Health needs and service use of parlour-based prostitutes compared with street-based prostitutes: a cross-sectional survey

Objectives  To compare the health needs of prostitutes (sex workers) working in massage parlours with that of those working on the streets.

Design  Cross-sectional survey.

Setting  Inner city, UK.

Population  Women aged 16 years and older selling sex in massage parlours.

Methods  Interviewer-administered questionnaires were undertaken with 71 parlour workers, and results were compared with our previous findings for street sex workers.

Main outcome measures  Self-reported experiences of health and service use.

Results  In comparison with street sex workers, parlour sex workers were less likely to report chronic (43/71 versus 71/71; P < 0.001) and acute (10/71 versus 35/71; P < 0.001) illnesses but more likely to be registered with a GP (67/71 versus 59/71; P= 0.06). They were more likely than street sex workers to have been screened for sexually transmitted infections in the previous year (49/71 versus 33/71; P= 0.011) and more likely to use contraception in addition to condoms (34/71 versus 8/71; P < 0.001). They were less likely to be overdue for cervical screening (5/46 versus 19/48; P= 0.001), and more of those booked for antenatal care in the first trimester attended all follow-up appointments (28/37 versus 14/47; P < 0.001). Fewer parlour sex workers used heroin (4/71 versus 60/71; P < 0.001), crack cocaine (5/71 versus 62/71; P < 0.001) or injected drugs (2/71 versus 41/71 versus; P < 0.001) They reported fewer episodes of intercourse per week (mean 14 versus 22; P < 0.001) with fewer different men (mean 11 versus 19; P < 0.001), less of whom were new (mean 8 versus 13; P < 0.001).

Conclusions  The two groups had very different health experiences, risk-taking behaviour and use of services. To be effective in improving health, different types of service delivered in different settings for different groups are required.