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Sexual Violence Against Women in Sex Work

Sexual violence against women involved in sex work remains a serious safeguarding and public health issue in the UK.

Understanding risk, harm and access to support in the UK

In 2015, it was estimated that approximately 72,800 people were involved in sex work in the UK. The World Health Organization defines sex work as:

“The provision of sexual services for money or goods.”

There is no single profile of a person involved in sex work. People come from a range of socio-economic backgrounds. However, UK research consistently shows that financial pressure — including poverty, homelessness and substance dependency — is a major driver of entry, particularly in street-based sex work.

While some describe their involvement as autonomous or temporary, others report being driven into sex work by addiction, coercion, or survival need. It is more accurate to understand sex work as existing on a spectrum of experience, rather than as a single narrative of either empowerment or victimhood.

Socio-economic vulnerability and survival

Qualitative research from Bristol (2008) found that street sex workers described a “typical working day” as a continuous cycle of buying and selling drugs. Only 23% of those interviewed had permanent accommodation, and many reported high levels of self-neglect, including limited access to food and fluids.

Seven out of 22 women interviewed disclosed having children, yet only one lived with her child.

A 2019 survey from the University of Bristol echoed similar themes. Participants cited:

Money
Drug dependency
Paying for food
Funding transport to education

These findings reinforce what safeguarding services observe daily: for many women, involvement in sex work is closely linked to survival.

This context matters when considering sexual violence. Economic vulnerability can severely limit a person’s freedom to refuse clients, negotiate conditions, or leave unsafe situations.

Violence is widespread

This gap between violence experienced and violence reported reflects ongoing barriers to justice, including fear of stigma, previous negative experiences, and concerns about criminalisation.

41–61%

of sex workers report lifetime workplace violence. Street-based sex workers face the highest risk.

6+ times

higher odds for outdoor workers of experiencing client violence compared to indoor workers.

c.10,000

sex workers accessed National Ugly Mugs (NUM)'s safety alert system in 2015. Around 60 incidents were reported to NUM every month. Only 25% of victims were willing to report directly to police.

Lone working and legal context

Current UK legislation does not criminalise selling sex itself, but it does criminalise brothel-keeping (where two or more people sell sex from the same premises). This can discourage shared working arrangements that might otherwise improve safety.

As a result, some women work alone to avoid legal risk — which can increase exposure to violence.

The National Police Chiefs’ Council (2019 guidance) emphasises that policing responses should prioritise safeguarding and diversion rather than routine prosecution of those selling sex.

Buyers and the normalisation of harm

Research examining the perspectives of buyers (“punters”) suggests that some actively normalise sexual entitlement and dismiss women’s boundaries.

Studies have reported:

Buyers minimising violence.
Complaints about condom requirements.
Attempts to remove condoms during sex (“stealthing”).
Viewing women’s distress as part of the transaction.

Condom negotiation is frequently cited by women as a source of conflict and coercion. Reports of attempted condom removal increase both physical health risks and psychological harm.

Sexual violence in this context may include:

Rape
Assault
Coercion into unagreed acts
Physical intimidation
Non-consensual condom removal
Image-based abuse
Trafficking or third-party control

Payment does not remove the requirement for consent. Under UK law, consent requires freedom and capacity — not simply financial exchange.

Sexual health and access to care

Women involved in sex work often engage with sexual health services at higher rates than the general population.

NHS data from the North West of England suggests that around 10% of women in the general population access sexual and reproductive health services annually. Female sex workers attend genitourinary medicine (GUM) clinics at higher rates — demonstrating engagement with health systems.

However, female sex workers have been shown to be:

Twice as likely to be diagnosed with chlamydia
Three times more likely to be diagnosed with gonorrhoea

Male sex workers show even higher rates of STIs and HIV.

Higher attendance does not eliminate vulnerability. It reflects both occupational exposure and, in many cases, proactive health-seeking behaviour.

Sexual Assault Referral Centres (SARCs)

Across England, NHS England commissions Sexual Assault Referral Centres (SARCs), which provide:

Acute crisis support
Forensic medical examinations
STI testing and treatment
Emergency contraception
Independent Sexual Violence Advisors (ISVAs)
Counselling and longer-term support

In its 2018 strategic direction for sexual assault and abuse services, NHS England stated that SARCs should provide care specifically tailored to the needs of sex workers.

This recognises:

Elevated exposure to sexual violence
Barriers to reporting
Complex trauma histories
Safeguarding needs

Some research examining SARC populations, including work at Saint Mary’s SARC in the North West, has aimed to better understand service users who identify as sex workers in order to improve targeted support.

Trauma-informed care requires that services understand the specific contexts in which violence occurs.

Useful links

References

This resource draws on research, reporting and expert analysis from the following sources:

World Health Organization – Definition of sex work and global violence data
Office for National Statistics – Sexual offences data
National Police Chiefs’ Council (2019) – National policing sex work guidance
National Ugly Mugs – Violence reporting data
NHS England (2018) – Strategic direction for sexual assault and abuse services
University of Bristol – Research on street sex work (2008; 2019 survey)
Systematic review data on violence prevalence among sex workers (global review)
UK sexual health surveillance data on STI prevalence among sex workers