abstract

This articles makes the case for using existing adult protection provision to improve the wellbeing of street prostitutes, whose circumstances often render them vulnerable and in need of better coordinated support.

key words adult protection street prostitutes co-ordinated interviews vulnerability

This paper explores the interpretive, moral and political dimensions of vulnerability, as expressed in the Department of Health's (2000a) No Secrets policy document, in relation to the lives and needs of a particular group of prostitutes,2 namely those whose lives are dominated by street sex work. In this context, vulnerability can be seen to be a lived experience of the women, but also as something that may be ignored as certain moral and social stances are adopted in relation to prostitution. We urge readers to consider the necessity of a broad definition of vulnerability if the realities of the lives of certain groups - street prostitutes, in our discussion - are to be addressed. It is also proposed that existing local vulnerable adult protection (VAP) policies, procedures and organisational structures constitute a potentially useful mechanism for coordinating the interventions needed to help to assist women caught in street prostitution.

Four case study examples of street prostitutes in one city are reviewed to illustrate our point about the need to consider prostitutes as prostitutes in order for VAP to be effective for them. Seeing them only in terms of one vulnerable dimension, such as at risk of violence or as drug addicts, would be to deny the complex nature of the vulnerabilities they face, thereby most likely rendering ineffective any individual intervention designed to assist.

Defining the population under discussion

In this paper we are not concerned with all prostitutes - ie those who sell sexual services for payment. We are only concerned with female prostitutes, and even these are not an homogenous group. For example, one distinction is made between street-based prostitutes and those who work off-street, such as in massage parlours. All types of prostitutes may face risk factors, such as the threat of violence.

We are interested here in those prostitutes who work on the streets, and even within this group we want to distinguish two sets of sex workers. Some street prostitutes seem to be more in control of their destinies, only working when they want to earn money. Cusick et al (2003) identified a group of prostitutes they defined as 'non-vulnerable', and they were characterised by being over 18, independent workers treating it as business, not currently involved in drugs and who saw that they could stop prostitution easily if they chose to. These were also seen to be factors making the prostitute more inclined to safer sex practices, and hence less at risk of infection of sexually transmitted diseases.

The other group of street prostitutes we distinguish are far from in control, and it is they who are of specific interest to us in this paper. It is not clear how many of these prostitutes there are, but we do know that in some areas it is a sufficiently troublesome problem to command national government attention, notably with the Home Office's (2004) consultation paper, Paying the Price.

Some characteristics of this group of street prostitutes found from previous research highlight why we are interested in them in the context of a journal about adult protection. Entry into prostitution is usually through initial vulnerability, including emotional, economic, homelessness, substance abuse and coming from the care system (Home Office, 2004). Many women entering prostitution are recruited as children under the age of 16 (Melrose et al, 1999), often by being 'groomed' (May et al, no date). As children in prostitution, they are potentially subject to a comprehensive framework of legal and social protection in which they are treated as victims of abuse (Home Office, 2004; Department of Health, 2000b). Once they become adults, however, this is lost to them and the frameworks to support them disappear, or at least are less clear and highly fragmented.

There are strong links between the prostitution industry and the trade in illegal drugs (May et al, 1999). It has been estimated that 80 to 95% of street-based prostitutes work to feed a serious drug habit (Home Office, 2004) - their own, that of a partner, or both. The impact of drugs may well be associated with a lack of stable abode, too. For street sex workers in these circumstances, daily life can be one continual round of sex to earn money for the next hit of drugs, to then go to a local 'crack house' before returning to the streets to work. In these circumstances, self-neglect is likely to be a major problem as they fail to eat properly and are more prepared to engage in unsafe sex (Home Office, 2004).

The risk of violence, from pimps and clients, is another frequent vulnerability faced by many street prostitutes. One project researching violence suffered by prostitutes (Barnard et al, 2002) found that two-thirds had experienced violence from a client, more than one-third had been robbed by clients, and 28% had reported attempted rape. These risks are greater for street prostitutes (Home Office, 2004). Violence to women prostitutes and the threat of it often comes from those acting as their pimps.

Being in control and having choices as a prostitute can be difficult to attain, particularly if the person is a street worker, addicted to hard drugs, being coerced by a pimp/partner and homeless. Basic needs, like accommodation, would have to be addressed to introduce some security and stability. More complex issues would need to be tackled, too, like drug addiction and other physical and mental health needs. They would most likely need protecting from the threat of violence. Hence, multifaceted, longitudinal and timely interventions would have to be co-ordinated if there were to be any chance of success. In one study of prostitutes, most of the women reported having tried to leave the trade and failing as a result of a drug problem and associated vulnerabilities (Hester & Westmarland, 2004).

In addition to the vulnerability that street prostitution brings to those working in it, the impact it has on the communities where it occurs cannot be overstated. Although the impact of street prostitution is beyond the scope of this paper, many communities report street prostitution as bringing potential threats and being associated with anti-social behaviour. For these reasons, tackling antisocial behaviour associated with street prostitution, such as drugs and crime is an important national policy issue (Home Office, 2004) and central to many local regeneration agendas.

Prostitution exists in a morally dubious position in our society. In general it is ignored, but when considered it is frequently frowned upon. Sometimes it is tolerated as something that exists out of sight but out of mind. The harsh realities of the lives of many prostitutes, especially street workers, are hidden away from general society. As such, there is a danger that the exploitative nature of their lives and the complex nature of the vulnerabilities they face are ignored. To be able realistically to help these women deal with these issues and perhaps move on from prostitution requires explicit consideration of the reality of their lives and the interplay of their problems. We need to be open and honest about the nature of vulnerability in this context and seriously consider the best policy and practice frameworks to deal with the challenges.

Vulnerable adult protection in England

The publication of No secrets (Department of Health, 2000a) in England was a significant development in recognising abuse of vulnerable adults and establishing policies and procedures to afford better protection. Here, we make four observations about key characteristics of the underpinning philosophy of the document.

First, its philosophy is both directive and non-prescriptive: the framework states that action will be undertaken to address abuse, but the details are left to be defined to fit local contextual concerns. There is, then, significant scope for local policy-makers to interpret No Secrets in diverse ways. As the document states, there is a requirement for:

'A framework for action within which all responsible agencies work together to ensure a coherent policy for the protection of vulnerable adults at risk of abuse and a consistent and effective response to any circumstances giving ground for concern or formal complaints or expressions of anxiety.'