The Effect of Systemic Racism and Homophobia on Police Enforcement and Sexual and Emotional Violence among Sex Workers in East London: Findings from a Cohort Study

Lucy Platt; Raven Bowen; Pippa Grenfell; Rachel Stuart; M. D. Sarker; Kathleen Hill; Josephine Walker; Xavier Javarez; Carolyn Henham; Sibongile Mtetwa; James Hargreaves; M. C. Boily; Peter Vickerman; Paz Hernandez; Jocelyn Elmes

doi:10.1007/s11524-022-00673-z

The Effect of Systemic Racism and Homophobia on Police Enforcement and Sexual and Emotional Violence among Sex Workers in East London: Findings from a Cohort Study

Lucy Platt
, Raven Bowen
, Pippa Grenfell
, Rachel Stuart
, M. D. Sarker
, Kathleen Hill
, Josephine Walker
, Xavier Javarez
, Carolyn Henham
, Sibongile Mtetwa
, James Hargreaves
, M. C. Boily
, Peter Vickerman
, Paz Hernandez
, Jocelyn Elmes

London School of Hygiene and Tropical Medicine
National Ugly Mugs
University of Bristol
University of Leeds
Imperial College London
Brunel University
Homerton University Hospital

Research output: Contribution to journal › Article › peer-review

18 Citations (Scopus)

91 Downloads (Pure)

Abstract

There is extensive qualitative evidence of violence and enforcement impacting sex workers who are ethnically or racially minoritized, and gender or sexual minority sex workers, but there is little quantitative evidence. Baseline and follow-up data were collected among 288 sex workers of diverse genders (cis/transgender women and men and non-binary people) in London (2018–2019). Interviewer-administered and self-completed questionnaires included reports of rape, emotional violence, and (un)lawful police encounters. We used generalized estimating equation models (Stata vs 16.1) to measure associations between (i) ethnic/racial identity (Black, Asian, mixed or multiple vs White) and recent (6 months) or past police enforcement and (ii) ethnic/racial and sexual identity (lesbian, gay or bisexual (LGB) vs. heterosexual) with recent rape and emotional violence (there was insufficient data to examine the association with transgender/non-binary identities). Ethnically/racially minoritized sex workers (26.4%) reported more police encounters partly due to increased representation in street settings (51.4% vs 30.7% off-street, p = 0.002). After accounting for street setting, ethnically/racially minoritized sex workers had higher odds of recent arrest (adjusted odds ratio 2.8, 95% CI 1.3–5.8), past imprisonment (aOR 2.3, 95% CI 1.1–5.0), police extortion (aOR 3.3, 95% CI 1.4–7.8), and rape (aOR 3.6, 95% CI 1.1–11.5). LGB-identifying sex workers (55.4%) were more vulnerable to rape (aOR 2.4, 95% CI 1.1–5.2) and emotional violence. Sex workers identifying as ethnically/racially minoritized (aOR 2.1, 95% CI 1.0–4.5), LGB (aOR 2.0, 95% CI 1.0–4.0), or who use drugs (aOR 2.0, 95% CI 1.1–3.8) were more likely to have experienced emotional violence than white-identifying, heterosexual or those who did not use drugs. Experience of any recent police enforcement was associated with increased odds of rape (aOR 3.6, 95% CI 1.3–8.4) and emotional violence (aOR 4.9, 95% CI 1.8–13.0). Findings show how police enforcement disproportionately targets ethnically/racially minoritized sex workers and contributes to increased risk of rape and emotional violence, which is elevated among sexual and ethnically/racially minoritized workers.

Original language	English
Pages (from-to)	1127-1140
Number of pages	14
Journal	Journal of Urban Health
Volume	99
Issue number	6
Early online date	12 Oct 2022
DOIs	https://doi.org/10.1007/s11524-022-00673-z
Publication status	Published - Dec 2022

Bibliographical note

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

Funder

Funding Information:
The National Institute for Health Research (NIHR) Public Health Research Programme (PHR) funded this study (PHR 15/55/58). Their committee peer reviewed the proposal before funding was approved. Thereafter, the NIHR PHR was entirely independent of the data collection, analysis, and interpretation.

