4 Welfare, health and safety

Key informant interviews - Welfare health and safety

One of the key aims of the PRA was to promote the welfare and occupational health and safety of sex workers. We asked key informants what changes, if any, they had seen since the PRA had been in operation. The areas of interest included:

  • the use of safer sex practices;
  • general health and well-being;
  • access to health services, information and training; and
  • issues of safety (violence and abuse).

4.1 Safer sex practices

Informants were not aware of any substantial change in the use of safer sex practices by sex workers. It was generally felt that most sex workers had already adopted such practices8 as a result of the effective HIV / AIDs prevention campaign that ran in the early 1980s. Many informants said that it was in sex workers' own best interests to look after their health. (Contracting a sexually transmitted infection (STI) meant they had to take time off work.) Sex workers in brothels seemed to actively police this, coming down hard on any sex worker gaining a client through providing sexual services without using a condom.

Negotiating safer sex practices with clients

The PRA makes it an offence for sex workers and their clients not to use safer sex practices. We asked informants if they knew whether sex workers were aware of this. Of those who replied, two-thirds (n=27), thought sex workers were aware, and 20% (n=8) thought they were not. (The remainder did not know.) Of the eight who thought not all sex workers were aware, six were NGOs and two SOOBs; none were BOPs. It should be noted this was just the opinion of the informants; a more accurate assessment will emerge from the HRC study which asked the sex workers directly.

Despite no great change in safer sex practices, there were several positive effects reported as a result of the PRA. Before, while it appeared not uncommon for clients to insist on having unsafe sex, workers felt in a weak position in resisting or even talking about using condoms with a client: they feared it might be used against them in an accusation of soliciting. In the current regime, sex workers could 'point to the legislation':

It is better that sex workers are able to talk about using a condom. Before, we didn't want to say the word out loud for fear of prosecution. (NZPC)

I now say, 'I don't want your germs, do you want mine? I could be fined and go to jail, and if you take it off, then I could send you to jail'. (SOOB)

There was wide endorsement for the stickers published by the Ministry of Health, saying that unsafe sex was an offence for both the sex worker and client and the penalties for it. Those in the industry said how helpful it was for sex workers to be able to point to the stickers, and for clients to see 'in writing' an offence was involved. This seemed particularly useful for younger, less experienced, sex workers who may be less confident in negotiating with clients:

There is back up now. The small sticker that is behind the door or in the bathroom says you must have protected sex. She can point to the bit about the fine. Because it's the law and the law is in print, the client backs down. It's great. (BOP)

The MOH stickers are great for 18 to 21 year olds. We're constantly being asked for more (NZPC).

Access to condoms and lubrication

Prior to the PRA, being in possession of condoms or lubrication ('lube') could be used as evidence to convict a sex worker. Brothel operators, in particular, commented that it was better that they were now able to supply and display these items:

We can now advertise the word 'brothel' and have condoms and lube on display. This saves the women lugging it around, and storing it at the family home. We now can supply the condoms and lube (part of room rental fee). There is information in the rooms and up in the bar. (BOP)

Operators adopting and promoting safer sex practices

The PRA has made it a legal requirement for brothel operators to adopt and promote safer sex practices, including to 'take all reasonable steps to give health information (whether oral or written) to sex workers and clients, and to display health information prominently'. All operators we spoke to were aware that this was a legal requirement.

However, some NGO informants were concerned that brothel operators were not complying. Certainly the MOH stickers mentioned above seemed to be readily available, and the brothels we visited were able to show us posters and / or stickers either in the rooms, at the reception, or in the bar areas. However, there were examples of operators doing a very poor job in promoting safer sex practices:

One time a guy in a parlour took his condom off, and it wasn't the first time either. I told the receptionist who didn't even bat an eyelid (this was after the Act). They leave it up to the girls. They think they are just renting the rooms to the girls. At home, I'd have kicked him out, but you're a bit restricted in parlours. (SOOB)

Barriers to adopting safer sex practices

There was concern among some NGOs that pressure to earn money, in particular for those on the streets, increased the likelihood that they would agree to unsafe sex. Street conditions were felt to be quite desperate. An offer of unsafe sex – after half a night of waiting – was difficult to resist. But this was countered by outreach workers who felt that most street workers were using safer sex practices:

The numbers of condoms we give out, and pick up, suggest they are using them.

