Advances in Applied Sociology
2012. Vol.2, No.1, 81-88
Published Online March 2012 in SciRes (http://www.SciRP.org/journal/aasoci) http://dx.doi.org/10.4236/aasoci.2012.21011
Copyright © 2012 SciRes. 81
Knowledge Mapping & Working with Difficult to Reach Groups:
Sex Work Knowledge in the City
Christopher Ha rt w ort h1, Joanne Hartworth1, Ian Convery2
1Barefoot Research & Evaluation, Newcastle upon Tyne, UK
2University of Cumbria, Penrith, UK
Received January 14th, 2012; revised Feb ruary 16th, 2012; accepted Feb r u ary 28th, 2012
This paper considers the lessons learned from researching sex markets in Northumberland and Tyne and
Wear, UK. It is based on a knowledge mapping approach, working with professionals in local authorities,
charities and the police involved with sex markets in the Northumbria Police Area. The research identi-
fied that the visible sex market in the area was part of a much bigger exchange system. A number of im-
portant themes emerged from the findings and strong links were found between sex work and issues such
as drug misuse, mental and physical health and the use of services. A key theme was that many sex work-
ers suffered economic, housing, health, social and physical vulnerabilities. These themes have implica-
tions for local statutory and voluntary services. However, despite increasing calls for more open public
debate on sex work and prostitution, our experience is that this remains a complex and restricted research
area in the UK. The knowledge mapping approach detailed in this paper represents an important step in
furthering the debate.
Keywords: Knowledge Mapping; Sex Markets; Prostitution
Introduction: Researching Sex Markets
Before any service provision decisions are made regarding
sex workers, a detailed mapping of the local situation should be
undertaken to establish what type of sex market there is. How-
ever, researching sex markets is difficult. The researcher may
face hostile and volatile envir onments, unsociable working hour s
and the need for a wide range of research skills including nego-
tiation, conflict manage ment and being able to ‘k eep quiet’ when
necessary (Sanders, 2005). It is doubly difficult when the po-
pulation is unknown (Pyett, 1998) and participant lifestyles are
chaotic and, of necessity, hidden (Mosedale, 2009).
As Cusick et al. (2009) note, it is very difficult to establish a
firm estimate of the UK sex working population1. Part of the
reason for this relates to a muddled legal system. In the UK
there have been recent debates about reforming existing prosti-
tution laws (Home Office, 2006) and some discussion regarding
moving towards a “tolerance zone system” (Howell et al., 2008;
Hubbard et al., 2008; McKeganey, 2006; West, 2000). The
present situation is paradoxical, for whilst prostitution is not
illegal, street walking, curb crawling and brothels are illegal,
thus it is impossible for sex workers to sell sex without break-
ing a number of laws (Hubbard, 2004). Moreover, whilst pros-
titution may not be illegal, a range of legislation and measures
(such as The Sexual Offences Act 2003; Policing and Crime
Bill 2009; AntiSocial Behavior Orders and Acceptable Behav-
ior Contracts) makes providing sex in exchange for money
difficult and dangerous (West, 2000; Sanders, 2004, 2005; Hub-
Writing in The Guardian newspaper, Rothschild (2009) ar-
gues that much of the debate around the sex industry in the UK
is infused with moral panic and states that when women are
presented as victims, they elicit sympathy; but when they assert
their agency, they are viewed as a threat to the moral fabric.
Yet sex markets are also an important sector within the black
economy (Sanders, 2008; Moffat & Peters, 2004). Ward et al.
(2005) indicate that approxi mately one in ten men (aged 16 - 44)
in Britain have paid for sex, and an earlier study by Coyle
(2001) estimated that prostitution in the UK was worth around
£770 m a year, which at the time equated to 13% of gross do-
mestic product, or about one pound in every eight, and lost tax
revenues of some £250 m (if legalized). As a comparison, De
Speigel newspaper (2011) reports how Bonn has become the
first city in Germany to introduce meters for sex workers as a
means of extending a general tax on prostitution beyond broth-
els to the city streets. The meters were installed in an industrial
area near the center of town used by freelance sex workers to
solicit clients, with each sex worker paying €6 per night worked,
regardless of how many customers they have. Those repeatedly
caught without a ticket they can be fined. Bonn authorities es-
timated that the prostitution tax (including meter payments)
would bring in €300,000 in 2011.
