The impact of policing and homelessness on violence experienced by women who sell sex in London: a modelling study

Josephine G Walker; Jocelyn Elmes; Pippa Grenfell; Janet Eastham; Kathleen Hill; Rachel Stuart; Marie-Claude Boily; Lucy Platt; Peter Vickerman

doi:10.1038/s41598-023-44663-w

The impact of policing and homelessness on violence experienced by women who sell sex in London: a modelling study

Josephine G Walker
, Jocelyn Elmes
, Pippa Grenfell
, Janet Eastham
, Kathleen Hill
, Rachel Stuart
, Marie-Claude Boily
, Lucy Platt
, Peter Vickerman

Bristol Medical School
London School of Hygiene and Tropical Medicine
Independent researcher
Brunel University
Imperial College London
NIHR Health Protection Research Unit in Behavioural Science and Evaluation, University of Bristol

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

1 Citation (Scopus)

57 Downloads (Pure)

Abstract

Street-based sex workers experience considerable homelessness, drug use and police enforcement, making them vulnerable to violence from clients and other perpetrators. We used a deterministic compartmental model of street-based sex workers in London to estimate whether displacement by police and unstable housing/homelessness increases client violence. The model was parameterized and calibrated using data from a cohort study of sex workers, to the baseline percentage homeless (64%), experiencing recent client violence (72%), or recent displacement (78%), and the odds ratios of experiencing violence if homeless (1.97, 95% confidence interval 0.88-4.43) or displaced (4.79, 1.99-12.11), or of experiencing displacement if homeless (3.60, 1.59-8.17). Ending homelessness and police displacement reduces violence by 67% (95% credible interval 53-81%). The effects are non-linear; halving the rate of policing or becoming homeless reduces violence by 5.7% (3.5-10.3%) or 6.7% (3.7-10.2%), respectively. Modelled interventions have small impact with violence reducing by: 5.1% (2.1-11.4%) if the rate of becoming housed increases from 1.4 to 3.2 per person-year (Housing First initiative); 3.9% (2.4-6.9%) if the rate of policing reduces by 39% (level if recent increases had not occurred); and 10.2% (5.9-19.6%) in combination. Violence reduces by 26.5% (22.6-28.2%) if half of housed sex workers transition to indoor sex work. If homelessness decreased and policing increased as occurred during the COVID-19 pandemic in 2020, the impact on violence is negligible, decreasing by 0.7% (8.7% decrease-4.1% increase). Increasing housing and reducing policing among street-based sex workers could substantially reduce violence, but large changes are needed. [Abstract copyright: © 2024. The Author(s).]

Original language	English
Article number	8191
Number of pages	10
Journal	Scientific Reports
Volume	14
Issue number	1
Early online date	8 Apr 2024
DOIs	https://doi.org/10.1038/s41598-023-44663-w
Publication status	E-pub ahead of print - 8 Apr 2024

Bibliographical note

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

This study was funded by the National Institute for Health Research (NIHR) Public Health Research Programme
(PHR) (PHR Project: 15/55/58). PV also acknowledges support from the Wellcome Trust (WT 226619/Z/22/Z)
and the NIHR Health Protection Research Unit in Behavioural Science and Evaluation at University of Bristol.

Funding

This study was funded by the National Institute for Health Research (NIHR) Public Health Research Programme (PHR) (PHR Project: 15/55/58). PV also acknowledges support from the Wellcome Trust (WT 226619/Z/22/Z) and the NIHR Health Protection Research Unit in Behavioural Science and Evaluation at University of Bristol.