One sexual health nurse expressed concern about some foreign workers who came to her clinic. She spoke of Asian girls who appeared not to understand the importance of safer sex practices:

What I hear from foreign women makes me think they are not good about using safe sex. They say they don't care. It's funny; it's a different culture. I try and explain about infections if they don't use a condom. They say 'no problem, it's good money. It doesn't matter if I get an infection'. (Sexual health nurse)

It was said that it had always been difficult for health professionals to access workers with poor English. But several informants felt that things were worse now that the PRA expressly made it illegal for non-residents to be sex workers. One felt it was unfortunate, especially because of the lack of sex education in the countries from where they came.

4.2 General health and well-being

We asked about other impacts the PRA may have had on the health and well-being of sex workers. The main impact mentioned was an improved sense of well-being due to sex work no longer being 'criminal'. Sex workers could go about their business without fear of being arrested by an 'undercover cop'. The relief this created was frequently mentioned. Both NGOs and those in the industry that we interviewed felt that decriminalising prostitution made sex workers feel better about themselves and what they did:

There's just an increase in confidence now it is legal – been validated. It's hard to explain, but it's something I've seen. When the Act was passed, the girls knew about it. They didn't know the technicalities, but they knew it was legal and the work could be less demeaning. (BOP)

Personally, I feel more confident now I've got rights. I still work secretly, but I can say 'the law says this'… There is now no fear of being caught by Police. It was difficult when I was younger. I felt like a criminal and was less assertive. (SOOB)

The biggest difference is that, very slowly, the women are more empowered. It will take a while, but they are starting to go public and telling friends and family. Their confidence is changing. (Sexual Health Nurse)

One nurse also felt the women she saw felt the environment in which they were working had improved, which also helped them feel better about themselves:

The brothels are posher since the Act. They've tarted them up. The girls feel better working in a better environment. It's given them a confidence boost.

Despite improvements, though, many felt there was still a long way to go to eliminate the stigma of sex work. There were also a few areas where informants felt improvements were needed. Some were concerned about the poor conditions of health among those working on the streets:

On the streets, I think health is gradually deteriorating. There is more drug use. Life is very chaotic. There is fighting, bitching, scrapping. (Street worker)

Others felt there was not enough attention given to the mental health stress of sex work and the support needed for this:

It is important that they have access to someone for debriefing. You can work ten days in a row, and start getting robotic. I think they should be made to take a break. All the parlours are so dingy and poorly lit. It's not good for you, day in, day out. I think breaks should be compulsory. (BOP)

Mentally, I think there should be more support. It can be tough and there should be free counselling. It's part of the risks of the job, like lifting correctly is with building. There are no harms from the physical sex. It's the mental effects of suppressing feelings of why you shouldn't be doing this, but have to get the income. It is a hard business. The suppression can take its toll if there is no release. Counselling would keep you healthier mentally. Otherwise you can be at risk of making poor judgements around drugs or bad boyfriends. (BOP)

4.3 Access to health services, information and training

NZPC was seen as the main provider of health services and information. Offices in Christchurch, Wellington and Auckland provided weekly sexual health clinics. Those in the industry valued greatly NZPC services in particular, which they felt had always been good. Most felt there had been no great change in access for sex workers, although some felt there had been improvements since the PRA:

The role of NZPC is so important. If the regional co-ordinator retires, it would be a disaster. They need more money and support. They play such a crucial role. (NGO – health / youth)

No change – there have always been opportunities through NZPC (BOP)

NZPC is more organised and able to provide good information. People can be more open now. Workers acknowledge NZPC more. They say it's their right to get information, people are more confident. (BOP)

Some informants felt that sex workers could be more open with other health professionals, such as their GPs. One NZPC office noted that one woman had been sent by her GP (She had discussed the possibility of becoming a sex worker with her GP who suggested she talked to the NZPC).

NZPC itself felt the PRA had made their work easier, as it was possible to speak openly about sex work and safer sex practices.

Occupational Health and Safety Guidelines

Two-thirds of operators (18 out of 27 who replied) said they were familiar with the Guide to Occupational Health and Safety in the New Zealand Sex Industry published shortly after the PRA. The rest – mainly SOOBs – were either not familiar with the guide, or had not seen it at all.

The Guide was generally thought to be good. While 'common sense' for most, they were felt useful for those starting out. Some sections of the Guide appeared of marginal relevance (e.g. under arm sex). There were comments from some that the Guides needed to be more 'user friendly'. It was referred to by those in the industry as that 'big blue book' and was not thought of as light bedtime reading. Further comments on accessibility to health information are covered below.