A range of methodologies have been used to investigate sex
workers1 (Cusick et al., 2009). These including observations
and interviews (Pasco, 2002; Port & Bonilla, 2000), question-
naires (Belis et al., 2007), autobiographical narratives (An-
nadale, 2005; Efthimiou-Mordant, 2002; Landale, 2005), dia-
ries (Gysels et al., 2002), unstructured interviews (Mosedale,
2009), semi-structured interviews (McKeganey, 2006) and eth-
nographic approaches (Sanders, 2005, 2006). In particular, the
1We use sex worker and sex work as general headings and they include the
range of different types of sex worker. By sex work we refer to male and
female workers who perform a sexual act in exchange for a commodity, for
example drugs, money, alcohol, status, goods, accommodation. After Cam-
eron (2004), we use the term market to signify that something is being
ought and sold. We recognize, however, that there is much debate and
controversy about the naming of those involved in sex markets.
C. HARTWORTH ET AL.
ethnographic approach has almost become the de rigueur for
research into sex work and encourages researchers to immerse
themselves in the sub-cultural world of the sex industry, to
observe, to get close to those involved, and sometimes to par-
ticipate (Wahab, 2003).
All these approaches are potentially useful and valid, but
they are also often time consuming and expensive and may not
fit the needs of voluntary or statutory service review or evalua-
tion, which often require a rapid appraisal approach. Moreover,
many researchers outside academic institutions and statutory
agencies (for example, researchers working for voluntary sector
organizations or small consultancy groups) simply do not have
the resources to meet the often complex and time-consuming
requirements associated with sex market fieldwork, where for-
mal ethical clearance, risk assessment and consent require
careful consideration and scrutiny by formal panels. We are not
arguing against such requirements (indeed, if ever a research
arena required careful ethical consideration and risk assessment
it is sex work), but rather that an unfortunate consequence of
what might be termed “academic formality” is often to limit
rather than enable public debate on sex work as discourse tends
to be restricted and knowledge hegemonic. This, we would
argue, ultimately helps keep sex markets hidden, and contrib-
utes to the lack of service provision and policy development.
By compareson knowledge mapping can provide a quick, ac-
curate and inexpensive overview of sex markets and informa-
tion gathered in this way can be triangulated with data from
other sources to inform areas such as service development and
the commissioning of longitudinal research.
As McKeganey (2006) notes, despite a recent interest in
prostitution research we know less than we might wish about
sex workers in the UK. Our research, which was funded by the
Northern Rock Foundation, was developed to investigate the
extent, nature and characteristics of the sex market and sexual
exploitation in Northumberland and Tyne and Wear (Figure 1
and Table 1) where such markets are not openly visible. Our
emphasis in this paper is not the social theory of sex work but
rather an applied sociological approach (knowledge mapping),
which we believe has great potential for sociological research
with hard to reach populations. Whilst our focus is methodo-
logical, we also report some of the main findings from our
study, cross-referenced with the findings from a peer-led pro-
ject (Voices Heard, 2007) conducted at the same time as our
research2 to “validate” our approach.
Previous research by the authors (Hartworth et al., 1998)
identified a thriving (though small) market of independent sex
workers trading through local papers and adult contact maga-
zines in Northumberland and Tyne & Wear, UK (Figure 1
indicates the study area and Table 1 discusses study area char
Map of study area.
Characteristics of the study area.
Population of almost 190,500 and borders the river
Tyne at its northern edge. The 2004 Index of Multiple
Deprivation (IMD, 2004) ranks Gateshead as the 26th
most deprived district in England (out of a total of
354) and almost half the population live in the top 20
most d epriv ed are as.
Regional capital, with a population of 270,000 (with
an additional 90,000 people commuting to the city
each d ay Ne w cas tle i s r ank ed as th e 2 0t h mo st
deprived district in Engl and.
Consisting of several town centers with a population
of around 190,000. It has b een asso ciated in th e past
with seaside tourismand heavy industry. However,
these have de clined ov er the l ast 30 years and th e
district is undergoing a slow regeneration. It is the
80th most deprived district in England and Wales.
One of the largest counties in England. It is a
predominantly rural area. Although the county has
a population of 310,000, no urban area within its
boundaries has more than 35 ,000 people. As an
average across the local authorities within
Northumberland it carries a score of 138th most
deprived district in Engl and.
