Exploring available knowledge and evidence on prostitution in Scotland via practitioner-based interviews

Annex: A Review of Prostitution in Scotland: Scottish Centre for Crime and Justice Research

Introduction ^[108]

This report constitutes a desk-based review of published research and evidence on prostitution in Scotland. It should be read alongside the report from researchers within the Scottish Government's Justice Analytical Services ( JAS) who were tasked with exploring and summarising existing evidence on the nature and scale of prostitution in Scotland. This report is intended to provide a contextual background to the JAS study, which is based on interviews and intelligence gathering from key informants including police, local authorities and the third sector. It is important to note that this review does not purport to provide a comprehensive and definitive account of the evidence on prostitution, but rather, constitutes a collation of the material which could be identified and accessed within a relatively short space of time. Furthermore, due to the limited focus on considering existing evidence from research carried out in Scotland, international comparative analysis was not undertaken.

Note on use of language

This report examines existing evidence on prostitution in Scotland but acknowledges the challenges of conducting research in this area, given the 'hidden' nature of this phenomenon and the ideological positions that often determine methodological priorities as well as dissemination and publication opportunities. Data produced are frequently subject to challenge or viewed as partial and subjective.

This report adopts a working definition which is focused on the sale and purchase of sex rather than sex-related activities (such as lap-dancing, pornography etc.). Terminology in this area is contested; however the Scottish Government has used the term 'prostitution' in other contexts and this report does the same. While 'sex work' is used by some academics and support organisations, the sale of sex is subject to dispute as a form of employment. The contested nature of words is significant and the report is premised on an acknowledgement that it is not possible to find a 'neutral' language on this subject. Accordingly, the term 'individuals involved in prostitution' is used throughout the review. When reporting studies which have adopted the terminology of 'sex work', this is used where appropriate.

Research and Evidence in Scotland

While the exact numbers of people involved in prostitution in Scotland, as elsewhere, is unknown, evidence suggests that women account for the majority of those involved (English Collective of Individuals cited in All-Party Parliamentary Group, 2014). Accurate figures are impossible to obtain due to the hidden nature of much of prostitution and the stigma attached to it. Attention is often given to the more visible forms such as on-street prostitution with limited knowledge surrounding indoor/off-street prostitution ^[109] . However, distinctions between 'on-street' and 'off-street' prostitution are unclear as individuals may move between different forms of prostitution at different points in time.

Existing estimates often draw upon evidence provided by organisations offering support services. In 1999, Kinnell estimated that around 80,000 people were involved in prostitution (on and off-street); a figure that she notes was an estimate and as such open to considerable inaccuracy. Nevertheless this figure was subsequently used in the Home Office document Paying the Price: a consultation paper on prostitution (2004). Cusick et al (2009), noting the limitations of this data, attempted to provide their own estimates in 2009, leading them to conclude that the number of individuals involved in prostitution did not appear to have risen substantially in the intervening period. However, they describe research in this area as being "fraught with theoretical and methodological difficulties" (2009: 709). Much of the research conducted in this area has focused on street-based prostitution resulting in criticism that this has (problematically) been used as a basis to inform and develop policy.

Estimates of involvement in prostitution in Scotland during the 1990's indicated that Glasgow had one of the highest levels of street prostitution in the UK (around 1100 in 1992, see McKeganey, 2005), compared to approximately 250 in 2010 (Matthews et al. 2014:1). In 2004, the Expert Group on Prostitution ^[110] noted that approximately 1400 women were involved in street prostitution in Scotland. This number was recognised as an estimate and it was acknowledged that attempts to calculate the number of individuals involved in indoor prostitution was even more challenging. The Expert Group agreed to review prostitution in Scotland in three phases and to focus first on women's involvement in street prostitution. The expectation was that subsequent attention would be given to indoor prostitution and male prostitution. However the Group was not reconvened after its' first report Being Outside: Constructing a Response to Street Prostitution was published in December 2004 and the remaining areas (indoor prostitution and male prostitution) were never addressed.

Figures on indoor prostitution in Scotland, as elsewhere, are difficult to obtain however an internal report for Glasgow Community Safety Services ( GCSS) in 2010 (cited in Matthews and Easton, 2010: 38) was produced from an examination of field reports from the PunterNet UK website relating to indoor prostitution in Glasgow and detailed examination of escort websites and advertisements in The Sport newspaper. This indicated that different clubs, saunas and massage parlours were providing 'sexual services' in Glasgow with women from 18 different non- UK nationalities advertised within these establishments. A total of 350 women were identified from PunterNet UK as involved in indoor prostitution in Glasgow although location changed across the years. The majority (from 2005 onwards) appeared to be involved in prostitution from their own house or flat. A further 315 women were identified in February 2010 as 'escorts' with 37 escort 'link sites' identified.

Pitcher (2015) drawing on her own work in this area attempted to provide estimates of the number of individuals involved in prostitution across Britain, taking account of male, female, and transgender individuals in both the indoor and outdoor sectors. Drawing on data and local knowledge provided by services she noted that although women appear to account for the majority of street-based workers there is greater diversity in the indoor sector (although women still accounted for between 80-89% of indoor individuals involved in prostitution). Pitcher noted that street-based workers accounted for only a quarter of all individuals involved in prostitution in Britain. Other studies have highlighted that many individuals will commute to larger cities through involvement in prostitution and there is a notable expansion in the use of new technology ( i.e. webcam work) (Connell, 2010).

