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Street-based Prostitution and Public Health Concerns: Analytical Essay
Prostitution is known to be one of the oldest professions, and today remains an active professional in countries all over the world. Despite its prevalence, prostitution is an ongoing source of public, academic, and moral debate (Benoit, Jansson, Smith & Flagg, 2018). Prostitution can be defined as “the trade of sexual services for items, money or a place to stay” (Williamson & Baker, 2009 P.28), with street-based prostitution involving a prostitute soliciting from a public place. Street-based prostitution is one of the many ways in which prostitutes acquire clients and accounts for around twenty percent of the industry (Scott & Dedel, 2006). This essay will focus solely on female street prostitutes, although both male and transgender individuals are also found in this line of work. This essay will explore the stigma associated with the term street-based prostitution, as well as discuss how public health concerns and the law on prostitution, along with feminist debates on the topic, shape our understanding of street-based prostitution.
Street-based prostitution is the most dangerous form of the profession. This is due to the fact that many countries have criminalized aspects of street-based prostitution such as loitering, soliciting and curb crawling; and the lack of protection for these workers. Due to its illegal nature in many countries, little is known about street prostitution and the profession is comprised largely of hidden populations. However, there is an estimate of around 72,800 prostitutes in the UK (Parliament UK, 2016). Furthermore, street prostitution paints a complex picture, with many women weaving in and out of the profession (Scott & Dedel, 2006). This compromises the ability to collect accurate statistics regarding the number of street prostitutes (McCarthy, Benoit, Jansson & Kolar, 2012).
Stigma is an extremely significant aspect in the understanding of street-based prostitution and an issue that affects sex workers around the world (Benoit, McCarthy & Jansson, 2015). Stigma has been defined by Goffman (1963) as a social attribute that discredits an individual or a certain group. There is a largely negative stigma surrounding street-based prostitution and workers are often stigmatized and viewed by the general public as deviant (Vanwesenbeeck, 2001). Those involved in this work will often experience stigma in the form of discrimination, victimization and moral judgment which can all lead to isolation and loss of status (Link & Phelan, 2001) along with physical abuse and assault (Scambler & Hopkins, 1986). Therefore, those involved in street-based prostitution often experience social exclusion, either due to others or excluding themselves due to shame and secrecy (Corrigan & Fong, 2014). Lazarus et al. (2012) research has found that 55.9% of street-based sex workers reported stigma surrounding their work, leading them to hide their status from others. This gives an insight into how society views individuals in this profession (Sanders, 2018). Furthermore, the stigma surrounding street-based prostitution has been found to lead to barriers, as well as hesitancy, to use health care services (Stuber, Meyer & Link, 2008). The criminalization of street-based prostitution has also been found to worsen the stigma that workers experience (Armstrong, 2018). The illegal nature simultaneously creates an image of prostitutes as threatening, dangerous, and deviating from social norms (Krüsi, Kerr, Taylor, Rhodes & Shannon, 2015) which shapes the public’s understanding and views on this profession. Therefore, the laws surrounding street-based prostitution reinforce the pre-existing stigmas surrounding street-based prostitutes, which maintains the negative social views surrounding street-based prostitutes and influences the way they are treated (Sanders, 2016)
The understanding of street-based prostitution is also largely influenced by the public health concerns that are related to this profession. Street-based prostitutes are usually associated with a high risk of spreading sexually transmitted infections (STIs), for example, syphilis, herpes, and HIV (Scott & Dedel, 2006). This has affected the way street-based prostitution is viewed, especially after the HIV crisis impacted the way in which the general public perceived and understood prostitution (Brooks-Gordon, 2013).
Despite the views of the public, researchers have found a mixture of results when it comes to supporting this claim. Love (2015) found that there is a high prevalence of STIs within the population of street-based prostitutes. Further to this, research has also found that UK street-based prostitutes were nine to sixty times more likely to have an STI than those in the general population (Jeal & Salisbury, 2004). However, these results could be affected by researcher bias that is often associated with the stigma surrounding street-based prostitution. Researchers may design their studies in such a way that will increase the chances of finding high rates of STIs from street-based prostitutes. Such methodological issues could include; choosing a sample that have a higher chance of being IV-drug users; not using groups of women who are not prostitutes as a control group for the research and user testing methods, that are often inaccurate, with a higher chance of producing false positives (Sacks, 1996).