The smallest district in the study area, covering just
64 km2, with a population of around 150,000. Similar
to North Tyneside, its history is dominated by heavy
industry, particularly in shipbu ilding;coal mining and
engin e erin g an d also s i mil ar l y, th es e ha v e
significantly declined since the 1980s to leave large
pockets of deprivation. South Tyneside is the 27th
most deprived distri ct in England and 60 % of th e
population live in ward ranked in the 25 percent
most deprived in England.
Sunderland has a population of 280,000 and is the
22nd most deprived distri ct in th e countr y with 46 % o f
the population living in the 20% most deprived areas
in England. Much of the deprivation has its origins in
the decline in heavy industry, particularly
shipbuilding, coal-mining and glass-making.
2The Voices Heard project (2007), which including ex-sex workers and
ex-problematic drug users as researchers, employed a ‘privileged access’
approach (Griffiths et al, 2006) to investigate sex markets and explore issues
relating to accommodation, criminality, drug use, health, survival and vio-
lence. This peer-led approach to researching sex markets had been used
successfully in other areas (Pyett, 1998; Elmore-Meegan et al., 2004). In
Australi a, Pyett trai ned sex wor kers as res earchers and found th at using th is
method, the overwhelming majority of workers were supportive and that
refusal to participate was rare (Pyett, 1998:12). In a study of sex workers in
Kenya, Elmore-Meegan et al. (2004) recruited peer interviewers to increase
a sense of ownership of the research by both interviewers and participants,
and to ensure that the interviews were carried out in as nonjudgmental a way
as possible. They also found that as interviewers were familiar with sex
work, they were less likely to accept implausible answers without attempt-
ing to get clarificati on ( see also Boynton, 2002).
Copyright © 2012 SciRes.
C. HARTWORTH ET AL.
acteristics). Yet knowledge and access to these sex markets is
limited, and effectively remains “hidden” to many professionals
in the public and voluntary sectors. By which we mean that
despite evidence that such markets exist, the lack of a “knowl-
edge network” leads to limited sharing of information and ex-
pertise between sectors and agencies, which in turn allows the
extent of the sex market to remain largely concealed. Below we
provide a narrative about the development of a methodology
that responded to these issues.
Our involvement with sex market research in the study area
dates back to 2005, when Safe Newcastle (the local Crime and
Disorder Reduction Partnership) began the implementation of
their three-year community safety strategy. Safe Newcastle com-
missioned Barefoot Research and Evaluation to consult with a
range of community and interest groups, local residents and
frontline agencies about community safety and the Crime and
Disorder Reduction Partnerships (CDRPs) response.
This exercise was intended to inform the service response
and measure the impact of the strategy from a “user’s perspec-
tive”. During this earlier research, the issue of sex markets and
prostitution was increasingly mentioned by a series of different
and unconnected organizations and individuals. However, little
was collectively known and what was known was attributed to
anecdote and rumor. A knowledge mapping approach is sug-
gested by the UK Home Office (2006: p. 14) Coordinated Pros-
titution Strategy, which stated that local partnerships take the
following actions to tackle prostitution:
Where prostitution is an issue locally… A first step will
be to map the nature and extent of the issues locally and to
develop an understanding of the complexity of the impact
of prostitution, and then consider ways to address it.
Indeed, one of the primary functions of CDRPs is informa-
tion exchange, and as Creech & Willard (2001: p. 19) note,
there has been an increasing interest in the value of knowledge
network models over the last 10 years or so as a means of ena-
bling statutory, non-statutory and private sector partnerships,
where the whole is greater than the sum of the parts. They de-
fine knowledge networks as agencies “working together on a
common concern, to strengthen each other’s research and com-
munications capacity, to share knowledge bases and develop
solutions that meet the needs of target [groups]” By bringing
together “knowledge nodes” across a range of statutory and
nonstatutory agencies it was hoped that a knowledge network
of sex markets in the region would emerge.
Devising the Metho dology
Developing a methodology for this study was initially prob-
lematic. We realized early on that recruiting sex workers for the
study would be difficult as the visible sex market in the study
area was geographically dispersed and hard to access. There
was also only one small drop-in service for sex workers in a
church in Newcastle (started in 2006) where relationships were
being built up between the service and a small group of women.