Local Responses

National attention to prostitution in Scotland in the 2000s highlighted the different circumstances that predominated in different parts of the country and the different models of response that were in place. The Expert Group, while calling for a national strategic framework, also noted the relevance of local implementation plans based on a multi-agency approach. The Scottish Executive supported the recommendation that local authorities should take the lead in developing approaches tailored to local need, in partnership with police, health boards and local community and voluntary agencies; acknowledging differences between situations across the country and particularly in relation to the four major Scottish cities (Glasgow, Edinburgh, Dundee and Aberdeen). The Expert Group report recognised that prostitution was an issue in three major Scottish cities (Glasgow, Edinburgh and Aberdeen) with some involvement in prostitution in Dundee. There is evidence to show distinctive practices in each of the cities where prostitution was identified. The following section therefore provides a recent historical overview of different approaches in each of the different areas and how these have developed in response to local issues. This should be read alongside the accompanying Justice Analytical Services report based on interviews with police, health professionals and third sector support staff which provides a more up to date description of key issues in each of the local areas as well as consideration of the structure of specialist service provision in the four cities.

Glasgow

In Glasgow, a number of deaths ^[111] and violent assaults on women involved in prostitution highlighted the need to address this issue and particular attention was focused on exiting and preventative work supported by increased inter-agency work. This (and leadership from Glasgow City Council) shaped an approach where prostitution was identified as 'violence against women' and 'intrinsically harmful' to the individuals involved. The aim of policy interventions in Glasgow was that prostitution should be reduced and ultimately eliminated, and women involved in prostitution should be seen as 'victims' in need of care and support, via an holistic, integrated inter-agency approach. The main objective of intervention was to be the demand for prostitution with women helped and encouraged to exit prostitution wherever possible.

In the Glasgow area, it was estimated that at one time, 1,400 individuals were involved in (street) prostitution, of whom 97% were intravenous drug users (Payne et al, 2004: 11). Although Strathclyde Police claimed that there was no unofficial 'tolerance zone' operating in Glasgow (Strathclyde Police evidence to Local Government Committee), the Committee nevertheless concluded that there was in practice (Payne et al, 2004: 11).

The Routes Out: Supporting Women to Leave Prostitution Social Inclusion Partnership (Routes Out SIP) was established to prevent women, particularly 'vulnerable' young women, becoming involved in prostitution; and to support women to leave prostitution. Established in 1999, the SIP was one of several themed SIPs and its evaluation (by Mckay et al, 2004) was part of a wider programme of SIP evaluations. The Routes Out SIP consisted of a strategic inter-agency approach to service delivery and organisational practice, and the establishment of a dedicated Intervention Team to assist individual women to leave prostitution.

Acknowledging the complexity of evaluating a structurally complex initiative, Mckay et al (2004) found that the contested nature of prostitution presented challenges for the partnership. The SIP's attempt to highlight prostitution as an issue of social exclusion, gender inequality, abuse and harm was controversial and led to some internal and external resistance. As well as learning from experience about what did and did not work, the objectives of Routes Out were periodically revised. The 'tangible benefits' identified as outcomes by the evaluation included:

• "A dedicated Intervention Team working with women seeking to exit prostitution
• Instances of multi-agency prevention work
• The development of a more 'joined-up' response to service issues which affect women involved in prostitution
• Participation in a variety of activities seeking to identify and overcome the structural barriers which women face
• A strong and committed partnership of key agencies
• A common approach and position on prostitution".

(Mckay et al, 2004: 6).

Matthews and Easton (2010) conducted a strategic review of services for women involved in prostitution in Glasgow. Their study emphasised the need for a cohesive co-ordination of service delivery as a response to conflict in ethos and working practices between Base 75 (which provided a confidential service for women involved in prostitution) and the Routes Out of Prostitution Intervention team (which provided long-term therapeutic support for women who wanted to exit prostitution). This strategic review led to the redesign of services and subsequently, both Base 75 and the Routes Out Prostitution Intervention Team were transferred to Glasgow Community and Safety Services ( GCSS) in February 2010.

Base 75 and Routes Out merged to form the new 'Routes Out' service - delivered across three areas: case-management, drop-in and outreach. This service involved information sharing between agencies and the introduction of Multi-Agency Case Conferences for women known to be involved in prostitution but who were not engaging with service providers. Glasgow City Council reaffirmed its position on prostitution in 2015 when a motion was passed which stated that selling sex was rooted in gender inequality, survival and the commodification of the bodies of women and vulnerable men. ^[112]

Edinburgh

In Edinburgh, an 'unofficial' tolerance zone operated for a number of years. The zone, which appears to have evolved over time with rules informally agreed by individuals involved in prostitution and the police, developed as part of a strategy to tackle problems associated with drug misuse, HIV/ AIDS and blood borne viruses. Edinburgh had, by the late 1980s, a higher proportion of intravenous drug users who were known to be HIV seropositive than any other British city. According to Morgan Thomas (1990), 969 people had tested positive by the end of March 1989, 55% of whom were intravenous drug users and some of whom were known to be involved in prostitution (Morgan Thomas 1990: 88); although there was little evidence that HIV infection had been spread through prostitution in the study area. A more co-ordinated approach to prostitution subsequently developed involving the police, health board, local authority and Scotpep (a rights group set up by and for sex workers).

Evidence from Lothian and Borders Police (cited in Payne et al, 2004: 15) indicated that individuals involved in prostitution from Glasgow and Aberdeen travelled to Edinburgh to work in the unofficial zone when it operated and that up to 44% of individuals involved in prostitution and working in Edinburgh were from the west coast of Scotland (Local Government Committee evidence (cited in Payne et al, 2004: 15).