Publisher Copyright:

Funding

We thank all the participants who were so generous with their time and for sharing their story. Thanks also to Jacqueline Vennard, Fatima Roberts, Ali Coxall, and Angela Costetsos at Open Doors and Kim Leverett at Barts Health NHS Trust, for expert advice and facilitating recruitment. We are also grateful for the expert input from our advisory group including Penny Bevan, Del Campbell, Rosie Campbell, Guy Collings, Alex Feis-Bryce, Gwenda Hughes, Cari Mitchell, Eammon O’Moore, Maryam Shahmanesh, Georgina Perry, Richard Unwin, and Helen Ward. We also thank the broader study team Janet Eastham, Aisling Gallagher, Sarah Creighton, Maggie O’Neil, Luca Stevenson, and Chelsea Ziegler for their time and insightful contributions. The National Institute for Health Research (NIHR) Public Health Research Programme (PHR) funded this study (PHR 15/55/58). Their committee peer reviewed the proposal before funding was approved. Thereafter, the NIHR PHR was entirely independent of the data collection, analysis, and interpretation.

Funders	Funder number
National Institute for Health and Care Research
Public Health Research Programme	PHR 15/55/58
Medical Research Council	MR/R015600/1

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being
SDG 5 Gender Equality
SDG 16 Peace, Justice and Strong Institutions

Keywords

Emotional and sexual violence
Ethnicity
Policing
Sex work
Sexuality

ASJC Scopus subject areas

Health(social science)
Urban Studies
Public Health, Environmental and Occupational Health

Access to Document

10.1007/s11524-022-00673-z

PublishedFinal published version, 250 KBLicence: CC BY

Cite this

Platt, L., Bowen, R., Grenfell, P., Stuart, R., Sarker, M. D., Hill, K., Walker, J., Javarez, X., Henham, C., Mtetwa, S., Hargreaves, J., Boily, M. C., Vickerman, P., Hernandez, P., & Elmes, J. (2022). The Effect of Systemic Racism and Homophobia on Police Enforcement and Sexual and Emotional Violence among Sex Workers in East London: Findings from a Cohort Study. Journal of Urban Health, 99(6), 1127-1140. https://doi.org/10.1007/s11524-022-00673-z

Platt, L, Bowen, R, Grenfell, P, Stuart, R, Sarker, MD, Hill, K, Walker, J, Javarez, X, Henham, C, Mtetwa, S, Hargreaves, J, Boily, MC, Vickerman, P, Hernandez, P & Elmes, J 2022, 'The Effect of Systemic Racism and Homophobia on Police Enforcement and Sexual and Emotional Violence among Sex Workers in East London: Findings from a Cohort Study', Journal of Urban Health, vol. 99, no. 6, pp. 1127-1140. https://doi.org/10.1007/s11524-022-00673-z

@article{9db85be3ef3949d99aa638001e17783c,

title = "The Effect of Systemic Racism and Homophobia on Police Enforcement and Sexual and Emotional Violence among Sex Workers in East London: Findings from a Cohort Study",

