A rapid review of evidence on exiting support of street-based sex work in the UK and some other countries - Print version

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Theme 1: Earlier-stages of support and interventions for exiting sex work (12 references)

Psychological impact and support needs

Gorry, J., Roen, K. and Reilly, J. (2010) 'Selling yourself? The psychological impact of street sex work and factors affecting support seeking', Health and Social Care in the Community, 15(5). Available at: Selling your self? The psychological impact of street sex work and factors affecting support seeking - PubMed [https://pubmed.ncbi.nlm.nih.gov/20584087/] (Accessed: 28 Nov 2025).   

• Abstract: Previous research investigating the risks of female street sex work has tended to focus on the most tangible risks to physical health and safety. This is reflected in the provision of support services for sex workers, where these aspects are prioritised. There is little research focusing solely on the psychological risks of sex work. This qualitative study aimed to explore the perceived psychological impact of street sex work and factors that affected support seeking. Interviews were carried out with a sample of UK female street sex workers (n = 7) who attended a drop-in clinic and health professionals (n = 5) who provided input to the drop-in service. The analytic process, which drew from an interpretative phenomenological approach, revealed four main themes that work together to describe the emotional impact of selling sex. Implications for support services and future research are highlighted 
• Identified four themes include: (1) the emotional impact of selling sex; (2) self-preservation and coping; (3) barriers to change; and (4) moving on.
• Excerpt: “Women acknowledged that exiting often seemed an unreachable target and one frequently linked to tackling substance use. Many participants said it was at the stage of wanting to move on that professional support was vital.” 
• The paper presents narratives from women with lived experience of street sex work about their emotional experiences of engaging in and moving on from sex work.
• Try to access this paper via Open Athens, contact Eve Wang for a copy if having access issues.  

Johnson, Helen (2015) The Emotional Trajectories of Women's Desistance: A Repertory Grid Study on Women Exiting Prostitution. Doctor of Philosophy (PhD) thesis, University of Kent (doi:10.22024/UniKent/01.02.53612 [https://doi.org/10.22024/UniKent%2F01.02.53612]). Available at: 33PHD in Criminology Helen Johnson .pdf [https://kar.kent.ac.uk/53612/1/33PHD%20in%20Criminology%20Helen%20Johnson%20.pdf] (Accessed: 9 Dec 2025). [google search result]

• Abstract: This research identifies and explores the emotions of women who are exiting (leaving) prostitution. In both the prostitution and desistance literature, emotional factors clearly emerge as part of the process of change for exiters and desisters; however, there has been very little direct focus on their importance and impact on this process. The research makes a unique contribution to the desistance literature by mapping the process of change for women with particularly complex and challenging circumstances and focusing on the emotional aspects of this change. Overall, the research confirms that understanding the emotional aspects of exit offers new insights and gives rise to a new approach to service provision. The findings reveal that emotions are central to desistance and that role transition is a prerequisite for desistance. The data has shown that exit is a process of self-determination, becoming one’s authentic self, and that this process is bound up with emotional drivers and barriers. The process of exit necessarily involves fostering positive emotional experiences through both external and internal changes. The data suggests that an understanding of dominant emotional constructs at any given time will give a gateway into how best to respond to the needs and motivations of the exiter through service provision and offers an emotionally intelligent model to meet these needs. Service provision plays a key role in bridging the change in lifestyle of exiters through generating emotional energy, increasing access to alternatives, fostering hope, and enabling women to reimagine their lives.
• Read the table of content page 2 – 3 to see if this paper is of any interest.

Addressing housing and homelessness

Davis, J. (2004) 'Off the streets: tackling homelessness among female street-based sex workers'. Available at: sex workers.indd [https://assets.ctfassets.net/6sxvmndnpn0s/4boaP9BVTx9mBi4SC5BQdP/aaa542ccb838be60bf7e7d29cce79b2e/Off_the_Streets.pdf] (Accessed: 4 Dec 2025).   