However, as the area in which the zone operated became more residential, complaints were made by the public and although the zone moved a few streets away complaints continued, culminating in a public demonstration in 2002 and organised patrols of the area from March 2003 by Leith Links Residents Association. This apparently led to a dispersal of individuals involved in prostitution across the city leading to claims from Scotpep that attacks on individuals involved in prostitution had increased while visits to Scotpep's facilities for advice, needle exchange or condom supply had decreased ^[113] .

In February 2014, indoor prostitution was affected by the Council's Regulatory Committee decision not to licence saunas. After partner engagement on the issue, a 'Harm Reduction Framework for Sex Work' in Edinburgh was approved (Health, Social Care and Housing Committee, 2015), taking an 'holistic approach' where saunas and massage parlours were a focus with street and on-line prostitution to be included. Agencies and individuals involved in prostitution participated in the development and implementation of the Framework. Reports from NHS Women's Clinic indicated that the number of women attending the clinic service had decreased in 2014 (reduction in consultations of 9.8% from 2013) and a slight increase in rates of sexually transmitted infection was noted. This, despite any evidence to suggest the number of women involved in prostitution had reduced. However, through the provision of more accessible outreach support, engagement with another project (Sacro's Another Way Service) was reported to have increased, while a number of women were reported to be informally supported in saunas and at the Women's Clinic in Edinburgh. Needle exchange, condom supplies and signposting to other services continued to be provided by various agencies including NHS Lothian, Sacro Another Way, and Streetwork.

The Health, Social Care and Housing Committee (2015) progress report recommendations were that the Committee noted the: "innovative partnership working, improved service interventions and improving knowledge of issues facing sex workers that have taken place during year one of the Framework; and agree that responsibility to address the key improvement actions identified be remitted to the multi-agency group with a reporting line to Edinburgh's Chief Officers' Group - Public Protection" (p2).

Aberdeen

In Aberdeen, Grampian Police pursued a prostitution management policy similar to Edinburgh in its aims. In both cities, interventions were aimed at providing a safer environment for individuals involved in prostitution which also enabled agencies to work with them and to offset criminal activity and nuisance for local residents. This approach can present a challenge in implementation for local authorities who are required to protect individuals involved in prostitution but who can subsequently be accused of aiding an illegal activity by introducing 'safety features' such as CCTV.

Like Glasgow and Edinburgh, Aberdeen faced a significant drug problem associated with prostitution which had increased during the late 1990s, with approximately 90% of individuals involved in street prostitution estimated to be intravenous drug users. Expansion of the area in which street prostitution had traditionally operated began to affect local businesses and a Sex Industry Forum was established as a task group of Aberdeen Community Safety Partnership aimed at resolving issues related to the unofficial zone and existing drop-in centre.

Lister (2008) conducted a small study in Aberdeen following the sudden end to the 'management zone' which had existed for six years in the city. Based on semi-structured interviews with three street-based sex workers, six project workers and one police officer, Lister illustrates the effects of the expansion of criminalisation as a result of this change. Her study shows increased 'risks' taken by women and the increasingly proactive approaches by women involved in prostitution towards men in the city, largely due to continued need to access money resulting from financial hardship.

The impact of re-gentrification in particular areas of Aberdeen and the subsequent change in working practices reflects developments in Edinburgh. The emergence of new technologies i.e. increasing use of the internet and moves to indoor prostitution has also continued to affect levels of street based prostitution.

Dundee

There is limited evidence available on prostitution in Dundee and it would appear that there tends to be fewer individuals involved in prostitution than in other major Scottish cities. The Expert Group report (2004) indicated that there were approximately 10-15 women involved in street prostitution in Dundee with three to four on the streets per night. Despite high numbers of drug users in the city it seemed that numbers of individuals involved in street prostitution remained low and as a result, there was no dedicated support service in place at the time of the data collection. McKeganey (2006), recounting his ethnographic research in Dundee as part of a study across the four major Scottish cities, noted that the situation in Dundee was 'markedly different' to Aberdeen, Glasgow and Edinburgh. There had never been a recognised street-based tolerance zone in the city and during his fieldwork he commented that: "On the basis of a series of two hour fieldwork visits to the city one had the impression of the near total absence of a street prostitution scene of any kind within the city". Police activity in the city meant that few women involved in prostitution actively contacted clients on the street, preferring instead to use telephone contact.

Consideration of 'policy drivers' across the country

Models of service provision across the main Scottish cities, and the understandings of prostitution that underpinned them, were evident. Holmes (2005) considered the differences in attitudes and approaches to the regulation of street prostitution in Aberdeen, Edinburgh and Glasgow. ^[114] At the time of her study, Aberdeen had an operational tolerance zone which was operating with little opposition. Public consultation had helped to offset public dissent and there appeared to be effective multi-agency working with funding forthcoming for a new drop-in centre. Edinburgh, at the time, had adopted a policy of discretionary policing where possible, following the discontinuation of the cities tolerance zone. Glasgow, at the time, addressed prostitution through the Routes Out of Prostitution Social Inclusion Partnership (Scottish Executive funded) and viewed prostitution as harmful to women.

Support services were in place across three of the cities which Holmes examined (Aberdeen, Glasgow and Edinburgh) to support women with drug and/or housing issues and to assist them to exit prostitution. In Aberdeen, the primary service provider was Drugs Action, in Edinburgh it was Scotpep, in Glasgow it was social-work run Base 75, a key partner in the Routes Out Partnership. Interestingly, while police respondents did not consider differences between the three cities to be significant, other respondents referred to the philosophical differences between, for example, Edinburgh and Glasgow. Holmes attributes the key differences in practice in the three cities to: people and organisations involved; and practical details of the prostitution 'scenes' characteristic of the cities.