This meant that an obvious route to gain access to sex workers
via support services was not available (Melrose, 2002; Sanders,
2005). Moreover, the primary researcher was male, and as
Hubbard (1999: p. 231) reflects, it is often difficult for a man to
investigate femal e sex work without it “becoming any thing more
than a masculine attempt to appropriate the feminine ‘other’”.
With this in mind, we decided to create two parts to the study:
phase I, a short knowledge mapping exercise to scope the re-
search task, based on interviews with professionals and practi-
tioners (from a range of agencies) likely to have contact with
sex workers; phase II, direct interviews with sex workers.
For the knowledge mapping phase we interviewed 150 pro-
fessional/practitioner respondents face to face and 50 by tele-
phone. They came from a range of statutory and voluntary and
community sector agencies, including: sexual health services
(for example, Genito Urinary Medicine (GUM) clinics and con-
traception services); child protection nurses; teenage pregnancy
services; children’s services; Social Services; drug support
agencies, including harm reduction and treatment services;
asylum seeker and refugee services; youth and community ser-
vices, including outreach housing and accommodation provid-
ers; services for sex workers; serv ices for lesbian, gay, bisexual
and transgendered people; services for victims of rape; central
government representatives; Crime and Disorder Reduction
Partnerships (CDRPs); Local Safeguarding Children Boards
(LSCBs) and Northumbria Police. Respondents were asked a
series of questions about their knowledge of the extent, charac-
teristics and magnitude of the sex market and we only counted
sex workers when the respondent had direct experience of
working with that person.
We asked professionals a series of questions about their
knowledge of the extent, characteristics and magnitude of the
sex market. They were asked how many people they were
aware of who were involved in sex work, what type of sex
work that was and how they knew this. We only counted sex
workers when the professional had direct experience of work-
ing with that person. We used a consistent line of questioning
to arrive at the data presented in this study. The questions we
1) Do you have any knowledge of what type of sex work
goes on in the area?
2) In the last year, do you know of any of your clients or
service users that have exchanged sex for resources (mo-
ney, drugs, alcohol, accommodation, etc.)?
3) How do you know this (have they told you) or do you
suspect (and why do you suspect)?
4) Do you know how or why they became involved?
5) Are you aware of any travelling for sex work/sexual ex-
6) Do you provide any services to sex workers? Is this any
different to you routine services?
7) Do you know of anyone who provides services to sex
8) Do you know the needs of sex workers in the area?
9) Do you have any concerns in relation to sex work in the
The research used “snowballing techniques”, i.e. asking pro-
fessionals who else they thought we should talk to, and in this
way we covered the majority of relevant people. Snowball
sampling is particularly effective in locating members of hard
to reach populations where the focus of the study is on a sensi-
tive issue (Hendricks & Blanken, 1992). We had confidence
with this approach as, towards the end of the research in each
area, we reached “saturation” where people were mentioning
the same set of names so we felt we had covered the most rele-
vant agencies. Many professionals were also approached both
on the telephone and in person who had no knowledge of sex-
ual exploitation or sex markets and essentially proved to be
Copyright © 2012 SciRes. 83
C. HARTWORTH ET AL.
“blind alleys”. To those we interviewed, we guaranteed confi-
dentiality and anonymity. If we had not done this, we would not
have been able to collect the quality and level of data that we
were able to. We have only gathered information on the extent
of sex work, not the outcomes (i.e. what has happened to the
person identified). We did ensure that every individual, par-
ticularly under 18 year olds, were known to the relevant ser-
vices (the Police or Children’s or Adult Services).
Data were analyzed using the grounded theory—constant
comparison method, where each item is compared with the rest
of the data to establish and refine analytical categories (Pope et
al., 2000). Themes emerged within individual interviews and
across different interviews. Recurring themes across transcripts
were taken to reflect shared understandings of the participants
(Smith and Marshall, 2007).
Developing the Me thodology
The first question we asked respondents was always “what
type of sex work takes place in the area?” A common response
to this question was “there’s no sex work, no street prostitution
around here… it’s not like Middlesbrough3 [a city in the North
East of England with highly visible sex markets]”.