• Abstract: This review, by Shelter’s Street Homeless Project, looks at four innovative projects in Lambeth, Bristol, and Birmingham. It is supported by a wider consultation with sex-work projects in England. The review highlights the need for a range of supported accommodation options for homeless female street-based sex workers. It shows how partnerships between specialist agencies and mainstream service providers can meet their complex needs. The featured projects directly target homeless female sex workers, providing stable environments where women can access intensive and comprehensive support to gain a home, address their drug use, and move towards leaving prostitution. 
• Details about the four projects are between page 12 and page 24. Additional effective reading is between page 25 and page 30 where commonalities among projects, learning, and recommendations are outlined.  
• Search keyword ‘exit’ to be swiftly directed to relevant findings. 

Addressing drug use

May, T., Martin, A., Home Office Research, D., Statistics, D. and Cusick, L. (2003) 'Vulnerability and involvement in drug use and sex work', Home Office. Nov, 86. Available at: Vulnerability and involvement in drug use and sex work [https://popcenter.asu.edu/sites/g/files/litvpz3631/files/problems/street_prostitution/PDFs/Cusick_etal_2003.pdf] (Accessed: 27 Nov 2025).   

• Abstract: Investigates patterns of drug use among young sex workers, focusing on the relationship between drugs and routes into and out of prostitution. Examines access to services and information, the impact of service provision on sexual health and problematic drug use, service integration for this group and recommendations for harm reduction strategies. 
• This is a very informative paper which incorporated narratives of different case studies among ‘exiters’ (from page 40 to page 46). Summary of findings on ‘exiting sex work’ can be found from page vi to vii.  
• Excerpt: “Non-vulnerable sex workers without current drug problems saw exiting sex work and/or drug use as readily achievable, but exiting was not a goal chosen by all. It is important to remember that the nature of problematic drug use (drugs used, frequency and circumstances of use) is key to ease of exiting from that habit.” 
• Guide your reading by using the table of content on page iii, and search keyword ‘exit’ to be swiftly directed to relevant findings. 

Gilchrist, G., Cameron, J. and Scoular, J. (2005) 'Crack and cocaine use among female prostitutes in Glasgow: Risky business', Drugs: Education, Prevention & Policy, 12(5), pp. 381-391. Available at: Full article: Crack and cocaine use among female prostitutes in Glasgow: Risky business [https://www.tandfonline.com/doi/full/10.1080/09687630500231894] (Accessed: 5 Dec 2025).   

• Abstract: The experience of cocaine and 'crack' use among participants involved in (n=19) or exiting (n=10) prostitution in Glasgow, Scotland, is described. In-depth semi-structured qualitative interviews enquired about their use and experience of using cocaine and their perception of its effect on working practice. Twenty-three of 29 participants had used cocaine and 15 out of 29 had used crack cocaine. In reality, freebase not 'crack' was being self-manufactured from cocaine powder. Participants considered that cocaine use in the city was not restricted to prostitution but was reflected throughout the drug scene generally. One possible reason suggested for this was a perceived reduction in heroin availability at a time when cocaine was increasingly readily available. There was no evidence from participants to suggest that they were first introduced to cocaine through prostitution. Most participants believed that using cocaine did not affect how they worked, however they perceived that other prostitutes were prepared to take more risks to support their cocaine use and had to work longer hours to finance a cocaine habit compared to financing a heroin habit. Only participants recruited from the east end of the city spoke about their desperation for money and the sexual risks that they were prepared to take to buy cocaine.
• Harm-reduction messages should address the sexual and personal risks that some female prostitutes may be taking to support their cocaine use. Treatment and support services in the city, traditionally established to work with problematic heroin users, need to adapt to the changing drug trends among female drug users, including those involved in prostitution, and offer appropriate treatment options and harm-reduction advice to cocaine users.
• Search keyword ‘exit’ to read relevant findings.

A specific focus on children/young people

Margaret, M. (2004) 'Young people abused through prostitution: some observations for practice', Practice: Social Work in Action, 16(1), pp. 17-29. Available at: Full article: Young People Abused through Prostitution: Some Observations for Practice [https://www.tandfonline.com/doi/full/10.1080/0950315042000254938#d1e160] (Accessed: 27 Nov 2025).   

• Abstract: Discusses the situation of young people sexually exploited through prostitution, noting the semantic and practical shifts that have occurred in relation to this issue as it has risen up the political agenda in recent years. Explores what we know about the context in which the commercial sexual exploitation of young people occurs, the scale of the problem and the processes through which young people become involved. Considers what these people might need in terms of practice responses if they are to be supported out of prostitution. 
• Excerpt: “First, and foremost, agencies working together need to build relationships of trust if they are to work effectively in partnership ... Different models of partnership working ... On the one hand, there is a model of ‘inter-agency’ working while on the other, a model of ‘multi-agency’ working.” (pp. 25-26)  
• Search keyword ‘involve’ to explore relevant findings. Try to access this paper via Open Athens, contact Eve Wang for a copy if having access issues.

