BMJ  2006;332:362 (11 February), doi:10.1136/bmj.332.7537.362-a

Letter

Sex workers to pay the price

Prostitution strategy is a missed opportunity

EDITOR—The safety of sex workers in prostitution as well as the neighbourhoods where it takes place is paramount, and therefore tolerance zones seem to be a better way to achieve this objective. Like Boynton and Cusik,¹ I am disappointed that the Home Office has missed the opportunity to consider tolerance zones in its strategy.

Walsall has its own prostitution and associated problems. During the mid and late 1990s, considerable anger prevailed among the community experiencing the direct affects of prostitution. We initiated a qualitative study to obtain the views of residents and sex workers so that a robust strategy could be developed. The findings of this study surprised many as they included hitherto unknown facts. For example, more than half the sex workers and their clients were Walsall residents, which was contrary to the perception of many, that prostitution was an imported problem. This finding alone made individuals and agencies own the problem. Most community representatives and sex workers also believed that tolerance zones were the best way for safety, health, and indeed prevention.²

A multiagency task group has been in existence, led by the police, for implementing many of the recommendations arising from this study. The prostitution problem and its impact on the community are better managed and a great deal of trust has been established. Some innovative programmes have been initiated, including a theatre in education programme in schools to discourage children from prostitution; intervention by the community arts team to identify sex workers' aspirations; and an active rehabilitation process. Clearly we could not pursue a tolerance zone proposal as there was no legal framework to do so. Hence my frustration with the current strategy.

Sex work is an extremely dangerous activity, and the use of harm reduction principles can help to safeguard sex workers' lives.³ An opportunity to establish tolerance zones as an effective option in this process has been lost in the recent strategy.

Walsall Teaching Primary Care Trust, Walsall WS1 1TE sam.ramaiah{at}walsall.nhs.uk

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Competing interests: None declared.

References

1. Boynton P, Cusik L. Sex workers to pay the price. BMJ 2006;332: 190-2. (28 January.)[Free Full Text]
2. O'Neill M, Campbell R, James A, Webster M, Green K, Patel J, et al. Red lights and safety zones. In: Bell D, Jayne M, eds. City of quarters—urban villages in the contemporary city. Aldershot: Ashgate, 2004.
3. Rekart ML. Sex harm reduction. Lancet 2005;366: 2123-34.[CrossRef][ISI][Medline]

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Relevant Article

Sex workers to pay the price

Petra Boynton and Linda Cusick
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