In contrast to these findings, a study conducted in San Francisco found that there was no difference in the prevalence of HIV between those women that were prostitutes and those that were not. In both groups, however, those that were HIV- positive were largely individuals that used IV- drugs (Stall, Heurtin‐Roberts, McKusick, Hoff & Lang, 1990). This is supported by a review by Platt et al., (2013) where it was found that HIV vulnerability for female sex workers in Europe was due to unsafe IV-drug injecting, and not the sex work that they participated in.
Street-based prostitutes in the UK were found to be more likely to take drugs, such as crack cocaine and heroin, than those prostitutes that don’t work on the streets (Sanders, O’Neill, M & Pitcher, 2018) and Sacks (1996) concluded that many members of the public hold the view that prostitutes that have HIV are responsible for developing this illness due to their own actions. However, although street-based prostitutes might get into prostitution to fuel their drug habits, the nature of the work and the distress caused to the worker often increases drug use to help the prostitute cope (Young, Boyd & Hubbell, 2000). Street-based prostitutes are not only stigmatized by the general public, but also by other prostitutes. Those prostitutes that don’t use drugs look down on those that do, viewing them as unprofessional prostitutes that are only in the profession to fuel their drug habits (Sterk, 2000). However, not all prostitutes have problems with drug use (Brooks-Gordon, 2013), and the stigma found between prostitutes in the same profession indicates just how deep-rooted the stigma surrounding street-based prostitution is.
This blame and stigma surrounding street-based prostitutes regarding the spread of STIs has led to barriers for these workers in accessing health care services. In a study researching Canadian street-based prostitutes, it was reported that 49.6% of these workers had difficulties in accessing health care (Lazarus Deering, Nabess, Gibson, Tyndall & Shannon, 2012). Furthermore, the illegal nature of street-based prostitution and drug use in many countries discourages street-based sex workers from even seeking medical care (Rusakova, Rakhmetova & Strathdee, 2015). Therefore, although there is no conclusive evidence that street-based prostitutes have higher rates of HIVor STIs (Sacks, 1996), the connection between street-based prostitutes and the spreading of STIs has remained in the public’s mind, creating a distorted understanding of street-based prostitution. Furthermore, with street-based prostitutes being blamed for spreading STIs, it perpetuates a stigma surrounding the profession. If these street-based prostitutes were not scapegoated for spreading STIs, the stigma would likely be decreased, creating easier access to health care, and reducing the prevalence of disease and illness in the profession, thus potentially leading to a change in understanding the profession.
The law on prostitution is complex and differs around the world, however, it further adds to our understanding of street-based prostitutes. In most countries, prostitution is completely illegal, whereas in other countries, prostitution is criminalized. This involves certain acts associated with prostitution such as soliciting, loitering, curb crawling and running a brothel being illegal, but not the act of prostitution itself. There are also a handful of countries that have legalized prostitution completely. Even though prostitution is at least partially legal in some countries, the law still does little to protect these workers. Many aspects of street prostitution, such as strolling down main and back streets to acquire punters, expose street base prostitutes to a greater risk of violence and danger. However, prostitutes will often be viewed by others, as well as themselves, as outside of any protection from the Law (Lowman, 2000). In a global review, it was found that 45-75% of prostitutes experienced violence in their lifetime (Deering et at., 2014) with most of the violence experienced coming from their clients.
The Radical Feminist theory is concerned with prostitution and violence against women, not only in the practice of prostitution itself but in the very idea of buying a women’s body. This notion constructs women as an object, thus taking away their individuality (Sanders, 2016) and treating them as a commodity (Scoular, 2004). This discourse takes the view that the very idea of buying sex is “the absolute embodiment of patriarchal male privilege” (Kesler, 2002 P.343). In order to achieve a more gender-balanced view on prostitution, many radical feminists support the reinforcement of curb crawling laws, which target punters, as well as prostitutes (Campbell & Storr, 2001). Furthermore, this law places the focus on aspects of prostitution, not the act of sex itself (Church, Henderson, Barnard & Hart, 2001).
Radical feminism has come under critique however as many believe that this theory “reduced women’s identity to a single trait, regardless of the structural effects of money, culture, and race” (Sanders, O’Neill & Pitcher, 2018).