Levy, A. (2004) '"Stigmatised, marginalized and criminalized": an overview of the issues relating to children and young people involved in prostitution'. [Online copies unavailable. However, if there is an interest in reading this article, please get in touch and Eve will try to locate a copy]  

• Abstract: Reveals that children and young people involved in prostitution are a 'thoroughly disadvantaged' group in society. Notes that while important changes in policy and practice; have been introduced, fundamental gaps exist in understanding, legislation, services and support for these young people. Looks at who is involved and where prostitution takes; place and at how and why children and young people become involved. Investigates the experiences of those involved and factors preventing them from exiting prostitution.; Considers the services and support available for children and young people involved in prostitution. Offers recommendations regarding prevention and early intervention; services, policy and legislative change, and intervention based on knowledge. 

Heal, A. (2004) 'The sex trap', Community Care. Available at: Sex trap - Community Care [https://www.communitycare.co.uk/2004/06/07/sex-trap/] (Accessed: 28 Nov 2025). 

• Abstract: This article details the links between sexual exploitation, drug 
  use and drug dealing. Based on research carried out in South 
  Yorkshire, it examines the use of drugs in the sexual exploitation 
  of young people, sometimes for the purposes of prostitution, and 
  the role of some drug dealers. It details the grooming process, a 
  profile of such perpetrators and highlights some of the issues for 
  agencies supporting young people. 
• Excerpt: “Young people need substantial support to limit the damage that trauma can have on their lives. Specialist agencies that work with 
  them to offer social services and child protection support, 
  individual counselling, drug treatment interventions, and 
  diversionary and educational support should be available. Many, but 
  not all, of the young people already have complex needs and have 
  experienced considerable difficulties in their young lives which in 
  turn makes them vulnerable to abuse and exploitation.” 
• Try to access this paper via Open Athens, contact Eve Wang for a copy if having access issues.

Coy, M. (2005) 'Leaving care loathing self (prostitution)', Community Care. No, 03(39). Available at: Leaving Care Loathing Self - Community Care [https://www.communitycare.co.uk/2005/02/03/leaving-care-loathing-self/] (Accessed: 4 Dec 2025).   

• Abstract: Suggests that the care system is failing to discourage female care leavers from drifting into prostitution. Reports on research into the experiences of young female care; leavers involved in the sex industry. Considers why female care leavers may be involved in prostitution. Highlights a lack of adequate aftercare support from social services. Discusses the psychological and emotional aspects of being in care. Suggests that the care system reinforces the conception of the women of themselves as sex objects. 
• This is a short and easy-read article providing insights into the entering and experiences of female care leavers who were involved in sex work.  

Willis, B. M. and Levy, B. S. (2002) 'Child prostitution: Global health burden, research needs, and interventions', Lancet, 359(9315), pp. 1417-1422. Available at: Child prostitution: global health burden, research needs, and interventions - The Lancet [https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(02)08355-1/fulltext] (Accessed: 5 Dec 2025).   

• Findings: Our estimates underscore the need for health professionals to collaborate with individuals and organisations that provide direct services to prostituted children. Health professionals can help efforts to prevent child prostitution through identifying contributing factors, recording the magnitude and health effects of the problem, and assisting children who have escaped prostitution. They can also help governments, UN agencies, and non-governmental organisations (NGOs) to implement policies, laws, and programmes to prevent child prostitution and mitigate its effects on children's health.