Other features noted by Holmes (2005) included the areas where prostitution took place in terms of contact with the public ( i.e. residential areas or not). Drug use was also noted as an issue (with estimated intravenous drug users believed to account for 95% of individuals involved in street prostitution in Glasgow compared to an estimated 50% in Edinburgh). The spread of HIV and AIDS was also distinct across the three areas with between 25% - 33% of Edinburgh's drug users infected with HIV in the early 1980s compared to less than 5% in Glasgow.

Holmes also considers characteristics of the cities in relation to religiosity (she suggests that people in Glasgow are more likely to define themselves as religious than Aberdeen or Edinburgh), socio-economic trends (Glasgow had higher unemployment and lower socio-economic prosperity) and political culture (stronger feminist influence and potentially "a more explicit gender awareness" (p80) in Glasgow). She highlights the challenge of introducing a nationwide policy that would be acceptable across the country. Differences were also evident in approaches to the development of policy across different local authorities - in Edinburgh and Aberdeen it was primarily police led, while in Glasgow the city council led within a multi-agency approach (Payne et al, 2004).

Research on Impacts of Prostitution on Health and Wellbeing

Research conducted in Scotland on the impact of prostitution on the individual has focused significantly on street-work and associated problems. The discussion that follows reflects this but considers, where possible, findings from off-street prostitution.

Prostitution and 'risk'

Concerns from the late 1980s saw a range of research turned towards women and men involved in prostitution and where possible, their clients ( e.g. Morgan Thomas, 1990) in Scotland and elsewhere in the UK and Europe (Plant, 1990). Fears surrounding the spread of HIV focused attention on those defined as 'high risk groups' with a view to estimating potential incidence and transmission of the virus and developing harm reduction practices to reduce this. Attention turned to the spread and incidence of HIV (Morgan Thomas et al., 1989; McKeganey and Barnard, 1992 and 1996; Rhodes et al., 1993; Taylor et al. 1993; Cusick, 1998) and there were claims of overlaps between markets for sex and drugs (May et al. 1999; Church et al. 2001). In a number of areas, this appeared to bring legislation into conflict with public health concerns ( e.g. Matthews, 1990).

McKeganey, Bloor and Barnard conducted a number of studies in Glasgow into the ethnography of drug injectors' behaviour and argued for accessible provisions for men and women involved in prostitution as well as attention to tackling the demand for prostitution by targeting 'clients' via outreach programmes. Their research explored the relationship between injecting drug use and prostitution in the spread of HIV infection (McKeganey et al, 1990; McKeganey and Barnard, 1992) and included both men and women involved in prostitution (Bloor et al, 1992). Over a six month period, individuals involved in street-work were contacted in two 'red-light' districts of Glasgow. 208 street-working women were contacted - an estimated 50% of the total number of street-working individuals involved in prostitution in Glasgow at that time (see McKeganey et al. 1990; Bloor et al., 1991). A high proportion of the women were injecting drug users (over 59% of new contacts), and it appeared that drug using women made up the majority of street-working individuals involved in prostitution, working more frequently and for longer hours than those who did not inject drugs (41% of new contacts). This research suggested that injecting drug users made up a much higher proportion of individuals involved in prostitution than was recorded in other cities such as London and Edinburgh (Barnard, 1993).

This body of work (by Barnard, McKeganey and Bloor) highlighted the ongoing risk of HIV transmission which women were subject to, despite evidence of risk reduction practices. For example, women continued to be under pressure not to use condoms in their contacts with clients and were reluctant to use condoms in their personal relationships. While the latter point reflected a wider issue of low levels of condom use in heterosexual relationships, the violence and intimidation which women were subject to as street-working individuals involved in prostitution limited the potential efficacy of policy recommendations.

Morgan Thomas (1990) reports on a study of 205 sex workers in Edinburgh interviewed between July and December 1988 - of whom 102 were men and 103 were women. As she notes, this represented methodological access arrangements rather than being representative of Edinburgh's 'sex industry'. As found in other studies, Morgan Thomas reported that despite being relatively well informed about the risks of HIV infection, a considerable number of men and women were at risk, as were their clients "due to their acquiescence to pressure to engage in unprotected penetrative sex" (104). This was related to low rates of condom use with lovers and non-paying partners. She notes the most alarming conclusion of her study as being the fact that large numbers of mainly male ^[115] clients actively requested unprotected sex and were willing to pay more for this, with many (almost one quarter of the study group) prepared to participate in unprotected sex for additional payment. From interview data and general information, Morgan Thomas notes the different risks experienced by those who were intravenous drug users in comparison to those who were not. Intravenous drug use was far less common among research participants who were sauna, massage parlour and escort agency workers than among those who worked in bars and on-street.

'Vulnerability' and street work

McKeganey and Barnard (1996) highlighted the growing recognition of the vulnerability and multiple deprivation of many women involved in street prostitution. This included experiences of poverty, drug and alcohol misuse, homelessness, abuse, and imprisonment. McKeganey (2006) considered the issue of 'tolerance zones' within the context of ethnography on street prostitution in Scotland (interviews with 33 women involved in prostitution on the streets across Edinburgh, Glasgow, Dundee and Edinburgh). The study highlighted that the majority of women said they had started to work as individuals involved in prostitution due to 'circumstances of dire need' (p155), with many funding a drug habit and some women describing experiences of childhood sexual abuse. A small number described their decision as a 'conscious occupational choice' (p155). Several women also appeared to have acquired a drug habit while working as individuals involved in prostitution. McKeganey comments that the language of choice appears inaccurate here; noting that the element of 'forced labour' has an impact on the extent to which prostitution could be considered as an occupational sector like any other.