Some feminists, such as Liberal Feminists, however, would disagree with this approach to prostitution. These feminists take the view that prostitution empowers women, as opposed to reducing them to sexual objects. Liberal feminists believe that a woman has the right to do what she likes with her body and see prostitution as selling a service as opposed to selling one’s body (Beran, 2012). With regard to the laws that criminalize prostitution, liberal feminists believe that they go against the woman’s right, and the freedom, to do what they want with their bodies, as well as fail to protect them through the law. In addition, laws that do not criminalize the act of buying sexual services, and therefore don’t prosecute the clients, discriminate against women prostitutes (Sloan & Wahab, 2000).
Although liberal feminists argue that prostitution involves free choice, many would argue that women do not choose prostitution, and instead are coerced into the profession (Sullivan, 2010). It is argued that factors such as homelessness, child abuse, low wages, abuse and rape are a number of reasons why women are forced down the route of prostitution without free choice (Sloan & Wahab, 2000).
There is no one uniform feminist approach to prostitution and all approaches contribute to our understanding of street-based prostitution. Each of these theories constructs prostitution in a certain way, as either exploited, empowered or coerced, thus offering a number of perspectives to shape ones understanding of street-based prostitution. Therefore, we have come to understand street-based prostitution on a continuum that ranges from prostitution as a way of empowering to prostitution as a way to exploit.
For many groups that support the rights of prostitutes, it is believed to be the incriminating laws on prostitution over anything else that place prostitutes in danger of exploitation or coercion (Davidson, 2013). There are therefore a number of debates as to whether prostitution should be decriminalized or legalized. Raymond (2003) argues a number of reasons why prostitution should not be legalized or decriminalized.
Firstly, it is argued that legalization or decriminalization won’t control the industry, but expand it (Raymond, 2003). There has been no research that has found that legalizing prostitution decreases the prevalence of street prostitution (Farley, 2004). Raymond (2003) argues that the number of street-based prostitutes will increase in the attempt to work independently from a pimp and the number of child prostitutes may increase.
Secondly, Raymond (2003) argues that women that are involved in the industry will not be protected from violence if prostitution is legalized or decriminalized. This is supported by findings in the Netherlands, where prostitution is legal, which show that sixty percent of women prostitutes are victims of violence (Vanwesenbeeck, 1994). Furthermore, Farley (2004) found that prostitute women from a variety of countries did not believe that they would receive greater protection from violence in their work if prostitution were to be legalized in their country. However, many would disagree with this as they see the decriminalization of prostitution as the key avenue to securing workers’ rights. Research has found that decriminalizing prostitution in New Zealand has increased safety within the industry as well as improved workers’ rights (Abel, 2014).
Lastly, by legalizing or decriminalizing prostitution, Raymond (2003) argues that women’s health won’t be promoted and women’s choices won’t be enhanced. There is research, however, that goes against this as it has been found that in New Zealand, the majority of prostitutes have regular check-ups regarding their sexual health (Abel, 2014). Research from Farley (2004) further supports Raymond’s argument surrounding the lack of choice. It was found that eighty percent of prostitute women showed a preference to leave prostitution, however, they did not have the means to do so (Farley, 2004). Therefore, many argue that by legalizing or decriminalizing prostitution, the government will be promoting a profession that many workers have entered due to lack of choice.
Overall, debates surrounding the legalization and decriminalization of prostitution are mixed and therefore there is no concrete understanding or view that governments or the general public hold on this issue.
To conclude, the stigma surrounding street-based prostitution, public health concerns and the law, including the various debates surrounding women’s rights on prostitution, all shape the way in which we come to view and understand this profession. The stigma surrounding street-based prostitution, which is worsened by criminalization, paints the prostitutes as deviant in the public eye and therefore not as equals in society which has a great effect on their social inclusion. Furthermore, part of this stigma revolves around public health concerns that view street prostitutes as vectors for a disease which can impact access to health care services. Feminist theories relating to violence against women or the empowerment of prostitution depicts these workers as either exploited or empowered in our views of the profession. Furthermore, it has been shown that there are mixed arguments in the debate surrounding legalization, making it harder to have a uniform view on prostitution. Finally, it is important to note that due to street-based prostitution being a largely hidden population, it is hard to fully research this community.
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