, J. (2000). Prostitution: Collectives and the politics of regulation. Gender, Work and Organization, 7, 106–118. Whittaker, D., & Hart, G. (1996). Research note: Managing risks: The social organisation of indoor sex work. Sociology of Health and Illness, 18, 399–414. WHO. (1995). World Health Organisation, Information, Education and Communication: A guide for AIDS programme managers. New Delhi: WHO-SEARO. Williamson, C. (2003). Understanding the experiences of street level prostitutes. Qualitative Social Work, 2, 271–287. Williamson, C., & Cluse-Tolar, T. (2002). Pimp-controlled prostitution: Still an integral part of street life. Violence Against Women, 8, 1074–1092. Willis, B. M., & Levy, B. S. (2002). Child prostitution: Global health burden, research needs and interventions. The Lancet, 359, 1417–1422. Yahne, C. E., Miller, W. R., Irvin-Vitela, L., & Tonigan, J. S. (2002). Magdalena pilot project: Motivational outreach to substance abusing women street sex workers. Journal of Substance Abuse Treatment, 23, 49–53. Zigman, M. (1999). Under the law: Teen prostitution in Kensington. Critique of Anthropology, 19, 193–201.