The impact of involvement in prostitution had, for the majority of women in McKeganey's 2006 study, "a profoundly negative impact on their own sense of worth and their private lives with family, friends and partners" (p157). The need for 'psychological survival' also set this work apart from other employment sectors (p159). McKeganey describes the findings as indicating "a lifestyle of multiple pressures and multiple needs" (p 163).

Studies by Connell and Hart (2003) (men) and Connell (2010) (men and women), although small and largely involving individuals in contact with services and drawing on service providers perspectives, suggested that many individuals involved in prostitution had been in local authority care and had experience of being roofless/homeless (as did Hester and Westmarland, 2004). The difficulties experienced by those involved in on-street prostitution is highlighted by many studies (Matthews and Easton, 2010 ^[116] ; Matthews et al, 2014) with a number providing evidence on the backgrounds of individuals involved in prostitution (indicating that large numbers of women involved in prostitution became involved as children, spent time in care, report experiences of childhood sexual abuse). These claims have been contested elsewhere ( UKNSWP), particularly in relation to indoor work where it is suggested similar experiences are less likely to characterise the background of individuals involved in prostitution (Sanders, 2005; Pitcher, 2015).

While problematic heroin and crack use is reported in many studies of women involved in street prostitution, similarly high levels of drug use and addiction do not appear to be found in studies of indoor sex work markets. Cusick (1998) conducted research with women working in each of the Glasgow prostitution sectors (street, sauna, flat, escort and 'sugar daddy') recruited by a multiple snowball sampling method which relied largely on research by privileged access. Data gathering was naturalistic and fieldwork extensive. Injecting, and acceptance of drug addiction was presented as a rationale for prostitution amongst individuals involved in street work in contrast with intolerance of routine drug use by individuals involved in indoor prostitution. However, it was suggested that forms of drug use ( i.e. drug of choice) may vary but drug use itself remains a feature of both indoor and street-based prostitution with traditional demarcations between street drug users and indoor non-users diminishing.

In Cusick's study (1998) recreational drug use appears to be popular amongst some indoor sector workers. Differing environmental conditions and the various 'social' demands of prostitution were linked with both contrasting applications and negative associations of at-work drug effects; with individuals involved in indoor prostitution using drugs to enhance the social aspect of their interactions with 'customers', and to counteract boredom; and individuals involved in street prostitution using drugs to cope with the dangerous environment and harsh working conditions. Negative associations of drug use in indoor sectors included loss of business acumen; while on the street, greater concerns with physical danger were expressed. By drawing attention to the range of social contexts in prostitution in Glasgow and showing the flexibility of norms these findings suggest that the health and education needs of individuals involved in prostitution may vary between sectors and over time.

Subsequent work by Cusick and Hickman (2009) examined the relationship between prostitution and problematic drug use based on a subsample (from 125 'sex workers' with experience of any drug use) of 92 participants with experience of sex work and problematic drug use (80 women, 12 men). They report that 70 research participants had recently sold sex outdoors, the others 'indoors with associates' (p373). The study concluded that 'outdoor' and 'drift' sex work sectors may serve as a site for linking and reinforcing vulnerabilities, with these settings characterised by disorder, poor area reputations, crime and poverty. They note that the combination of involvement in prostitution and problematic drug created the potential for maximum harm.

Researchers such as McKeganey and Barnard (1992) in highlighting the potential risks to which individuals involved in street-prostitution are exposed, (in relation to injecting drug use and associated infections) argue for action to reduce potential harms, through accessible outreach and 'drop-in' services. They also outline the need for some form of intervention with potential purchasers through targeted outreach work.

Experiences of violence

Connell and Hart (2003) indicated that men involved in prostitution in Glasgow and Edinburgh reported incidents and threats of violence, rape, sexual and physical assault perpetrated by 'clients' while McKeganey and Barnard (1996) described a range of violent behaviours towards women involved in prostitution in Glasgow ranging from name-calling to physical assault, rape and murder. While 'clients' of individuals involved in prostitution are often focused on as perpetrators, studies also showed that men and women involved in prostitution were at risk of actual and threatened violence by 'pimps', drug dealers, others involved in prostitution and members of the general public (Barnard, 1993, McKeganey and Barnard, 1996, Church et al 2001, Connell and Hart, 2003, Sanders, 2005). Fears about not being taken seriously by the police often meant that rates of reporting were low ^[117] .

For many individuals, reluctance to inform the police about experiences of violence was notable. It was suggested that this also meant they were reluctant to pass on information to the police about violent individuals and/or other forms of criminal activity (Pitcher, 2015). Individuals involved in prostitution expressed concerns about potential criminalisation should they contact the police and noted the potential for increased stigmatisation (Smith, 2015). ^[118] The policing model used in Merseyside has been noted as a positive example of good practice, where crimes against women involved in prostitution are treated as hate crime and where conviction rates for reported crimes against individuals involved in prostitution are high (All-Party Parliamentary Group, 2014).

National Ugly Mugs ( NUM) is a project managed by the UK Network of Sex Work Projects and a third-party reporting mechanism which shares information to provide legally compliant warnings to members. NUM also supports victims of crime to report to the police and signposts individuals to appropriate local services. Reports received by NUM were analysed from July 2012-July 2014 by the Leeds Social Sciences Institute at the University of Leeds. 74% of reports came from support projects (n=710) and 17% from individual sex workers. Only 6% of reports were based on information from the police. 93% of reports submitted were from women (5% male, 1% transgender and 1% unspecified). Over half of the reports (60%) were from street sex workers, almost 25% were from 'independents' and a further 7% from workers in brothels, saunas and parlours. The most prevalent form of crime reported was violence (419 reports) 409 of this number submitted by women, and 322 reports from street-based sex workers (followed by 11% private or independent market; 6% brothels, saunas and parlours). Robbery and attempted robbery was experienced by 20% of reportees; 162 incidences of rape were reported (17% of reports).

