Abstract
BackgroundBuilding on a broader sociological discourse around policing approaches towards vulnerable populations, increasing public health and human rights evidence points to policing practices as a key health determinant, particularly among street-based sex workers. Despite the importance of policing as a structural health determinant, few studies have sought to understand the factors that underlie and shape harmful policing practices towards sex workers. This study therefore aimed to explore the drivers for policing attitudes and practices towards street-based cisgender female sex workers.MethodsDrawing on ethnographic methods, 280 h of observations with police patrol and 10 stakeholder interviews with senior police leadership in Baltimore City, USA were carried out to better understand the drivers for policing strategies towards cisgender female sex workers. Analysis was data- and theory-driven, drawing on the concepts of police culture and complementary criminological and sociological literature that aided exploration of the influence of the ecological and structural environment on policing practices.ResultsEcological factors at the structural (e.g., criminalization), organizational (e.g., violent crime control), community and individual level (e.g., stigmatizing attitudes) emerged as key to shaping individual police practices and attitudes towards cisgender female sex workers in this setting. Findings indicate senior police support for increased alignment with public health and human rights goals. However, the study highlights that interventions need to move beyond individual officer training and address the broader structural and organizational setting in which harmful police practices towards sex work operate.ConclusionsA more in-depth understanding of the circumstances that drive law enforcement approaches to street-based sex work is critical to the collaborative design of interventions with police in different settings. In considering public health-police partnerships to address the rights and health of sex worker populations in the U.S. and elsewhere, this study supports existing calls for decriminalization of sex work, supported by institutional and policy reforms, neighborhood-level dialogues that shift the cultural landscape around sex work within both the police and larger community, and innovative individual-level police trainings.
Highlights
Building on a broader sociological discourse around policing approaches towards vulnerable populations, increasing public health and human rights evidence points to policing practices as a key health determinant, among street-based sex workers
The discussion addresses the implications of this study for intervention and policy development to drive forward a public health and human rights centric policing of sex work
In conclusion, much can already be garnered from current public health and human rights literature on the types of police practices that compromise female sex workers (FSW)’ health and safety, as it relates to HIV and violence
Summary
Building on a broader sociological discourse around policing approaches towards vulnerable populations, increasing public health and human rights evidence points to policing practices as a key health determinant, among street-based sex workers. Extensive criminological and sociological literature has explored the role of policing in the social control of urban spaces and the communities within them (e.g., homeless persons, black youth, people who use drugs) [7,8,9,10]. These works have included an examination of how policing drives socio-economic exclusion and ‘system avoidance’ whereby marginalized groups fail to access healthcare and other forms of social support that make up fundamental social rights [11]. Criminalization and police enforcement of sex work has increasingly been associated with negative healthrelated outcomes and human rights abuses among FSW including, increased risk of experiencing different forms of violence and sexually transmitted diseases [13]
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