We then clarified what we meant by sex work (any sexual act
exchanged for a commodity, for example drugs, money, alcohol,
status, goods, accommodation) and in the discussion that fol-
lowed this usually resulted in a realization amongst the profes-
sionals that, yes, they were aware of particular clients who may
have exchanged sex for somewhere to stay or for drugs. We
then asked, “amongst your client group in the last year, how
many people can you think of that engaged in such work?” A
respondent from harm reduction service (SM63), for example,
noted that “yes, I can think of at least three clients who I know
of, and another three who I strongly suspect were, because they
were picking up more condoms than you would use every two
weeks, or their boyfriends were”. Data obtained were triangu-
lated through interviews with other agencies involved with
similar client groups both within and outside the areas. This
helped us to verify findings and minimize double counting4.
After several interviews it became apparent that we would
have to broaden our definition of sex work to include the sexual
exploitation of children, as many agencies reported knowledge
of under 18 year olds being involved in prostitution. Yet as one
professional (SM67) told us “I don’t think it’s taken seriously
by professionals… it’s the 16 to 18 year olds who are the prob-
lem… the professionals think that once they’re older they bring
it on themselves… two weeks after X was raped, she couldn’t
walk very well, she was showing me a Playboy thong that she’d
bought to go out in… she’s not making good decisions”.
We use the term sexual exploitation5 as the 2003 Sexual Of-
fences Act stipulates that people under 18 are victims not per-
petrators, i.e. they are treated as being sexually exploited rather
than selling sex. Similar to our definition of sex work, we de-
cided the sexual exploitation of children includes cases where a
young person (between 13 and 18 years old) exchanged sex for
money with an adult. It must be noted that all those children we
did identify were already known to the Police, social services or
LSCBs in the areas.
Sex Markets in Northumberland and Tyne & Wear
The summary findings of our knowledge mapping research
are presented below. We then go on to triangulate these find-
ings within the context of the Voices Heard research discussed
earlier. We do this in order to demonstrate the validity and re-
liability of our findings viz-a-viz researching sex work with a
knowledge mapping approach.
Sex work in the UK is a varied and diverse area, but similar
to other studies of UK sex market characteristics (Hunter et al,
2004) our research indicates a broad typology of sex markets: a
high section, which includes workers attached to certain agen-
cies or independent workers who charge relatively high fees for
their services. A middle section, which includes independent
workers, those attached to escort agencies (“out call”) and those
working in brothels (“in-call”). People working in this section
of the market can be “career” sex workers, or many simply drift
in and out of it over considerable periods of time (when they
need the cash). This multinational group make up the majority
of sex workers in the area.
The low section includes problematic drug users, failed asy-
lum seekers and those working on the streets and in crack
houses. These groups are extremely vulnerable and have vary-
ing degrees of involvement in sex work, from full time to occa-
sional. This section is characterized by “survival sex work”,
which we define as the practice of exchanging sex not only for
money but also for a range of essential resources such as ac-
commodation, drugs, food, laundry and tobacco (see Voice
Heard, 2007; Hartworth, 2009). A respondent working for
Northumbria Police (SM09) had this to say about this group:
“All sex workers can fall foul of ‘dodgy punters’ but it is
the girls that make up this section that are at most risk.
These girls operate on a local basis, occasionally working
on the streets or exchanging sex for a roof over their
3Middlesbrough has a reputation as the North-East’s prostitution capital.
According to Strange (2005) Prostitution in Middlesbrough goes back many
years. Although the town’s heavy industry dwindled prostitutes continued to
work in t he tradi tional areas n ear to th e old dock area on th e north fringe o
the town. During the early to mid 90’s the prostitution scene in Middles-
brough changed considerably. The numbers involved in prostitution in-
creased su bs tant ial ly to an est imated 250 s ex wor kers , a ri se whi ch ap
to coincide with increased availability of heroin locally (Middles
one of the lowest street heroin prices in the country).
4With a drug treatment service (SM25, SM26, SM27), for example, we
asked how many of the clients who they knew or strongly suspected o
engaging in sex work, how many of these would be likely to access harm
reduction services or any other services.
5We are aware of t he disco u rs e t h at suggests th at al l p ro stitutes ar e ex
thus ignoring the fact that, as Hubbard (2004) argues, many work interped-
on their own terms.