Areas for improvement

About a third of informants noted that there was still room for improvement as regards access to health services, information and training. A Hawkes Bay operator felt that an NZPC outreach clinic was needed there. Several people commented that there should be more outreach into brothels:

I think there needs to be more – perhaps someone visiting the brothels providing education. I see girls who have lost sponges they've put in when they had periods, but forgotten to take them out. There needs to be more on health information. (Sexual health nurse)

As said earlier, most brothel operators appreciated the service provided by NZPC and appeared to rely heavily on them for providing health information and safer sex materials. Some operators had their own in-house training, but many preferred to send their workers (particularly new ones) to NZPC. However, there were concerns from several sources that some brothels strongly discouraged their workers accessing NZPC:

NZPC has always been here and they are good. But down the road there are some places NZPC are not allowed in. There may be more access now for NZPC. (BOP)

A lot of girls don't know about NZPC because the operators suppress them. (SOOB)

The issue of some brothel operators 'isolating' their workers is discussed in Section 5.

One SOOB commented that accessing mainstream health services could still be awkward even now:

There is no difference really. The GP at student health – his eyes popped out when I said I was a sex worker. (SOOB)

Improving accessibility

Access to health information (in particular on sexual health) was seen as vitally important. Several informants drew on parallels in other occupations (e.g. nurses being taught how to lift properly). Some had suggestions on how access to information might be enhanced. These included:

  • Better internet resources. These were felt to be useful especially in maintaining privacy (e.g. an update to the NZPC website). Lack of internet access was noted as a constraint though.
  • More user friendly leaflets, in different languages. One operator said they found internet sites that translated into different languages useful for those for whom English was a second language.
  • 'Hooker school' – An NGO recommended that more experienced sex workers taught younger ones about safety and health matters. This had more immediacy than 'paper leaflets'.

4.4 Safety issues

Improving the safety of sex workers was another important aim of the PRA. Opinion among informants differed on the impact of the PRA. The majority felt that it was able to do little about the violence that occurred in the sex industry:

Clients getting stroppy will always happen. This was the case before the Act and after it. (BOP)

There has been no impact. There will always be ugly mugs. (NGO – health)

Others (but less than a quarter) felt there had been an improvement:

It's better now… I've heard workers say "don't have to take that crap anymore". They know they have a right to report stuff. (NGO)

Some of the difference in opinion reflected the sector of the industry about which informants were speaking. The situation in parlours was not seen as having changed much, but it was felt never to have been particularly problematic:

Violence is more on the streets, not in parlours. What I've seen in parlours has more to do with personal relationships. (BOP)

No change that I'm aware of, and we don't really get those situations here. (BOP)

Violence may not be common in parlours, but it exists nonetheless. NZPC were aware of a few incidents of sex workers being raped in parlours.

Street workers were generally seen as being at most risk of violence. There was considerable concern among many informants over the two street-based sex workers murdered in Christchurch since the PRA. The violence was very visible:

The violence is there, even in daylight. We were setting up at 10am for an event and a girl was getting thumped by a client. Workers are still putting their necks on the block every time they get into a car. (NGO)

It's worse. There are more rapes. The other night there was a girl running up saying she'd just been raped. I'd say it's happening every night, but they don't report it. Rape is either up, or I'm just hearing more about it now. (NGO – youth)

One informant suggested there were less people working on the streets as a consequence of the Act, so in that way safety had been improved.

There was a sense among some informants that things had been made worse early on by the increased attention paid to sex workers by the media and the general public following the PRA:

A bad consequence of the law change has been more attention on sex workers. There are more people shouting out 'filthy whores', and more risks of being battered. (BOP)

It's still out there. Maybe there is more. This would be a slap in the face to the intention of the Act. People don't like prostitutes. Now there is more attention on them, and more exposure. It can lead to more problems. (SOOB)

There were mixed views on whether the risks faced by SOOBs had changed. In general, the SOOBs we spoke to had felt – and still feel – safe and in control. They said they were good at detecting clients who might be 'trouble' and simply refused them. However, there were a few operators with concerns. This was mainly due to the increase in the number of SOOBs for whom they felt some risk was inevitable:

There have been more girls going private. This is okay if they're switched on, capable of running a business and able to pick the different personalities. If they've got a quick temper, it could be dangerous. You have to know how to talk to people who might be on P; they are volatile. (BOP)

Privates, however, I think are much less safe. I've heard of them getting ripped off by clients. They have a lot of cash on the premises. (BOP)

