Street sex workers often have a difficult time getting the most out of drug rehab because of their inability to discuss the root causes of their trauma, and the stigma associated with sex work, a recent study found.
Researchers from the University of Bristol in the U.K. conducted 20- to 90-minute interviews with 24 current and former street sex workers with a history of heroin and/or use of crack cocaine to discuss their experiences in addiction treatment. The interviews revealed that many of the participants in the study had issues coming clean about their sex work, and when they did, they were often stigmatized by others in treatment or staff members who were unable to empathize.
According to researchers, drug use among street sex workers is more prolific than other drug users, and they aren’t as successful in achieving abstinence, which results in a higher mortality rate. In addition, they found that many of the addiction treatment services that are available do not have programs that are specifically catered to sex workers.
Group therapy, which has been found to be an effective modality in addiction treatment, was actually counter productive for street sex workers who felt unable to discuss their sex work due to fear of attracting negative attention and sexual advances from male group members. Participants who chose to discuss their sex work found that they constantly needed to deflect advances or run the risk of involving themselves in unhealthy relationships. These relationships, if entered into, often caused early termination of treatment, “and could ultimately lead them back to drug use,” researchers stated.
One-on-one therapy sessions were more productive, as many participants stated that they were able to go below the surface and discuss personal issues, which they felt they could not do in a group setting. However, staff gender was an issue for the female participants who felt it was difficult to be in a one-on-one setting with a man.
Treatment that required medication had mixed reviews. Some participants were able to doctor shop and manipulate health-care workers to receive excessive amounts of medication. Others stated that there was a lot of turnover in the facilities they visited to receive medication, and as a result, there was a lack of trust between the participant and the health-care workers providing the medication. However, there were instances in which staff members were “ex-service users,” who could empathize with street sex workers and were described as giving them hope for recovery.
All the participants in the study stressed the importance of receiving addiction treatment services that made them feel safe and able to address their experiences as sex workers. They also stated that groups focused solely on street sex workers could provide the safe and judgement-free environment they needed to… (continue reading)