abstract = "There is extensive qualitative evidence of violence and enforcement impacting sex workers who are ethnically or racially minoritized, and gender or sexual minority sex workers, but there is little quantitative evidence. Baseline and follow-up data were collected among 288 sex workers of diverse genders (cis/transgender women and men and non-binary people) in London (2018–2019). Interviewer-administered and self-completed questionnaires included reports of rape, emotional violence, and (un)lawful police encounters. We used generalized estimating equation models (Stata vs 16.1) to measure associations between (i) ethnic/racial identity (Black, Asian, mixed or multiple vs White) and recent (6 months) or past police enforcement and (ii) ethnic/racial and sexual identity (lesbian, gay or bisexual (LGB) vs. heterosexual) with recent rape and emotional violence (there was insufficient data to examine the association with transgender/non-binary identities). Ethnically/racially minoritized sex workers (26.4\%) reported more police encounters partly due to increased representation in street settings (51.4\% vs 30.7\% off-street, p = 0.002). After accounting for street setting, ethnically/racially minoritized sex workers had higher odds of recent arrest (adjusted odds ratio 2.8, 95\% CI 1.3–5.8), past imprisonment (aOR 2.3, 95\% CI 1.1–5.0), police extortion (aOR 3.3, 95\% CI 1.4–7.8), and rape (aOR 3.6, 95\% CI 1.1–11.5). LGB-identifying sex workers (55.4\%) were more vulnerable to rape (aOR 2.4, 95\% CI 1.1–5.2) and emotional violence. Sex workers identifying as ethnically/racially minoritized (aOR 2.1, 95\% CI 1.0–4.5), LGB (aOR 2.0, 95\% CI 1.0–4.0), or who use drugs (aOR 2.0, 95\% CI 1.1–3.8) were more likely to have experienced emotional violence than white-identifying, heterosexual or those who did not use drugs. Experience of any recent police enforcement was associated with increased odds of rape (aOR 3.6, 95\% CI 1.3–8.4) and emotional violence (aOR 4.9, 95\% CI 1.8–13.0). Findings show how police enforcement disproportionately targets ethnically/racially minoritized sex workers and contributes to increased risk of rape and emotional violence, which is elevated among sexual and ethnically/racially minoritized workers.",

keywords = "Emotional and sexual violence, Ethnicity, Policing, Sex work, Sexuality",

author = "Lucy Platt and Raven Bowen and Pippa Grenfell and Rachel Stuart and Sarker, \{M. D.\} and Kathleen Hill and Josephine Walker and Xavier Javarez and Carolyn Henham and Sibongile Mtetwa and James Hargreaves and Boily, \{M. C.\} and Peter Vickerman and Paz Hernandez and Jocelyn Elmes",

note = "Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article{\textquoteright}s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article{\textquoteright}s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.",

year = "2022",

month = dec,

doi = "10.1007/s11524-022-00673-z",

language = "English",

volume = "99",

pages = "1127--1140",

journal = "Journal of Urban Health",

issn = "1099-3460",

publisher = "SpringerOpen",

number = "6",

}

TY - JOUR

T1 - The Effect of Systemic Racism and Homophobia on Police Enforcement and Sexual and Emotional Violence among Sex Workers in East London

T2 - Findings from a Cohort Study

AU - Platt, Lucy

AU - Bowen, Raven

AU - Grenfell, Pippa

AU - Stuart, Rachel

AU - Sarker, M. D.

AU - Hill, Kathleen

AU - Walker, Josephine

AU - Javarez, Xavier

AU - Henham, Carolyn

AU - Mtetwa, Sibongile

AU - Hargreaves, James

AU - Boily, M. C.

AU - Vickerman, Peter

AU - Hernandez, Paz

AU - Elmes, Jocelyn

N1 - Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

PY - 2022/12

Y1 - 2022/12

N2 - There is extensive qualitative evidence of violence and enforcement impacting sex workers who are ethnically or racially minoritized, and gender or sexual minority sex workers, but there is little quantitative evidence. Baseline and follow-up data were collected among 288 sex workers of diverse genders (cis/transgender women and men and non-binary people) in London (2018–2019). Interviewer-administered and self-completed questionnaires included reports of rape, emotional violence, and (un)lawful police encounters. We used generalized estimating equation models (Stata vs 16.1) to measure associations between (i) ethnic/racial identity (Black, Asian, mixed or multiple vs White) and recent (6 months) or past police enforcement and (ii) ethnic/racial and sexual identity (lesbian, gay or bisexual (LGB) vs. heterosexual) with recent rape and emotional violence (there was insufficient data to examine the association with transgender/non-binary identities). Ethnically/racially minoritized sex workers (26.4%) reported more police encounters partly due to increased representation in street settings (51.4% vs 30.7% off-street, p = 0.002). After accounting for street setting, ethnically/racially minoritized sex workers had higher odds of recent arrest (adjusted odds ratio 2.8, 95% CI 1.3–5.8), past imprisonment (aOR 2.3, 95% CI 1.1–5.0), police extortion (aOR 3.3, 95% CI 1.4–7.8), and rape (aOR 3.6, 95% CI 1.1–11.5). LGB-identifying sex workers (55.4%) were more vulnerable to rape (aOR 2.4, 95% CI 1.1–5.2) and emotional violence. Sex workers identifying as ethnically/racially minoritized (aOR 2.1, 95% CI 1.0–4.5), LGB (aOR 2.0, 95% CI 1.0–4.0), or who use drugs (aOR 2.0, 95% CI 1.1–3.8) were more likely to have experienced emotional violence than white-identifying, heterosexual or those who did not use drugs. Experience of any recent police enforcement was associated with increased odds of rape (aOR 3.6, 95% CI 1.3–8.4) and emotional violence (aOR 4.9, 95% CI 1.8–13.0). Findings show how police enforcement disproportionately targets ethnically/racially minoritized sex workers and contributes to increased risk of rape and emotional violence, which is elevated among sexual and ethnically/racially minoritized workers.

