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Despite the health problems, many women worked for a long time in the sex industry and remained when other choices presented themselves, such as those associated with completing vocational training or higher education. The sponsors had no role in the de, collection, analysis or interpretation of the data.

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However, it is clear that prejudice towards the sale of sex and legal penalties marginalised sex workers both during and after their time in the industry, and the majority of respondents attributed their symptoms to this burden of disrespect and the difficulties they faced in hiding what they did.

In other words, sex work is not simply a form of social exclusion but a conduit to social mobility and opportunities such as home ownership and a family wage. This study is limited by sampling and follow up bias. We did not consult official mortality reports, as we had not obtained specific consent for this record united kingdom prostitute phone number. We have shown that in this cohort, many women worked for a long time in the sex industry and were highly mobile within it.

Women also combined jobs within the sex industry with work, education, and training outside. Bias because of loss to follow up was explored by comparing baseline characteristics of those who were followed up with those who were lost.

Some women combined this with other work see text for details. We analysed occupational mobility within and outside the sex industry. While the short term impact of sex work on health has been studied extensively in recent decades, 456 prompted by concerns about the risks of HIV, little is known about the longer term impact. Mortality data are based on reports from other sex workers or family members.

For the purposes of this paper we refer to an initial cohort of women recruited between and who were interviewed at least twice and consented to ongoing research. Sex work is conventionally considered a highly segmented industry, with vulnerable street workers at the bottom and call girls at the top.

We have detailed information on nine women who undertook undergraduate education, two of whom subsequently left sex work, a further eight who studied at postgraduate level, four of united kingdom prostitute phone number left sex work. However, on completing training, many women stayed in the industry. We established a cohort of sex workers in London between and Detailed methods, baseline findings, and initial follow up data have been reported elsewhere.

The women followed up are not representative of sex workers in general or even the baseline cohort. There were no ificant differences in other demographic characteristics, family, or health status. For 28 of the remaining 70, information was obtained from a third party another sex united kingdom prostitute phone number or relativeand for 42 it was obtained from clinic or project records.

Questionnaire data were coded and stored electronically and analysis was carried out using SPSS. There were six deaths, a mortality of 4. Sex work has been seen as a problem: a threat to public health, public order, decency, the formal economy, the integrity of borders, and women's rights.

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The combined follow up time for these women was years mean 9. In common with others, we have conducted short term studies and found that sex workers in the United Kingdom face increased risks of HIV and other sexually transmitted diseases and blood borne viruses.

The mortality documented in this paper is lower than ly found, but is still higher than expected for women in this age group. Therefore, these negative factors have to be assessed against the positive benefits to women's health and wellbeing.

The relation between these health problems and sex work is complex, and despite the longitudinal nature of this study, we are not able to determine causation. Unfortunately there is little evidence to support such policies. A range of other chronic health problems were reported by 97 women, including gynaecological 36 womenmusculoskeletal 10and cardiovascular 6. Most policy debates share the premise that the sex industry is harmful to participants; its workers are considered to be socially excluded and vulnerable.

Both authors drafted, reviewed, and revised the manuscript and have approved the final version. In addition to the high mortality, there were ificant health problems including a high cumulative risk of STI, mental health problems, and addiction. Looking specifically at 28 women who first worked on the streets, 16 were introduced by women, five by men, two were coerced, two were solicited, and three entered without introduction.

Outcome data were collected using a structured questionnaire, or through completion of a data collection form from third party information. United kingdom prostitute phone number women were contacted directly, 47 of whom were interviewed, and 13 took part in more informal discussions.

In addition, data were missing on some variables. Sex work has been seen as both a health and a social problem.

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Past gonorrhoea was associated with pelvic inflammatory disease RR 2. None the less, this study constitutes the only long term prospective study of its kind and challenges prevalent assumptions that sex work is necessarily a transient occupation, which is highly stratified, and intensifies social exclusion.

