When women involved in prostitution experience multiple and intersecting needs, they may face barriers in accessing help and support. These barriers can include geographical location and opening hours of agencies, limited childcare support, and a lack of female-only provision. As a result, women are frequently disadvantaged, and their personal safety put at risk, as they become increasingly vulnerable to exploitation, particularly if they do not have access to secure accommodation. This research project seeks to understand the choices and decisions women make when they engage with helping services. The findings report on an in-depth qualitative study with 11 women involved in, or at risk of involvement in, prostitution. The women attended a third sector drop-in centre in an English city. Semi-structured interviews were used to understand the experiences that led participants to seek support and what they liked or did not like about helping services. Interviews were transcribed and analysed using Bacchi’s (1999) ‘What is the problem?’ approach in order to understand how women framed their experiences, as well as how they negotiated service provision. Women’s decisions to use services were shaped by a number of factors, including knowledge, availability, suitability, and assessment of caregivers’ behaviour. The way caregivers behaved was important in determining whether they could be trusted. A dissonance emerged between the framing of women’s needs by policy and services, and women’s lived experiences. This mismatch led to a complex network of support services that were both difficult for women to access and often failed to meet their needs. It is vital that social care services and training providers pay attention to the interactions between caregivers and women seeking help and support. A model is presented to reflect the decisions and choices made by women when seeking help and support, and the associated responses required by policy, service commissioners and providers.