Edwards J. (2023) ‘Invisible children: understanding the risk of the cost-of-living crisis and school holidays on child sexual and criminal exploitation’, Barnardo’s. Available at:  summer23-report-invisible-children-cost-living-criminal-sexual-exploitation.pdf [https://www.barnardos.org.uk/sites/default/files/2023-06/summer23-report-invisible-children-cost-living-criminal-sexual-exploitation.pdf] (Accessed: 8 Dec 2025). [google search result]

• Introduction: Barnardo’s is concerned that the cost-of-living crisis will mean that more children are at risk of exploitation, and that statutory and voluntary sector services will struggle to respond to this increased demand. We know that the cost-of-living crisis is having an unprecedented impact on children, young people, and families, with many struggling to access food, fuel, clothing and safe and warm housing. This report suggests that, as with past crises, organised criminal gangs are capitalising on rising costs and financial pressures, leaving children more exposed to criminal and sexual exploitation. On top of this, already-limited services to protect and safeguard child victims of exploitation are being stretched, meaning that many child victims are going without critically needed support.
• Read the table of content on page 2 to see if this report is of relevance.

Searcey, R. (2022) ‘Youth transitions pathways from child to adult sexual exploitation: the voices of female street sex workers and agencies’. Loughborough University. doi: 10.17028/rd.lboro.19952930.v1. Available at: Item - Youth transitions pathways from child to adult sexual exploitation: the voices of female street sex workers and agencies - Loughborough University - Figshare [https://repository.lboro.ac.uk/articles/thesis/Youth_transitions_pathways_from_child_to_adult_sexual_exploitation_the_voices_of_female_street_sex_workers_and_agencies/19952930?file=35504897] (Accessed: 9 Dec 2025). [google search result]

• Background: This original thesis examines the pathways from child sexual exploitation (CSE) to street-based sex work. The concept of adult sexual exploitation is developed to emphasise the links between child sexual exploitation and continued exploitation of these women as they move into the most precarious form of sex work, underpinned by the failure of services to support these survivors of CSE. The thesis identifies interventions that could support women to make positive pathways out of sexual exploitation. The voices of female street-based sex workers and key voluntary sector professionals who support these women are prioritised, by examining the narratives of 20 street-based sex workers and five key professionals from the voluntary sector, alongside a critical policy analysis. This research focuses on whether it is possible to identify some of the key transition needs for young people affected by sexual exploitation, to disrupt or stop the continued pathway of sexual exploitation into adulthood.
• I recommend reading this thesis as this is highly relevant to the requestors’ interest. 

Theme 2: Targeted interventions for exiting of sex work (25 references)

Theorising models of interventions

Baker, L. M., Dalla, R. L. and Williamson, C. (2010) 'Exiting prostitution: an integrated model', Violence Against Women, 16(5), pp. 579-600. Available at: Exiting Prostitution: An Integrated Model - Lynda M. Baker, Rochelle L. Dalla, Celia Williamson, 2010 [https://journals.sagepub.com/doi/10.1177/1077801210367643] (Accessed 5 Dec 2025). This paper is under restrict access, please try to access it with Open Athens account. If still unavailable, pleases contact Eve Wang for a copy.

• Abstract: Exiting street-level prostitution is a complex, convoluted process. Few studies have described this process within any formal conceptual framework. This article reviews two general models and two prostitution-specific models and their applicability to the exiting process. Barriers encountered as women attempt to leave the streets are identified. Based on the four models, the barriers, the prostitution literature, and the authors' experience with prostituted women, a new integrated six-stage model that is comprehensive in scope and sensitive to women's attempts to exit prostitution is offered as a foundation for continued research on the process of women leaving the streets.
• The figure of an integrated model is attached below:

Perri M, Shareck M, Buhariwala P, Hassan M, Balla E, O'Campo P. ‘Assessing program fidelity to critically reflect on the suitability of Critical Time Intervention [CTI] to facilitate exiting sex work.’ Transl Behav Med. 2022 Dec 30;12(12):1106-1112. doi: 10.1093/tbm/ibac047. Available at: Assessing program fidelity to critically reflect on the suitability of Critical Time Intervention to facilitate exiting sex work - PubMed [https://pubmed.ncbi.nlm.nih.gov/36190345/] (Accessed 5 Dec 2025).

• Abstract in Plain English: Limited research exists that speaks to the appropriateness of the Critical Time Intervention [CTI] model for women who attempt to exit sex work. We found that many components of the CTI model [e.g., time limited nature] were not appropriate for providing care to women who engage with sex work due to their complex and intersecting needs/realities. Considering population specificities is key to providing effective health and social care to these groups. These findings contribute to existing gaps in the implementation science literature and program development which aims to assist women exit sex work and other similarly marginalized groups.

