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.