As stated, however, this is a broad categorization, and the re-
ality is likely to be more fluid and dynamic. For example,
SM20, a project manager for a sex worker support project in
Newcastle noted that:
“There are different layers to the sex industry in Tyne and
Wear. Some may work independently or for escort agen-
cies and charge high fees for their services. This group’s
involvement in sex work is unlikely to relate to social ex-
clusion factors. Others may be involved in what could be
described as survival sex and their involvement in sex
work relates directly to homelessness, drug and alcohol
dependency, failed asylum claims, etc… In my experience,
Copyright © 2012 SciRes.
C. HARTWORTH ET AL.
there are not three distinct strands but there is one extreme
to the other with everything in between.”
Similar to sex market typology, it is very difficult to quantify
the sex working population (Cusick et al., 2009; Hunter et al.,
2004). Our research indicates that approximately 1000 people
across the study area are involved in sex work to some degree
at any one time. This can be contrasted with estimates of be-
tween 48,000 to 80,000 sex workers in the UK.
We found that the Internet was a common medium used for
advertising by sex workers. This is an increasingly common
trend, as Cameron (2004: p. 1654) notes, anyone with a credit
card and modest search engine abilities can access porn images
and buy sex toys in a very short space of time. Significantly,
Hubbard (2004) argues that the use of websites to locate sex
workers “off-street” helps to make prostitution appear invisible.
These web-based sex workers could be divided into two
groups: indepen dent individual s selling sex (80% of cases), often
from their own premises; and individuals working for someone
else, usually a partner, an escort agency or pimp (20% of cases).
Independent individuals selling sex either had their own web-
sites, or more commonly had their contacts and adverts on other
“adult” websites. These sex workers usually worked from a
specific location for “in call s”, though many stated on their web-
sites that they travelled for “out calls” throughout the region.
Placing adverts in newspapers (including The Ad Mag and
The Sport) was a common practice for escort agencies, indi-
viduals and brothels. For example, one professional (SM04)
discussed an 18-year-old female who lives in a B&B. She has
been sexually exploited since she was 14 years old and is now
pimped by her father and brother who also live in the same
B&B. She works from the B&B and advertises on both the
Internet and in The Sport. It was reported that “she doesn’t like
having sex without a condom but is sometimes forced to… her
father or brother negotiate a price with the customer over the
phone on her behalf”.
There are increasing reports of street sex work and escort
agencies producing advertising material to recruit sex workers
(posted through doors—see Figure 2). Escort agencies were
typically the same as those advertised on the Internet. Individu-
als advertising in the papers may also have websites or more
commonly advertise on adult contact websites.
We found evidence of a remarkable variation in the prices of
sex, from £10 in crack houses to £650 for an overnight stay
with an escort (Table 2). As already discussed money is often
not the means of exchange, sex workers may also exchange sex
for drugs, food and lodging, a system where sex work is a sur-
vival strategy fulfilling a range of needs rather than just access
The space in which sex work takes place is an integral part of
why and how sex is sold in certain streets of cities and towns.
Cameron (2004) suggests a typology of urban sex market ma-
turity, including sporadic sex economy, partially laddered sex
economy and a mature sex economy. He cites the establishment
of a ‘Spearmint Rhino’ lap dancing club in a regenerated in-
ner-city area of Birmingham as an indication of a developing
mature sex market in the UK. However, both Hubbard (2004)
and Sanders (2004: p. 1705) argues that sex work locations are
frequently the target of resources from public services, espe-
cially the growth of multi-agency partnerships and forums cre-
ated to act upon what has historically been considered spoiled
identities associated with drugs, disease, dysfunctional families
Recruiting flyer for escort agency.
The price of sex in the study area.
The price of se x With condom Without condom
Full sex (penetrative vaginal sex) Highest £150
Oral sex Highest £100
Hand job Highest £30
Anal sex Highest £100
and danger. Hubbard (2004) cites the persistence of discourses
that associate sex work with crime and help perpetuate the idea
that sex work is a genuine threat to the quality of urban life.
Thus despite the trend towards sex market maturity outlined by
Cameron above, it is frequently the case in provincial UK cities
that locations where sex work takes place are “low value”
(Cameron, 2004) and have a “very run down, derelict feel”
(McKeganey, 2006: p. 153).
