The health and welfare needs of female and transgender street sex workers in New South Wales

Objectives: To determine the health and welfare status of female and transg ender street sex workers and their work-related experiences. Also to estima te population numbers, determine work locations, and identify the most appr opriate education, health and welfare services for this group. Methods: Forty-eight street sex workers completed a questionnaire, mainly a t their place of work. Demographic and sexual health profiles of sex worker s attending the Sydney Sexual Health Centre and the Kirketon Road Centre in 1997 were compared with the street sample. Results: Up to 120 female and transgender sex workers worked on the streets in Sydney, Newcastle, Wollongong and surrounding areas in any one night: m ore than 80% of these were female. Of those sampled, fewer street workers t han brothel sex workers (6% vs. 41%; p<0.001) were from non-English speakin g backgrounds, and mote (77% vs. 7%; p<0.0001) were currently injecting dru gs. The street workers reported fewer rates of condom use at work than loca l brothel workers (91.7% vs. 98.8%; p<0.016) and high rates of hepatitis B and C infection. Seventy-five per cent had experienced violence at work. Ch ild care, lack of supportive relationships, community intolerance and low s elf-esteem were important problems for the street workers. While the police were frequently required by the community to move the street workers on, t here were no reports of corrupt behaviour by police. Conclusions: Health services need to specitically target this group with pa rticular attention to the prevention of blood-borne virus infections. contr aception. drug dependency and transgender issues. Consideration should be g iven to developing a network of safe houses to reduce community pressure an d violence.