Blackpool Council has an integrated alcohol, drugs and sexual health support service for all residents known as Horizon and delivered by a partnership of different organisations.
- A dedicated outreach worker provides holistic support to sex workers, working alongside other agencies and services
- More than 100 sex workers have been supported in the past year
- The support includes engaging sex workers in conversations about PrEP, which is part of a wider push to promote the benefits of the therapy.
Blackpool Council has an integrated alcohol, drugs and sexual health support service for all residents known as Horizon and delivered by a partnership of different organisations. As part of this service, there is an experienced and dedicated outreach support worker for those engaged in sex work
The service – known as the sex worker outreach support service (Swoss) – works closely with other agencies including the police and sexual health services as well as the rest of the Horizon team.
The outreach worker visits parlours and the streets where the sex workers are known to work, alerted by the police and other agencies, and over the last year has supported more than 100 women.
In recent months that has involved engaging them in conversations about PrEP.
Building up trust
Blackpool Council Public Health Practitioner for Sexual Health Janet Duckworth said: “The Swoss has been operating for a number of years as an important element of the harm reduction service arm of the Horizon service, providing outreach support to engage and support sex workers to access HIV and STI testing and long-acting reversible contraception (LARC) as well as providing condoms and lube.
“The worker has a really good relationship with the women who work on the streets and in the parlours. They trust her. She will accompany them to sexual health clinics if need be and arrange a fast-track appointment if appropriate.
“The worker is now promoting PrEP as an effective preventative medication to reduce HIV transmission. We know this is a group that is not accessing PrEP as much as we would like and interventions are aimed at helping sex workers to consider it’s use and it’s protective benefits.”
Anthony Harrison-West, who is the sexual health manager for the Horizon service, says having a dedicated worker for this group is essential.
“Many have a range of vulnerabilities and need a wide range of support. That is why having an integrated service is really useful. Our outreach worker can work alongside the drug and alcohol team and also help them to access other support they may need for things such as housing and benefit issues.
“Engaging this group with the use of PrEP can be a challenge – clients of the service will tell us that they use condoms so don’t need it, but we know that will not always be the case.
“We are going to keep talking to them about PrEP, utalising our own and national literature to keep the conversations active. It takes time sometimes to convince this group.”
Online outreach and pop-up testing
The outreach worker also devotes time to engaging those who offer their services online.
Mr Harrison-West added: “There are a number of different websites sex workers, both male, female and transgender, use. The Swoss worker will reach out through these sites by sending messages via their phone numbers or on the web platforms.
“Engagement is low, but we have been able to offer support to sex workers through this initiative, including support to unplanned pregnancy services, sexual health services and access to safe sex materials. The main focus of this work is to raise awareness of the services available to this group if and when they may need to access support.
The Horizon service also has an outreach worker that works with the gay, bisexual and men who have sex with men (GBMSM) community.
The practitioner visits bars, saunas and other places frequented for sex.
Mr Harrison-West said: “This community is much more aware of PrEP and many are using it, but we maintain a regular presence in these settings to support this group with any sexual health support they need. We focus on encouraging regular testing and offer avenues to test in person and through both local and national digital offers.”
As part of the outreach work with this community Horizon delivers pop-up testing clinics using its “Big Sexy Bus” facility. There is also a weekly community testing outreach clinic at the service’s headquarters in the heart of Blackpool.
This started as a drop-in clinic for GBMSM and now offers services to anyone that identifies as male. Plans are in place to extend this offer in 2024 to anyone at risk, regardless of their sex or gender identity.
A PreP mobile service was also deployed by Horizon to Blackpool’s Pride event last year, in conjunction with the local clinical sexual health provider, as part of a Lancashire-wide push to raise awareness about the therapy.
Other measures are also being considered, including a podcast aimed at primary care staff to increase awareness about PrEP and how they can support their patients to access it.