The study areas were typified by geographically dispersed
sex markets, with street-based sex work identified in car parks,
bus interchanges, around hostels, pubs and on the streets. In
particular, the on-street market in Newcastle is different to the
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C. HARTWORTH ET AL.
traditional image of the “red light area”. There are areas that
have been traditionally associated with on-street sex and con-
tinue that association, such as the area around Central Station,
but there are also new, often transient, areas connected to on-
street sex workers. For example, we received reports of un-
der-18 year old males soliciting around the Metro Radio Arena
and the area known as “the Gardens” in Newcastle (although
this area is less used now due to nearby housing redevelop-
ments). There have been cases of young men from care homes,
often with significant mental health problems, soliciting in
these areas and exchanging sex for cigarettes. There is also
evidence of heterosexual males with problematic drug use sell-
ing sex to gay men in these areas.
The occasional nature of some sex work6 explains character-
istics of street work in certain areas; they are not permanent
street markets but are areas where purchasers of sex can be
found, the sporadic sex economy described by Cameron (2004),
where sex workers may run either “poor-quality establishments”
or sell their bodies on the streets in unsafe, low-value economic
spaces. For example, one project worker (SM15) said “There
was one woman who had a bad injecting injury and I had to
take her to a Newcastle hospital. We went at 5.30 pm and left at
10.30 pm; she was getting really stressed that the shops had
closed and she couldn’t go shoplifting and she said she’d have
to go to the bus station to sleep with a dirty man”. There are
other locations across the study area that are not places where
“punters” go to buy sex, but are places where sex workers know
they can go if they need to sell sex.
We also received detailed reports from services about their
clients being involved in sex work. These include:
Contraceptive and Sexual Health (CASH) services in two
out of the six areas where between five and six individuals
were reported to be known to be sex workers.
Harm redu ction services (such as needle excha nges) through-
out the region consistently reported that a significant num-
ber of their female caseload and some of their male clients
occasionally or regularly exchanged sex for drugs or money
for drugs. Many of these services across the region have
high caseloads, for example, 150 active service users (those
accessing their service at least once a month or more). This
is consistent with Bellis et al., (2007) who identified than
85% of the sex workers they interviewed were drug users,
and Church et al., (2001), who found that around 90% UK
street sex workers had used an illegal drug in the past 6
months (see also Gilchrist et al., 2005; El-Bassel et al.,
2001; McKeganey, 2006; Hester & Westmarland, 2004).
Drug treatment and support services across the region also
consistently reported that they knew of service users who
were involved in sex work.
GUM clinics across the region reported that sex workers
regularly access their services, both male and female. Sig-
nificantly, a GUM clinic professional (SM33) stated that the
figures or knowledge that they have are undere stima te s.
Women support services across the region identified indi-
viduals in their caseload who were sex workers, ranging
from sex work as the sole means of paying for drugs to oc-
casional sex work.
Asylum seeker and refugee services across the region report
that many destitute failed asylum seekers exchange sex for
accommodation and other es s ential resources.
Housing providers such as emergency accommodation,
B&Bs or hostels had knowledge about their clients involved
in sex work, for money, alcohol, drugs or status.
The findings presented in the previous section are based on a
knowledge mapping approach where professionals and practi-
tioners (from a range of agencies) likely to have contact with
sex workers were interviewed (rather than sex workers them-
selves). Whilst the primary focus of this paper is methodologi-
cal, our findings are remarkably similar to the Voices Heard
(2007) research in terms of numbers of people involved, the
types of sex work and exploitation and the themes associated
with the marginalized groups (for example, low self esteem,
high levels of problematic drug use, frequency of violence,
significant health and mental health issues). As might be ex-
pected, such findings are consistent with other sex work re-
search (Gossop et al., 1994; May et al., 2000; El-Bassel et al.,
2001; Gilchrist et al., 2005; Saunders, 2005; Tomura, 2009;
The peer-led approach of the Voices Heard research provides
a perspective from the ground, which complemented our per-
spective “from above”. It also added validity to our methodol-
ogy by confirming our findings. We would argue, therefore,
that when questioned sensitively, with a strong rationale behind
the study (i.e. to improve knowledge and services to a margin-
alized group and to develop policy) individual professionals
have considerable knowledge about sex work and exploitation
within their client group which can be used to map the nature
and extent of sex markets. We also feel that this methodology
can be replicated at reasonably low cost by other agencies (both
statutory and non-statutory) interested in understanding the
characteristics of sex markets. This in turn opens up the ability
to carry out research with difficult target groups. Moreover, as
the primary researcher was male, it was clearly impossible to
conduct a female-centered approach (Boynton, 2002; Sanders,
2004; Tomura, 2009).