Multidimensional interventions

Scottish, G. (2017) 'Exploring available knowledge and evidence on prostitution in Scotland via practitioner-based interviews'. Available at: Exploring Available Knowledge and Evidence on Prostitution in Scotland Via Practitioner-Based Interviews [https://www.gov.scot/binaries/content/documents/govscot/publications/research-and-analysis/2017/02/exploring-available-knowledge-evidence-prostitution-scotland-via-practitioner-based-interviews/documents/00514437-pdf/00514437-pdf/govscot%3Adocument/00514437.pdf] (Accessed: 27 Nov 2025).   

• Abstract: Looks at the available knowledge and evidence on the scale and nature of prostitution in Scotland, the support services currently available, the links to organised crime and trafficking, the impact of prostitution on local communities and the demand for sexual services. Draws on information from semi-structured qualitative interviews with a range of professionals dealing with prostitution including police, local authority, NHS and third sector contacts. Examines the scale of prostitution in Aberdeen, Edinburgh, Dundee and Glasgow. Looks at the demand for prostitution and the support available for women and men involved in prostitution and help to exit. Annex includes 'A review of prostitution in Scotland' by the Scottish Centre for Crime and Justice, which includes evidence on: the extent of prostitution; responses, attitudes and approaches to the regulation of street prostitution in Aberdeen, Edinburgh and Glasgow; research on the impacts of prostitution on health and wellbeing (risk, 'vulnerability' and street work, and experiences of violence); the legal context; legislative developments and the criminalisation of prostitution; demand for prostitution; and exiting prostitution. 
• Excerpt: “In the 4 cities there are a range of specialist support services working in partnership with other key agencies including health, social work, housing advice, employability services etc. to assist people involved in prostitution. The majority of services are aimed at supporting women, with the exception of Roam in Edinburgh and the Steve Retson project in Glasgow, which provide support and assistance to men involved in prostitution (who sell sex). The approach of specialist support providers includes a harm reduction‟ aspect, providing health and safety support for people at immediate risk as well as services to help people exit prostitution.” (p. 10) 
• Barriers to exiting sex work can be found on page 60. 
• Search keyword ‘exit’ to explore relevant findings in four cities  

Home, O. (2004) 'Paying the price: a consultation paper on prostitution', Home Office. Jul. Available at: 5413-HO-Paying the Price [http://news.bbc.co.uk/nol/shared/bsp/hi/pdfs/16_07_04_paying.pdf] (Accessed: 28 Nov 2025).   

• Abstract: Considers the nature and scope of prostitution, focussing on children and young people, adults and criminal connections. Examines routes into and out of sex work, looking at the ways people can be manipulated or coerced into prostitution. Details proposed legislation designed to tackle criminals controlling prostitutes, ways to treat individuals, particularly regarding drug addiction, and measures to protect communities from antisocial and disorderly impacts of street prostitution. 
• This government report presents intervention programmes delivered by various local authorities in the UK.  
• Use the table of content (p. 1) to guide reading. Search keyword ‘exit’ to explore relevant reading.  

Home Office. (2011) ‘Effective practice in responding to prostitution.’ Available at: Foreword [https://assets.publishing.service.gov.uk/media/5a796d2eed915d0422068539/responding-to-prostitution.pdf]  (Accessed: 8 December 2025). [google search result]  

• Purpose: The murders of three women who were involved in street prostitution in Bradford, and earlier murders in Ipswich, were a stark reminder of the dangers that can be faced by people involved in prostitution. The characteristics of prostitution make it hard to estimate the number and nature of people involved in the UK, but what is clear is that people involved in prostitution are particularly vulnerable to violent and sexual crime. At least 137 have been murdered since 1990 and women in street prostitution are 12 times more likely to be murdered than the rate for all women in same age group in the UK.
• I recommend reading this policy paper because the motivation of the paper was the same as it of the requestors.
• Please use the table of content on page 1 to guide your reading. Examples of existing interventions can be found under case studies in sections: ‘4 multi-agency working’ (pp. 9-12), ‘5 prevention’ (pp. 12-15), ‘6 holistic support’ (pp. 15-30).

Hester, Marianne & Westmarland, Nicole. (2004). Tackling Street Prostitution: Towards a Holistic Approach. Available at: Tackling Street Prostitution: Towards an holistic approach (Accessed: 28 Nov 2025).   