In general, studies which are largely focused on on-street prostitution highlight experiences which include violence, problematic drug and/or alcohol use, homelessness, harassment from police and communities, criminalisation and challenges accessing statutory services (Pitcher, 2006).

The relative 'safety' of on-street versus indoor prostitution is however, unclear. It is recognised that indoor prostitution is not homogenous and that certain circumstances will increase risk. For example, Easton and Matthews (2012) conducted research with women trafficked into commercial sexual exploitation ( CSE) in Scotland (ten women and additional written documentation). Their interviews indicated that CSE commonly occurred in privately owned flats with most victims kept indoors, supervised and controlled. Other studies have suggested that street work can be safer than some forms of off-street working (Abel and Fitzgerald, 2012) with different forms of prostitution making it increasingly difficult for harm reduction services to detect or access women (Cusick and Berney, 2005). Farley et al (2009) challenged the view that indoor prostitution was safer than outdoor prostitution arguing that many of the 'most vulnerable' women were kept under control indoors. Matthews et al. (2014) indicated that women involved indoors in saunas and flats were subject to a range of constraints, coercion and exploitation - a point also made by O'Neill et al (2015) who noted that some forms of off-street working may be less safe than street sex work, despite the general association of the latter with lack of safety.

Concerns that policy reforms may have the potential to create a 'spatial shifting' of prostitution from on-street spaces to increasingly exploitative off-street spaces are voiced by Hubbard and Scoular (2009), while Sanders and Campbell (2007) have highlighted mixed evidence concerning the working conditions and safety within the indoor industry. Importantly, they highlight the potential to improve safety for individuals involved in prostitution through appropriate 'harm-reduction' measures, enhancing working practices and enabling individuals involved in prostitution to work in circumstances where they have some degree of control over their environment ( i.e. working collectively without risk of prosecution).

Legal Context

The settled approach to criminalisation in Scotland has been to prosecute individuals involved in prostitution (known to the police following two police warnings) for soliciting and loitering offences. While there is a long legacy of legal intervention in relation to prostitution, it is outwith the scope of this report to present the historical development of law and policy here. Of note however, is that legal attention has generally focused on the individual involved in prostitution, and until 2007, the purchaser was not subject to prosecution. In 2007 a commitment to penalise kerb-crawlers, and thus the demand for prostitution, came into force (Prohibition and Public Places Act (2007)). Current legislation is summarised below:

• (i) Individual loiters/solicits for purposes of prostitution ^[119] - this has been an offence since 1982 (although women involved in prostitution have been subject to legislation prior to this) and an individual must have received two warnings from a police officer for prostitution before it can be proved that they are involved in prostitution. Thus, they can only be reported for an offence on the third occasion.

• (ii) Purchaser loiters/solicits for purposes of obtaining services of a person engaged in prostitution ^[120] - this was made an offence in 2007. The key difference between this offence of being a purchaser and the offence of loitering or soliciting for the purposes of prostitution, is that there is no requirement to prove that the person from whom services are being obtained is 'a known prostitute', only that they were engaging in prostitution at the time of the offence. This means that a purchaser can be prosecuted on the first occasion. This legislation was supplemented in 2011 by an Order ^[121] giving power to the Court to disqualify convicted persons from driving, where a motor vehicle was used in the commission of the offence.

• (iii) Payment of sexual services of a child ^[122] - this legislation was primarily introduced to allow the Chief Constable to apply to the Sheriff for a Prevention of Sexual Harm Order, where a convicted sex offender is residing in the local area and there is a risk of harm. It also introduced the offence of paying a child or a third party to have a sexual encounter with a child. Its under-utilisation has been criticised (Barnardo's, 2015) and defended on the grounds that, where possible, the Crown would prefer a charge of rape (Justice Committee, 2014).

• (iv) Brothel Keeping ^[123] - Offences under this section include 'obtaining immoral earnings' and 'managing an immoral house' or being the tenant or occupier of an 'immoral house'.

• (v) Human trafficking ^[124] - there is now legislation to specifically make it an offence to exploit another human being. Exploitation is defined within the Act and covers sexual exploitation. Trafficking can be within one jurisdiction and does not need to cross borders. This legislation also makes specific provision for support and assistance to victims of trafficking.

Recent interest in prostitution, increasingly referred to as 'commercial sexual exploitation' ( CSE) arose with the introduction of Scottish legislation aimed at dealing with human trafficking. During this process, interest in the relationship between CSE and human trafficking became increasingly pronounced - although continually contested. The 2015 Human Trafficking and Exploitation (Scotland) Act acknowledges 'coercion' but does not set out explicit measures to tackle prostitution in Scotland. A number of international instruments also address human trafficking and various aspects of prostitution from a human rights perspective including the 1949 Convention for the Suppression of the Traffic in Persons and the Exploitation of the Prostitution of Others, adopted by the UN General Assembly.

Legislative Developments ^[125]

There have been various attempts to introduce legislation in Scotland, such as the Prostitution Tolerance Zones (Scotland) Bill which was introduced to the Scottish Parliament by Margo Macdonald MSP on 8 September 2003. The Bill would have enabled local authorities to designate areas within their boundaries as 'prostitution tolerance zones', amending section 46 of the Civic Government (Scotland) Act 1982 to ensure that loitering, soliciting or importuning by prostitutes within these zones was not illegal - effectively decriminalising soliciting within a designated area.