Whilst we are confident about our methodological approach,
we do recognize that there are limits to our methodology, spe-
cifically in terms of relying upon the testimony of others as a
data source. When we documented the direct professional
knowledge of those interviewed we accepted it as ‘the truth’.
We had no reason to doubt the integrity of the reports of pro-
fessionals about their client group. Therefore, one of the limits
to the methodology is this level of trust. However, we would
argue that our large dataset of 200 interviews gives both legiti-
macy and consistency to our findings, and has allowed us to
cross-reference interview material across a range of agencies
Moreover, the study was carried out across six local authority
areas, a consistent line of questioning was used and the findings
from key agencies were b roadly similar, for example, drug ha rm
minimization services, GUM clinics and looked after children’s
ser vices all reported similar contact with sex workers and y oung
people who were known to be sexually exploited.
6Whilst the number of problematic drug users involved in sex work is high,
many would not identify themselves as sex workers. They will occasionally,
although regularly, exchange sex for drugs or money for drugs and often
accommodation. Some women may rarely engage in sex work for money
when they need desperately to buy drugs.
Mapping urban sex markets via professionals is a valid
methodology and one that can be used in other areas. The re-
sults are grounded in the professional experience of the partici-
pants and present an important case study of “hidden” sex mar-
Copyright © 2012 SciRes.
C. HARTWORTH ET AL.
kets. Many agencies still fail to understand the range of needs
faced by sex workers (Church et al., 2001; Smith & Marshall,
2007). We believe that mapping knowledge in this way has the
potential to deliver more appropriate and specific policy inter-
ventions. After Creech & Willard (2001) we would argue that
the rationale for investing in sex market knowledge manage-
ment include filling the knowledge gaps that inhibit good pol-
icy practice and learning from each other across sectors and
regions about best practices.
We have identified that the small visible sex market in the
Northumbria Police Force Area provides only an indication of a
much bigger exchange system. We have briefly outlined some
of the factors leading to what Hubbard (2004) terms an in-
creasingly invisible urban sex market. If we are to truly open a
public debate on sex work, then as Shaver (2005) correctly
points out, a continued focus on sex work and sex workers will
help make it, and them, more visible. A key element to such a
continued focus is being able to use a methodology that is quick,
relatively cheap, user friendly and valid. Mapping sex markets,
as described in this paper, can provide a useful source of data,
which may be used as a baseline to develop further empirical
research or for triangulation with existing research. However,
when findings are produced and shared, there must be an open-
ness to consider and act upon them.
As already discussed, our mapping work corroborates the
findings of the Voices Heard study. Indeed, once we had trian-
gulated our data with the results of the Voices Heard study, we
were so confident about our findings that we decided Phase II
of the project (individual interviews with sex workers) was
unnecessary. Strong links were found between sex work and
issues such as drug misuse, mental and physical health and the
use of services. Many sex workers suffered economic, housing,
health, social and physical vulnerabilities. We have also found
significant evidence of a range of people involved and many
different types of market. What is of most concern, however, is
the number of marginalized and vulnerable men and women
who are involved. Sex work for this group is mostly linked to
problematic drug use and consequently is associated with high
levels of criminality, health risk both to themselves and others
and risk of death and violence. This group is the most difficult
to reach but their needs are amongst the greatest in society.
These themes have implications for statutory and voluntary
services, not only in the UK but also in international contexts
where it is necessary to understand the dynamics of hidden or
hard to reach groups. Despite increasing calls for more open
public debate on sex work and prostitution, our experience is
that this remains a complex and restricted research area in the
As Hunter et al. (2004) argue, before any service commis-
sioning decisions are made, a detailed mapping of the local
situation should be undertaken to establish what type of sex
market there is. We would argue that the knowledge mapping
outlined in this paper is fully defensible, reliable and replicable
and represents an important step both in terms of furthering the
debate and developing a knowledge network of closer statutory
and non-statutory agency working.
We are grateful to the Northern Rock Foundation for funding
this research. The views expressed in the study are those of the
authors and not necessarily those of the Northern Rock Founda-
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