Minimising harm in sex work

xvii, 424 p. :ill., forms ; 30 cm. Includes bibliographical references. "June 2010."This thesis takes a community-based participatory approach, using mixed methods to examine the impact of the decriminalisation of sex work in New Zealand through the lens of a public health discourse of harm minimisation. The key question addressed in this thesis is whether decriminalisation has minimised the harms experienced by sex workers. Rather than taking a narrow view of harm minimisation and looking merely at the practices of sex workers, I have taken a more holistic stance, taking into account structural social issues which contribute to the health and wellbeing of sex workers. Data were collected through a survey of 772 sex workers and in-depth interviews with 58 sex workers in Auckland, Wellington, Christchurch, Napier and Nelson. Estimates were done of the number of sex workers in these cities which show little change post-decriminalisation compared to estimates done prior to decriminalisation. There has been some change in the shape of the industry with more people working privately in the suburbs and fewer in the brothels and escort agencies but little change in size of the street-based sector. Such minimal change in the size of the sex industry is not surprising as the underlying motivations for working in this industry have not changed in a decriminalised environment. As this thesis demonstrates, structural factors (such as economic climate, employment opportunities, welfare, housing and sickness benefits) are associated with the entry into sex work rather than the way the industry is regulated. Theories of social exclusion and stigma are utilised in the thesis to show how sex workers have been cast predominantly as a deviant population, associated with disease, crime and drugs. The media often make use of these associations in reporting on sex workers, which leads to heightened public anxiety and campaigns to exclude sex workers from society. Even in a decriminalised environment in New Zealand, such campaigns continue, which has meant that although decriminalisation has given sex workers in New Zealand human rights, they continue to experience stigmatisation. This thesis found that sex workers have poorer self-reported mental health than the general population of New Zealand and some of this poorer perceived mental health could be due to their ongoing stigmatisation. This is not to say that decriminalisation has not been a success. As this thesis demonstrates, sex workers in New Zealand have more control over their work environment, including their safety and their sexual health, since the passing of the Prostitution Reform Act (2003). The Act has given them legal, employment and occupational health and safety rights which has made it easier to negotiate services and safer sex with clients, has made it easier for managed sex workers to refuse to see certain clients without penalties from management and has improved the relationship between sex workers and police. The fact that sex workers can make use of the law has given them a sense of legitimacy and respectability which was absent under laws that criminalised them. The provision of human rights to sex workers through the decriminalisation of the sex industry has led to the minimisation of harm to New Zealand sex workers