Sexual Health Planning for 2012 Games: People Who Sell Sex Subgroup Georgina Perry, Service Manager Open Doors, Homerton

1. The London Sexual Health Programme Sexual Health Planning for 2012 Games:People Who Sell Sex SubgroupGeorgina Perry, Service ManagerOpen Doors, Homerton University Hospital

2. The London Sexual Health Programme Today’s presentation • Update on current situation in London for PWSS • Summary of the 2012 service planning template • Updating understanding of the requirements for sexual health services of people in the sex industry during 2012. • Contributing to the legacy of effective service provision for people in the sex industry

3. The London Sexual Health Programme Contributors to the sub-group Rob Kidd – London Councils (Chair) Peter Nash – South West London and St Georges David Mackintosh – London Drug Policy Forum Frances Broderick – Eaves Housing Georgina Perry – City and Hackney NHS Graham Ritchie – CEOP Hannah O’Sullivan –Metropolitan Police (Sapphire) Hong Tan – London Sexual Health Programme Marion Winterholler – Havens Michelle Farley – SHOC Miriam Merkova – Toynbee Hall Thara Raj – Newham PCT Wendy Gaston – Newham PCT Yeliz Osman - GLA

4. The London Sexual Health Programme Current situation in London for PWSS • Policing and Crime Act 2010 plus pan London policing initiatives equals static or reduced numbers of sex workers engaged in services. • East London (host boroughs) client numbers are down by 30% in past 6 months. Outreach teams are finding it harder to locate and maintain contact with flats and saunas. Rise in ‘Independent Escorts’ • Research published in 2010 from the LSHTM by Dr Lucy Platt into Sexual Health of Eastern European sex workers; ‘significant was the finding that women who had recently been in contact with an outreach service had a lower rate of infections’

5. The London Sexual Health Programme Based on current data trends there is no evidence that we are likely to see an increase of people working in the sex industry But after The Games have ended???

6. The London Sexual Health Programme Aims of the subgroup • Develop a planning template around the needs of PWSS for local use to commission effective and targeted services as part of the Olympic planning process and beyond. • To promote good sexual health among PWSS and engage them with sexual health and other health promotion messaging associated with the Olympics. • To embed a legacy of effective service provision and positive sexual health for PWSS.

7. The London Sexual Health Programme The 2012 PWSS template Acts as a set of principles and guidelines for health practitioners wishing to assess the need for and deliver outreach and clinical services to people who sell sex in their local authority.

8. The London Sexual Health Programme • The guidelines outlined in the document should be considered when commissioning sexual health services for people who sell sex. • Not all will be possible or affordable, and individual services should see them as best practice that may need to be adapted to suit local circumstances.

9. The London Sexual Health Programme • Addresses the needs of male, female and transgender people in the sex industry. • Highlights the complexities that often surround people working in the sex industry • Does not isolate sexual and reproductive health needs from wider health and social determinants.

10. The London Sexual Health Programme Data collected since the early 1990’s from eight public health services working with people who sell sex across London demonstrate that wherever specialist services are in place they will be well utilised. Where services are not coordinated it is less likely that this cohort will make contact.

11. The London Sexual Health Programme What do we mean by co-ordinated? • Outreach • Clinics • Staff with specialist knowledge • Skills and ability around referral pathways and case management

12. The London Sexual Health Programme • The health and wellbeing of people in the sex industry should not be seen as a series of isolated clinical and social needs, but as an interconnected set of social, emotional, health and wellbeing issues reflecting the complexity of an individual’s life. • Sexual health may be the first and, in some cases, most obvious point of contact. • However, good practice should reflect the need for effective and holistic assessment, as well as pathways into appropriate services

13. The London Sexual Health Programme Crucial to consider • Mistrust by people in the sex industry of institutions. • Societal stigma faced by people in the sex industry. • Potential for vulnerability • Personal agency of people who sell sex • Importance of embedding knowledge about this cohort into the Joint Strategic Needs Assessment (JSNA) to influence future provision of service.

14. The London Sexual Health Programme To Summarise • A template developed as a multi-agency response. • Identifies complexity • Asks authorities to assess need locally • Identifies need for coordination

15. The London Sexual Health Programme Additional developments for 2012 • Temporary Outreach Centre for Health (TORCH) in East London. • Sex workers as safer sex ambassadors – consultation with sex workers and sex worker services • Sub group to contribute towards development of appendix for IOC UNAIDS toolkit on sex workers rights