Effectiveness of sexual health service delivery within a drop in centre for street sex workers

Effectiveness of sexual health service delivery within a drop in centre

for street sex workers

D. Wakelam (1), A. Wells (2), A. Webb (3)

The Linx Project, Liverpool, UK (1); GUM department, Royal Liverpool

University and Broadgreen Hospital, UK (2); Abacus Clinics for Contraception and

Reproductive Health, Liverpool, UK (3)

Introduction: Street sex workers (SSW) are a socially excluded and

difficult to reach group. The majority are drug users and many have no fixed

home. Their consequent chaotic life style and fear of discrimination or

judgemental attitudes explains their difficulty in accessing standard services.

The Linx project actively supports SSW to overcome these barriers and assists

them in accessing a range of services. In late 2002 a drop in centre for SSW was

opened. Twice weekly there is a session from 8–11pm when SSW can drop in for a

chat, meal, a wash and to obtain condoms and clean clothes. Outreach Linx

workers make contact and distribute condoms on the street where they inform the

women of the service available and give them a lift in and back if requested.

Aims and Methods: to pilot a sexual health service within the Linx

drop in sessions providing pregnancy testing, contraceptive advice and supplies,

blood testing for viral infections and hepatitis B vaccination. By making

personal contact it was hoped this would also assist in easing access to

mainstream contraception and infection screening services.

Results: An outreach health adviser from the genitourinary medicine

clinic with experience of working with sex workers and a senior doctor in

contraception agreed to attend an evening drop in once a month. In the first six

months 9 women were seen at six sessions on 15 occasions. In the second six

months a further 14 women were seen at seven sessions. Over the year 35 visits

were made. Eleven women started a hepatitis B vaccination programme and 10 made

arrangements to attend for full infection screening. Three started on

Depo-Provera and two had Implanons fitted. The Linx staff were trained in

performing and interpreting pregnancy tests. A number of women were referred in

directly by the Linx workers to either the contraception or infection testing

services. An audit of both the SSW and the Linx Project workers showed that the

women were very pleased to have this service and felt more confident about

requesting help at Linx than at standard health services.

Conclusions: an outreach service in a space where the SSW feel safe

can improve the access of an often marginalised group to health services and

reduce the risk to public health of not offering protection against unwanted

pregnancies and infections.

Scroll to Top