Step Up, Step Back
 Non-Judgmental Approach
 Talk with Each Other, Not at Each Other
 Agree to Disagree
 Confidential Space
 Push
Defined by individuals engaging in
sexual activities in exchange for a
monetary value or other needs.
 Adopted by health, labor and human
rights organizations.
 Neutral, descriptive and informative term
that is not judgmental.
 Recognizes a reality, regardless of an
opinion of the term itself.
 Affirms the humanity of a person.
Consensual and/or non-consensual
 Empowering and/or disempowering
 Often illegal in the U.S.
 The only or best option for some
 A gateway to community health
Sex work IS work
Human trafficking
 Child labor
 Only female-bodied
 Risky for everyone
 A gateway to drug use
 Against the law everywhere
Sex work encompasses a variety of activities,
most of which are legal, but some of which are
Every state has its own penal code that defines
what constitutes illegal conduct - these
definitions vary from state to state
Prostitution, a type of sex work, is illegal in every
state except Nevada, where there are some
highly regulated legal brothels in smaller cities
Many states have loitering for prostitution,
solicitation, and other laws primarily targeting
street-based workers
New York penal law defines prostitution
as: “when such person engages or
agrees or offers to engage in sexual
conduct with another person in return for
a fee.” PL 230.00
 The courts have been left to interpret
what constitutes “sexual conduct” :
› While there are grey areas, the following
constitutes sexual conduct: oral, anal,
vaginal sex, or manual stimulation of
another’s genitals
Sex Work &
Our Views
What is your first memory of either coming
into contact with someone who does sex
work or hearing about someone who does
sex work?
 What stereotypes do you hold about sex
workers, or that you have held in the past?
 Where did these stereotypes come from?
 Have you been able to debunk these
stereotypes? How have you done that?
Drug use and sexual behaviors exist along a
› Abstinence is one of many goals, not practical
for all
Drug use and sex work is what someone
does, not who they are
 Acknowledges reality
 User-driven, client-centered, selfdetermination
 Drug or sexual-related harm cannot be
› Drugs and sex can meet important needs
Pragmatic, not idealistic
 Non-judgmental, non-punitive, noncoercive
 Low-threshold
 Neither condemns nor condones
Street-based prostitutes/hustlers
Escorts (venue, online/internet)
Porn Stars/Actors
Lap Dancers
Cam/Video Star/Actors
Phone Sex Operators
High level of policing by cops and law
 Experience extreme stigma and
discrimination from community, society,
and law enforcement
 A large majority of sex workers
experience fear, intimidation, violence,
harassment, arrest, or humiliation by law
enforcement, and other perpetrators
Confiscation and destruction of safe sex
supplies by NY police and law
enforcement have public health
implications in a city with one of the
highest HIV/AIDS rates in the country
› “No Condoms as Evidence” Bill/Policy
› Key players: Sex Workers Project at Urban
Justice Center, Gay Men’s Heath Crisis
(GMHC) & PROS Network
Crack cocaine and heroin are highest
among street-based sex workers in NY
 High level of detoxification, methadone
maintenance, and other treatment is
common and available
 Street-based outreach providing harm
reduction supplies and materials is highly
Myth & Reality
There is no good reason for anyone to go
into or remain in sex work.
 For many people, sex work is their best or
even their only opportunity to earn enough
to support their families.
 Most sex workers are coerced or forced into
doing it.
 No evidence supports this claim. Sex
workers are individuals whose reasons for
engaging in sex work – and leaving it – are
personal, economic, social – as complex as
anyone’s reasons for involvement in any
type of work.
Allowing sex work to happen without
criminalizing it will encourage human
trafficking and coercion into the sex
 Giving sex workers more rights would likely
discourage trafficking into sex work.
 Demand for sex work drives human
 People are susceptible to the lies and tricks
of human traffickers because they are
seeking better lives, a way out of poverty,
joblessness and discrimination.
Focusing law enforcement efforts on the
customers of sex workers will stop the
commercial sex trade.
It is not the number of customers but economic
trends and social conditions such as
unemployment and a shortage of living wages
that determine the number of sex workers.
Sex workers are dangerous to the general
population because most have diseases – they
can transmit HIV/AIDS and other STI’s.
Sex workers are often more knowledgeable
about sexual health – and practice safe sex
more often – than the general population.
Raids of sex worker venues (brothels,
apartments, clubs, etc) are the best way
to help trafficked sex workers.
 Raids of sex worker venues typically lead
to arrest, detention, incarceration and
deportation of people caught there.
Tips for Sex Workers,
Their Clients &
Save Your Money
 Know Your Boundaries
 Know and Respect Your Work
 Respect Your Customers
 Develop Positive Relationships Both
Inside & Outside of Your Work
 Work Safely
Do Your Research on Sexual Transactions
 Ask Questions
 Know and Share Your Rules
 Keeping Healthy is Your Responsibility
 Respect – you are paying for their time,
not their lives!
 Be Prepared
 Reward – pay and tip well!
Everyone has a different story
› Listen and ask questions to better understand
Sex workers may not need or want your help
› What you see happening or your interpretation may
not be their reality
› Not everyone practices the same behaviors
Some people enjoy street work, others may not
Street workers are very cautious about who
approaches them
› Often the helpers cause more issues or disappear
Sex workers have good survival strategies
› Be compassionate of the strategies they may use
Your safety comes first, always be mindful of
your boundaries
› Be alert, be aware, be attentive
Be patient and work on building trust
› Go slow, you may not engage the first time
Don’t lie
› If you don’t know the answer, do your research
or find resources
Involving the police may not be helpful
› Find out if it is necessary, what is dangerous to
you may not be to someone else (and vice
Everyone has a unique story to tell
 Not all sex workers are high risk
 Sex work is not necessarily a gateway
 Sex work is what someone does, not who
they are
 Remain client-centered, empowering,
and strengths-based
 People who do sex work have excellent
survival instincts
Stephen Crowe
[email protected]

Working with Substance Using Sex Workers from a Harm Reduction