AB - There is extensive qualitative evidence of violence and enforcement impacting sex workers who are ethnically or racially minoritized, and gender or sexual minority sex workers, but there is little quantitative evidence. Baseline and follow-up data were collected among 288 sex workers of diverse genders (cis/transgender women and men and non-binary people) in London (2018–2019). Interviewer-administered and self-completed questionnaires included reports of rape, emotional violence, and (un)lawful police encounters. We used generalized estimating equation models (Stata vs 16.1) to measure associations between (i) ethnic/racial identity (Black, Asian, mixed or multiple vs White) and recent (6 months) or past police enforcement and (ii) ethnic/racial and sexual identity (lesbian, gay or bisexual (LGB) vs. heterosexual) with recent rape and emotional violence (there was insufficient data to examine the association with transgender/non-binary identities). Ethnically/racially minoritized sex workers (26.4%) reported more police encounters partly due to increased representation in street settings (51.4% vs 30.7% off-street, p = 0.002). After accounting for street setting, ethnically/racially minoritized sex workers had higher odds of recent arrest (adjusted odds ratio 2.8, 95% CI 1.3–5.8), past imprisonment (aOR 2.3, 95% CI 1.1–5.0), police extortion (aOR 3.3, 95% CI 1.4–7.8), and rape (aOR 3.6, 95% CI 1.1–11.5). LGB-identifying sex workers (55.4%) were more vulnerable to rape (aOR 2.4, 95% CI 1.1–5.2) and emotional violence. Sex workers identifying as ethnically/racially minoritized (aOR 2.1, 95% CI 1.0–4.5), LGB (aOR 2.0, 95% CI 1.0–4.0), or who use drugs (aOR 2.0, 95% CI 1.1–3.8) were more likely to have experienced emotional violence than white-identifying, heterosexual or those who did not use drugs. Experience of any recent police enforcement was associated with increased odds of rape (aOR 3.6, 95% CI 1.3–8.4) and emotional violence (aOR 4.9, 95% CI 1.8–13.0). Findings show how police enforcement disproportionately targets ethnically/racially minoritized sex workers and contributes to increased risk of rape and emotional violence, which is elevated among sexual and ethnically/racially minoritized workers.

KW - Emotional and sexual violence

KW - Ethnicity

KW - Policing

KW - Sex work

KW - Sexuality

UR - https://www.scopus.com/pages/publications/85139765766

U2 - 10.1007/s11524-022-00673-z

DO - 10.1007/s11524-022-00673-z

M3 - Article

AN - SCOPUS:85139765766

SN - 1099-3460

VL - 99

SP - 1127

EP - 1140

JO - Journal of Urban Health

JF - Journal of Urban Health

IS - 6

ER -

The Effect of Systemic Racism and Homophobia on Police Enforcement and Sexual and Emotional Violence among Sex Workers in East London: Findings from a Cohort Study

Abstract

Bibliographical note

Funder

Funding

UN SDGs

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this