The different methods of collecting the data have led to missing values in a of variables as indicated by the varying denominators. Seventy seven women described the circumstances in which they started selling sex.

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Others were contacted at their last known address united kingdom prostitute phone number phone. In this study, sex work was a choice for the majority who were followed up, and for many a route out of poverty rather than a vicious circle of social exclusion.

Women often combined jobs. Alcohol consumption appeared to be high, although we only obtained detailed reports from 33 women completing an extended interview; 18 scored one or more on the CAGE scale for problem alcohol use, 15 of whom described themselves as having an alcohol problem. This belief underpins recent policy changes in the United Kingdom.

Those who were still attending the sexual health clinic or local sex worker service were approached directly. In particular we would like to thank Kate Cooper and Anna Green for data collection in the follow up phase of this study, and the staff of the Praed Street Project and the Jefferiss Wing United kingdom prostitute phone number. Health issues were validated where possible by clinical records, and participants were invited to another sexual health check.

Fifty seven were selling sex, and they had done so for between 4. Vital status, most recent occupation, duration of sex work, sexually transmitted infections STImajor health problems. Given the new possibilities offered by higher education and vocational training, sex work must therefore be considered a positive choice, preferable to alternatives. This hierarchy dissolves when women's lives are looked at over time.

Six of the women had died: four deaths have been reported in an earlier paper, 7 including two with AIDS and two who were murdered.

The second most common was to go straight into the sex industry and remain there. Viral infections, associated with sexual exposure or drug use, can also lead to chronic problems ranging from problematic genital herpes to liver failure. Of the women who were no longer working in the sex industry, we only have detailed information for 12 women, 11 of whom had other jobs. There were no ificant differences in health outcomes between women who were still in the sex industry and those who had stopped.

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The most ificant problems related to mental ill health and substance misuse. We would like to thank all the participants, and to the many collaborators who have contributed to this work over the years. None of the surviving women had HIV infection 98 were tested at follow up. However, there is a paucity of evidence on the longer term impact on health.

We used four for analysis based on the local industry: street, escort which includes working for a madam and privatelysauna sex work businesses including clubsand flat sex work businesses where women tend to work on their own. When these attempts failed, we established simple outcome measures through a review of case notes or information volunteered by other participants.

Alcohol misuse was defined for interviewees using the CAGE scoring system. Seven united kingdom prostitute phone number the nine women completing vocational training left sex work. We were unable to control for these because of the relatively small s followed up, and limited baseline information on chronic health problems.

Outcome data were obtained through interview, clinic records, or third parties. We have further details for 51 women still working in the sex industry: 21 combined sex work with other jobs, five with education, 25 united kingdom prostitute phone number only in the sex industry. We recorded outcome data from onwards. Multiple factors predispose sex workers in general to chronic ill health, including poverty and poor education. Health outcomes were collected through the use of precoded interview questions, including specific questions on sexually transmitted infections STIself defined addiction and mental health problems, as well as open questions.

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Governments may sponsor training schemes for sex workers, but as we have shown women may well train but then combine new skills with sex work in order to retain the economic advantage and flexibility that the occupation can offer. The highest mobility was in women who first worked on the streets. While it was not possible to establish whether the study was strictly representative of the local sex industry, methods of recruitment were as inclusive as possible including women attending the clinic, their colleagues and friends, plus direct recruitment through outreach to local streets, escort agencies, flats, and saunas.

Sex work is associated with excess mortality and united kingdom prostitute phone number including the sequelae of STI, mental health problems, and substance misuse. Women provided informed consent. Five women cited recurrent genital herpes as a ificant health problem at follow up. Both authors contributed to the initial concept and de, data collection and analysis of this study. The relation between these health problems and sex work is complex.

Sex work is associated with excess mortality and morbidity.

Research participants reported that sex work created the opportunities for such initiatives qualitative data not shown. Those followed up varied in baseline characteristics and had been ificantly older, had been working in the sex industry for longer, and were more likely to work privately or on the streets than those who were lost.

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