Although the Bill was not progressed, the (then) Scottish Executive established the Expert Group on Prostitution (the Expert Group) in 2003 following the suggestion of the Local Government and Transport Committee during its' consideration of the proposal on tolerance zones. The Expert Group's task was to consider the legal, policing, health and social justice issues surrounding prostitution in Scotland. In 2007, a new offence which allowed for the prosecution of those who purchase sex (see above).

In April 2010, an attempt was made to criminalise the purchase of sex but was rejected. A similar Bill was subsequently introduced by Trish Godman in 2011 but was also unsuccessful. A more recent attempt to introduce legislation in the Scottish Parliament in relation to prostitution include Rhoda Grant's Proposed Criminalisation of the Purchase of Sex (Scotland) Bill (2) . The draft proposal was lodged on 11 September 2012 for a Bill to make it an offence to purchase sex. The proposal was accompanied by a consultation document which received 953 responses in total but it did not receive cross-party support.

In September 2015, Jean Urquhart introduced a proposal for a Bill to decriminalise activities associated with the buying and selling of sexual services and to strengthen the laws against coercion in the sex industry ( Prostitution Law Reform (Scotland) Bill). This Bill aimed to reform and repeal existing laws which criminalise activities associated with sex work and to introduce more robust safeguards against coercion and exploitation. This has not been progressed.

Criminalisation

Although women were not imprisoned for soliciting (by the late 1990s) they could be imprisoned for failure to pay associated fines. 'Other crimes of indecency' constituted the only category in the crime statistics where more women than men were convicted ^[126] and according to the Ministerial Steering Group on Women's Offending (2002), 10% of women imprisoned for fine default in 2000 (59 out of 616) had been originally fined for soliciting.

In 2004, the Expert Group concluded that the current legislation (at that time) was unfair on the grounds that it was an example of inequality. In reviewing the options, the Expert group considered that soliciting and loitering offences should be repealed and exchanged with: " offensive behaviour or conduct arising from a prostitution related sexual transaction - whether caused by purchaser or seller" although the Scottish Government did not follow their recommendation. The Expert Group sought to address general concerns that penalties such as fines and custodial sentences have no rehabilitative function recognising that these disposals can often impact on work undertaken by other agencies.

Matthews and Easton (2010) note that evidence from police statistics suggested a decrease in the number of women being charged with prostitution offences in Glasgow over the last decade (from estimated 1100 in early 1990s to approximately 250 in 2009). This was also related to changes in the organisation of prostitution over this period in the city, with a move away from traditional areas within the city centre. As well as geographical diversification, there was also evidence that women were involved in prostitution during the day and night, however, only 13% of women accessing Base 75 between March and July 2010 (150 different women) were known to the police as being involved in street prostitution.

Over the same period, Strathclyde police charged a further 60 women with prostitution-related offences, all of whom were unknown to the main support services; this suggests that the number of women involved in street prostitution in Glasgow was higher than had been estimated. Notably, 28% of women accessing the Base 75 drop-in lived in other local authorities and a review of the 150 women known to Base 75 indicated that most had around four to five different agencies involved with them at any one time. Most agencies were unaware of the women's involvement in prostitution and in some cases, unaware of the role of other agencies in her support, suggesting a significant amount of duplication.

Whilst the number of prosecutions of persons involved in prostitution appears to have markedly decreased, the number of prosecutions is still higher than it is for those involved in the purchase of sex. In 2012-13, 127 charges were made under the Civic Government (Scotland) Act 1982 for loitering for the purposes of prostitution and 27 for soliciting; while 65 charges were prosecuted under the Prostitution (Public Places) (Scotland) Act for soliciting for the purposes of obtaining the services of a prostitute and 48 for loitering for the same purpose. ^[127]

Many respondents to various consultations on either the criminalisation of the purchase of sex and/or proposals for decriminalisation have clearly noted that they did not believe that individuals involved in prostitution should be criminalised. Sanders (2007) notes that leaving prostitution is hampered by involvement with the criminal justice system with non-payment of fines potentially increasing rates of imprisonment for women.

There are obvious tensions which characterise prostitution policy in relation to those involved in street prostitution, predominantly women, where their vulnerability is often highlighted yet who remain subject to ongoing criminalisation - despite the fact that all the evidence highlights that a criminal record is a formidable barrier to finding employment and a way out of prostitution. Carline and Scoular's (2015) analysis of the Engagement and Support Orders introduced in England and Wales highlight the underpinning problems of the 'enforcement plus support' model. Sanders (2007) also challenges the notion of 'compulsory rehabilitation' and current developments to manage street prostitution via emphasis on exiting implement through anti-social behaviour legislation mechanisms; a practice she refers to as 'public patriarchy' (2009).

The All-Party Parliamentary Group (2014) recommended removing soliciting offences that target women involved in prostitution from statute, dealing with persistent anti-social behaviour under ASB legislation and diverting women from the criminal justice system wherever possible while at the same time, increasing penalties for those controlling individuals in prostitution and at the same time, reviewing the law to prevent the prosecution of individuals independently selling sex on the same premises for the purpose of their safety.

'Demand'

While the number of individuals involved in prostitution is relatively unknown, the demand for prostitution is potentially unknowable. Recent figures on the purchase of sex were obtained by Fuller et al. (2015). Their study Natsal-3, estimated that 4% of men in Scotland have paid for sex. The figure for women was 0%. Although the sample used was fairly small (508 men and 643 women) the study used a random probability sample and is considered to be generally representative.

