A sensitive approach can be a lifeline to women whose lives revolve around drugs and sex work, as DDN reports. Read the full article in November 2018 DDN ‘Without these guys I probably would be dead now.’ These are the words of a woman who accessed the SWOP drop-in at a stage in her life when she thought nothing would ever change. The Sex Worker Outreach Project (SWOP) was set up by the Nelson Trust specifically to help women who had become involved in street-based sex work to fund their addiction. The specialist programme grew from a knowledge base of working with some of the most disadvantaged, marginalised and stigmatised women in the community, and the realisation that intervention could be extremely successful in changing the lives of people who would not otherwise come into contact with services. ‘It can take a long time to gain a woman’s trust,’ says SWOP co-ordinator Katie Lewis. ‘Sometimes they have been through services many times before and their needs may not have been addressed appropriately.’ These needs can be extremely complex. Many of the women SWOP comes into contact with have experienced abuse, trauma and sexual exploitation before adulthood. For some, engaging in ‘transactional sex’ has become a practical way of affording accommodation and drugs. Many have families – and many have come to accept that living with a controlling and abusive partner is the norm. Unsurprisingly, women in this situation are highly unlikely to walk through the door of a daytime service – not just because the hours don’t suit them, but also because of the stigma they have experienced. So SWOP goes out onto the streets to try to engage women who are likely to be at risk, offering hot food and drinks, clothes, toiletries and the all-important emotional support. ‘We offer kindness and give women the safe space to be listened to.’ ‘We work extremely hard to engage women from a non-judgemental and trauma-informed approach,’ says Lewis. ‘We offer kindness and give women the safe space to be listened to.’ Offering support also involves encouraging the women to engage with other specialist support services, she explains, ‘and if it takes ten to 12 attempts for a woman to engage, we will continue to offer this support until she is ready to accept the help.’ Developing local partnerships has been central to the project’s effectiveness and SWOP works with police and probation, social care, child protection, housing and substance use treatment services, among many others. As SWOP co-ordinator, Lewis supports case workers to navigate complex conditions and chairs a monthly multi-agency forum, where all the partner agencies come together to discuss safeguarding and risks for the women, sharing information on how best to support them. It’s a sensitive process that needs to be mindful of clients’ confidentiality, but Lewis is careful to protect the ‘trusting and respectful relationships’ they have built up. ‘If they were to disclose any safeguarding or risk information, we would have an honest conversation about when information needs to be shared,’ she says. While it can take many attempts to engage with the women, through out-of-hours services, there is much to offer them in the safe spaces of the van in Swindon and Wiltshire or the drop-in centre at Gloucester. Both environments offer a place of respite and safety, and over food and hot drinks they have the opportunity to talk about the support they need. Some need protection from clients and stalkers; others need help with abusive relationships at home. Many need help with finding safer accommodation for themselves and their children, and there is often the need for help at different stages of the criminal justice system – from attending court to ‘through the gate’ support when leaving prison. At each stage SWOP encourages feedback, which helps the team adapt and grow their services. ‘We’re always consulting our women on how they want their services, and this may mean changing times of delivering outreach or providing more underwear,’ says Lewis. ‘We listen to our women and give them a voice.’ Improving the women’s health is a driving force of SWOP’s work and the approach is grounded in harm reduction. The network of partner agencies enables swift referral to treat sexually transmitted diseases, infections and HIV, and working with sexual health and homeless health teams helps with access to testing and healthcare. There are often mental health issues to address, particularly where distress has led to suicidal thoughts. Tackling clients’ addiction can be a gradual step-by-step process that needs support from different partner projects and agencies. SWOP has developed three specialist interventions for sex workers, each of them based on giving women a safe space to explore their feelings about sex work while providing emotional and practical support. At the harm minimisation end of the scale, the Pegasus Programme works through assertive outreach or prison inreach, night drop-ins and intensive key work with women who are actively sex working. The Griffin Programme offers drug and alcohol treatment at an abstinence-based residential treatment centre to women who are no longer actively sex working; while the Phoenix Programme gives aftercare to women who have been in recovery for over three years, but who still need support. All three programmes use shared experience and the concept of connectedness to reframe past trauma and explore the concept of choice for the future. The work is challenging in many different ways, particularly when it can take many attempts to make the first successful connection, but Lewis says it’s the women they help that keep the team motivated. ‘We work with some of the strongest women I have met, who face adversity and prejudice daily,’ she says. ‘They empower us to continue to support them to exit sex working – and when we see an outcome of supporting one of our women to rehab, we know our model works.’ Partnership of trust: Rachel’s story After a year of Rachel’s engagement with her key worker and partner agencies, she was able to exit sex work and is now in recovery. Rachel (not her real name) was street sex working most nights to fund her addiction when she was encouraged to engage with SWOP by other women who had accessed the service. She was very anxious about getting involved, but she was experiencing housing problems and had been a victim of domestic abuse. Because of her anxiety and feeling ‘very closed up’ she would sporadically engage by accessing evening drop-in services only. She mentioned she wanted to exit sex working and quit drugs, so SWOP offered her support and encouragement to leave sex work and access treatment for her addiction. After building a trusting and safe relationship with her key worker, Rachel was supported to access a script through the drug and alcohol service and reduced the frequency of her drug use and sex working. She was also now accessing the Nelson Trust Women’s Centre in the daytime, where she attended the Pegasus intervention. Following regular intensive key worker sessions, Rachel hadn’t taken drugs for three months and hadn’t sex worked in more than four months. This enabled her to focus on her housing situation and pay off all her rent arrears by accessing benefits and learning to budget. SWOP supported her to access safe housing through a local housing provider. After a year of Rachel’s engagement with her key worker and partner agencies, she was able to exit sex work and is now in recovery. She has resettled into recovery accommodation for women only and finds she is ‘at peace’ there. She has found the courage to reconnect with her mum – something she longed for. There have been many ups and downs but her relationship with her key worker helped her keep her strength and determination. Rachel’s hope for her future is that she will be able to peer mentor women who want to exit sex work.