I've got my own panic button that is monitored. Everyone should have one. There should be something in the Act about having one. You don't know what some guys can do. (SOOB)

Reporting of violence

It appears the PRA has been limited in its ability to prevent incidents of violence from occurring. However, informants indicated that the Act had assisted in violence being reported to Police, with some indication that the Police response may assist in resolving a situation. There was a sense that the PRA meant incidents of violence against sex workers would now be taken seriously. Of those feeling in a position to comment, the majority (70%, n=22) felt sex workers were now more likely to report incidents of violence to the Police. It appeared that this was particularly true for the street workers:

Since the Act… I'd say the incidence of violence has been lessened a little, because the girls can stop a Police car now and make a legitimate claim. One night I was in a Police car with a Senior Sergeant and this girl had just phoned 111 and waved us down. She was traumatised, but perhaps because I was in the car and she knew me we were able to encourage her to report the assault. (NGO)

If it is serious, I'd make a complaint now, over violence against me or someone I know. (SOOB)

While sex workers were more likely to report incidents of violence to Police, willingness to carry the process through to court was less common:

Street workers come in here and tell us, and we talk on their behalf if they want us to; others are happy for Police to know but won't report if it has to go through. (NZPC)

A distinction was drawn between assaultive behaviour and 'violence' from clients using deceptive practices during sex. The reporting of these latter incidents was much less likely; it appeared accepted by many as part of the job:

...guys still try it, especially on new girls. They ask for doggy and rip it [the condom] with their finger nail. I always hold the base of the condom to make sure, but new girls don't realise. (SOOB)

I wouldn't report it if a guy took a condom off, only if he'd been really violent. All the guys give it a try; I broke the finger of one guy who tried it on. I would have reported before and I would now. (SOOB)

Barriers to reporting

While most informants felt there was an increased likelihood of violent incidents being reported to Police, barriers to reporting were still seen as existing – some perceived and some real. It was pointed out that many street workers used illegal drugs which made them reluctant to ask for assistance from the Police. For others, fear of being publicly exposed as a sex worker was still a significant barrier. One SOOB spoke of deciding against making a complaint when a Police officer asked how she would feel if her name was in the newspaper. There was also a perception that Police might not take sex workers seriously:

Some girls don't report because they think the Police will say 'well you're a hooker, what do you expect'. (SOOB)

Reporting has increased. Or at least they will give more consideration to reporting. But although they can, they often don't as they are concerned with how the Police will treat them. They still expect to be treated disrespectfully, due to the stigma that still exists. (NGO)

Reluctance among sex workers to make official complaints has led some brothels to develop their own strategies for dealing with 'in house' violence – particularly 'Ugly Mug' books of photos of clients who had acted inappropriately and were barred.9 This did not prevent troublesome people from using other brothels of course. There was one successful prosecution of a man who had raped a sex worker, but the operator who had supported the worker in making the complaint noted:

It was difficult though. Other parlours had info on this guy, but they hadn't passed it around. They weren't that helpful in putting us in touch with other girls who had had problems with same guy. (BOP)

In Christchurch, NGOs had put in place a Phone Text system. Sex workers could voluntarily supply a cell phone number to NZPC, and if NZPC received information of a potentially violent client (and the information was verified from the Police) they sent out alerts to those registered on the Phone Text system.

Relationships with the Police

The role of Police with regard to sex workers has changed as a result of the PRA, switching from 'prosecutors' to 'protectors'. Some regions appeared to have done better than others in making this shift and communicating it to sex workers.

Relationships between the sex industry and Police appeared good in Christchurch. Informants spoke positively about the way the Police had conducted the murder enquires, and noted how this has improved what were previously already good relationships. There were also reports of Police in Christchurch donating Christmas presents for the children of street workers, with one sex worker reported to have said, 'So they really do care about us'. The shift in relationship was also evident from a story told by an NGO:

A Police car had pulled up right next to a street worker in order to arrest a boy racer who had been pulled over. The sex worker waved her finger at the Policeman, saying "not here, I'm working". Apparently the Policeman moved his car to the other side of the road and down a way! (NGO)

Informants in other regions felt that more still needed to be done, with sex workers still seeing Police as 'prosecutors' not 'protectors'.


Footnotes

8. The New Zealand Prostitutes Collective was set up for this purpose in 1987 and is provided with funding from the Ministry of Health.

9. Photos taken off close circuit TV.

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