Funders	Funder number
National Institute for Health and Care Research
Public Health Research Programme	15/55/58)
Wellcome Trust	226619/Z/22/Z
NIHR Health Protection Research Unit in Behavioural Science and Evaluation, University of Bristol

UN SDGs

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

SDG 16 Peace, Justice and Strong Institutions

Keywords

London - epidemiology
Violence
Police
Sex Workers
Cohort Studies
Female
Pandemics
Ill-Housed Persons
Humans

Access to Document

10.1038/s41598-023-44663-wLicence: CC BY

Hill2024VoRFinal published version, 1.4 MBLicence: CC BY

Cite this

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abstract = "Street-based sex workers experience considerable homelessness, drug use and police enforcement, making them vulnerable to violence from clients and other perpetrators. We used a deterministic compartmental model of street-based sex workers in London to estimate whether displacement by police and unstable housing/homelessness increases client violence. The model was parameterized and calibrated using data from a cohort study of sex workers, to the baseline percentage homeless (64\%), experiencing recent client violence (72\%), or recent displacement (78\%), and the odds ratios of experiencing violence if homeless (1.97, 95\% confidence interval 0.88-4.43) or displaced (4.79, 1.99-12.11), or of experiencing displacement if homeless (3.60, 1.59-8.17). Ending homelessness and police displacement reduces violence by 67\% (95\% credible interval 53-81\%). The effects are non-linear; halving the rate of policing or becoming homeless reduces violence by 5.7\% (3.5-10.3\%) or 6.7\% (3.7-10.2\%), respectively. Modelled interventions have small impact with violence reducing by: 5.1\% (2.1-11.4\%) if the rate of becoming housed increases from 1.4 to 3.2 per person-year (Housing First initiative); 3.9\% (2.4-6.9\%) if the rate of policing reduces by 39\% (level if recent increases had not occurred); and 10.2\% (5.9-19.6\%) in combination. Violence reduces by 26.5\% (22.6-28.2\%) if half of housed sex workers transition to indoor sex work. If homelessness decreased and policing increased as occurred during the COVID-19 pandemic in 2020, the impact on violence is negligible, decreasing by 0.7\% (8.7\% decrease-4.1\% increase). Increasing housing and reducing policing among street-based sex workers could substantially reduce violence, but large changes are needed. [Abstract copyright: {\textcopyright} 2024. The Author(s).]",

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AB - Street-based sex workers experience considerable homelessness, drug use and police enforcement, making them vulnerable to violence from clients and other perpetrators. We used a deterministic compartmental model of street-based sex workers in London to estimate whether displacement by police and unstable housing/homelessness increases client violence. The model was parameterized and calibrated using data from a cohort study of sex workers, to the baseline percentage homeless (64%), experiencing recent client violence (72%), or recent displacement (78%), and the odds ratios of experiencing violence if homeless (1.97, 95% confidence interval 0.88-4.43) or displaced (4.79, 1.99-12.11), or of experiencing displacement if homeless (3.60, 1.59-8.17). Ending homelessness and police displacement reduces violence by 67% (95% credible interval 53-81%). The effects are non-linear; halving the rate of policing or becoming homeless reduces violence by 5.7% (3.5-10.3%) or 6.7% (3.7-10.2%), respectively. Modelled interventions have small impact with violence reducing by: 5.1% (2.1-11.4%) if the rate of becoming housed increases from 1.4 to 3.2 per person-year (Housing First initiative); 3.9% (2.4-6.9%) if the rate of policing reduces by 39% (level if recent increases had not occurred); and 10.2% (5.9-19.6%) in combination. Violence reduces by 26.5% (22.6-28.2%) if half of housed sex workers transition to indoor sex work. If homelessness decreased and policing increased as occurred during the COVID-19 pandemic in 2020, the impact on violence is negligible, decreasing by 0.7% (8.7% decrease-4.1% increase). Increasing housing and reducing policing among street-based sex workers could substantially reduce violence, but large changes are needed. [Abstract copyright: © 2024. The Author(s).]

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KW - Ill-Housed Persons

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The impact of policing and homelessness on violence experienced by women who sell sex in London: a modelling study

Abstract

Bibliographical note

Funder

Funding

UN SDGs

Keywords

Access to Document

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