Evidence from a review of relevant research for the Home Office Review on tackling the demand for prostitution suggests that the arrest of the purchaser may be the single biggest deterrent to buying sex (see Wilcox et al, 2009). In Scotland, a study carried out by the Women's Support Project (2008) indicated that, based on interviews with 110 men (80% of whom had bought sex indoors, while 56% had bought sex outdoors), the five key deterrents to purchase of sex were: being added to the sex offender register (89%); spending time in jail (79%); increased criminal penalties (72%); having their car impounded (70%) and higher fines (69%). Although this was an exploratory study, it was strongly criticised by a number of academics, 18 of whom produced A Commentary on 'Challenging Men's Demand for Prostitution in Scotland collectively arguing that the study did not meet standards of academic rigour, nor was it grounded in empirical research ethics (see Sanders et al, 2008).

The Women's Support Project study did, however, reflect findings from other studies ( i.e. Farley et al, 2009) who interviewed 103 men in London who had bought sex, finding along with McKeganey and Barnard (1996); Coy, Horvath and Kelly (2007) that biological imperative or basic rights as consumers appeared to be at the root of the reasons given for purchasing sex. 96% of the men in Farley et al (2009) had bought sex indoors (in brothels, flats, saunas, massage parlours).

Matthews and Easton (2010) note that in recent years there has been a greater focus on male clients as culpable, while women are increasingly viewed as vulnerable and in need of support rather than punishment ( e.g. high numbers of problematic drug users, estimates that between 25-50% of women in street prostitution are homeless). Alongside this, research on male clients suggests that demand for prostitution is often opportunistic and that most male clients would be deterred by relatively low level sanctions.

One of the recommendations of the review conducted by Matthews and Easton (2010) was that "Greater emphasis needs to be placed on reducing 'demand' from male clients" (p6). Their final recommendation states: "The aim of removing street prostitution within three years is a realistic possibility if a concerted multi-pronged strategy is developed and this objective should be formally adopted by all the key agencies". (p6). The conclusions note that "If legislation is passed outlawing the purchase of sexual services street prostitution could be removed in an even shorter period of time" (p72). However, the Association of Police Chief Offices in Scotland ( ACPOS) have highlighted concerns about implementation.

'Exiting'

The extent to which 'exiting' prostitution is a difficult and lengthy process is debated (Hester and Westmarland, 2004). Cusick et al. (2011) highlight the challenges which characterise the exiting process, which they view as signifying a shift in emphasis that parallels the 'harm to health' change in drug policy focus; with prostitution strategies shifting from public health to an emphasis on exit. They note the emphasis placed by exiting programmes on addressing problematic drug use, high rates of which are reported among women involved in street prostitution, in contrast to lower levels of problematic drug use found amongst individuals involved in indoor prostitution. Their paper brings together findings from a 2002 Home Office funded study of sex work and drug use and a 2007 UK Network of Sex Work Projects review of specialist services for sex workers which examined 'exiting services' within projects. Their discussion highlights the complex variables of 'exiting' and the importance of adequate resourcing that is necessary to support individuals move out of prostitution.

Bindel et al (2012); and Matthews et al (2014), suggest that exiting prositution is a process which can be relatively easy, or facilitated by appropriate agency interventions. Sanders (2007) highlights that structural, political, cultural and legal factors are key to trapping women in prostitution. Policy and practice which does not address these wider structures is unlikely to make improvements to the lives of individuals involved in prostitution and can, on occasion, exacerbate existing problems. Matthews et al. (2014) argue that the necessary resources for making exiting prostitution more widely available should be provided (as does Cusick et al, 2011). They challenge scepticism about exiting put forward by Cusick et al (2011) who suggest that exiting is a lengthy and problematic process by countering this on the basis of their research which shows that many women are able to leave prostitution with a limited degree of formal support while others appear to exit unaided by formal agencies. Drug use, rather than being a key component for entry to prostitution may in fact increase as a result of involvement in prostitution. They also note that there is a tendency to overestimate the role of drugs in keeping women 'trapped' in prostitution. On the basis of their research, drug use is only one of a number of barriers to exiting.

Summary

Literature on Scotland is limited, much of it dated and focussed on street work. Limited information is available on indoor prostitution, however, that which exists suggests there is greater diversity amongst individuals involved (although women still constitute the vast majority). Obtaining estimates of numbers involved is challenging, especially in relation to indoor prostitution, and this has presented difficulties for policy and practice based on existing evidence which appears to rely considerably on data from street-based prostitution. Research on impacts has focussed predominantly on street work and associated problems and there is limited information on indoor prostitution. However, the literature highlights a range of risks and adverse impacts such as HIV and STI infection, vulnerability and multiple deprivation, links with drug use, and adverse impacts on wellbeing.

There is evidence of divergence in approaches across the four major Scottish cities which has emerged in response to specific concerns (such as drug use and HIV; concerns around safety and agency leadership). However, the challenges of identifying the extent and nature of prostitution are significant due to the absence of robust data and disagreement around appropriate responses, noted for example by the Equality and Human Rights Commission Scotland (2009) at their debate on prostitution in Scotland. While such debates and contested knowledges are evident across Scotland, they are also features of national inquiries such as the House of Commons Home Affairs Committee (2016) who examined a range of legislative approaches to prostitution but were unable to draw clear conclusions on the basis of available evidence; and international reviews (see the Evidence Assessment of the Impacts of the Criminalisation of the Purchase of Sex, 2016).

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