• Background: In December 2000 the Home Office awarded £850,000 as part of the £250 million Crime Reduction Programme (CRP) to fund 11 multi-agency pilot projects (‘CRP projects’) which aimed to reduce the number of young people and women involved in prostitution, reduce crime and disorder associated with street-based prostitution and find out which interventions helped women to exit prostitution. These eleven projects were split into three packages according to their main intervention (protecting young people; policing and enforcement; and support and exiting) and evaluated by evaluation teams based at the Universities of Luton, London South Bank and Sunderland. In this overview we draw on material from all three evaluations to present the key findings from the 11 CRP projects, and present lessons on how to tackle street-based prostitution. 
• Read the table of content (p. iiii) to guide reading. Conclusion and recommendations to services are from page 137 onwards.  

Department of, Justice. (2011) 'Research into Prostitution in Northern Ireland'. Available at: Microsoft Word - Prostitution Research - Final Report.DOCX [https://www.justice-ni.gov.uk/sites/default/files/publications/doj/prostitution-report-nov-update.pdf] (Accessed: 4 December 2025).  

• Abstract: This is the first academic study that aims to assess prostitution as a complex social phenomenon in Northern Ireland. The aim of the research is to provide the Department of Justice with a better understanding of the extent and characteristics of prostitution and human trafficking for the purpose of sexual exploitation in Northern Ireland. 

• Please use the table of content to guide your reading (from page 3). 
• This report thoroughly examines the landscape of sex work Northern Ireland, as well as introduces exiting programmes elsewhere in the UK and the Europe. Details of exiting programmes in the UK and Ireland, and other countries are from page 155 to page 158. 
• Directions: Content regarding ‘entering prostitution’ are on page 73 to page 79. Content regarding ‘support services -> exiting services in Northern Ireland’ are on page 147.  

Clinks (2014) 'A Way Out and Changing Lives: engaging vulnerable and hard to reach women'. Available at: A-Way-Out-and-Changing-Lives-case-study.pdf [http://www.barefootresearch.org.uk/wp-content/uploads/A-Way-Out-and-Changing-Lives-case-study.pdf] (Accessed: 4 Dec 2025).   

• Abstract: Provides two case studies of charities in northeast England and Cumbria working with women involved in prostitution to help them exit prostitution, find stable accommodation, reduce drug use and reunite mothers with their children. Examines the work of 'A Way Out', an outreach and prevention service based in Stockton, and 'Changing Lives', a national charity which supports people experiencing homelessness, addiction and other problems. Explains the need for the support services, the outreach approach each takes and the impact they are having on helping vulnerable women to become self-reliant. 
• The two case studies are worth reading as the article outlines the intervention, outcomes, and impact. This paper also proposes an approach for change, including four steps: pre-change: harm reduction; accepting help – crisis interventions, practical and emotional support; change – progression; self-reliance – stability.  

Another report was conducted in the same areas: Northeast England and Cumbria. Barefoot Research and Evaluation 2016. Selling sex for survival: Adult sexual exploitation and prostitution in the North East and Cumbria. Available at: Selling Sex in NE 8pp update NOV2015.indd [http://www.barefootresearch.org.uk/wp-content/uploads/Selling-Sex-in-NE-Jan16.pdf]. (Accessed: 9 Dec 2025). [google search result]

• Background: We collected the information for our studies by: mapping of the knowledge of frontline professionals working for agencies we judged likely to come into contact with those involved with prostitution or exchanges of sex; and by Internet searches as much sex is advertised online. The professionals we interviewed came from agencies such as housing providers, sexual health services, police, probation, drug and alcohol services and many more. We then asked those professionals who else should we talk to, and then we went and interviewed them too. We engaged with these via focus group interviews, often team meetings, and individual in depth interviews. We interviewed 555 professionals from over 200 organisations in this way.

Bindel, J. and et al. (2012) 'Breaking down the barriers: a study of how women exit prostitution'. Available at: Breaking-down-the-barriers-a37d80.pdf [https://rebuildingshatteredlives.org/eaves/2012/11/Breaking-down-the-barriers-a37d80.pdf] (Accessed at: 27 Nov 2025).   

• Abstract: Assesses the effectiveness of different interventions designed to support women who want to leave prostitution. Presents the findings of interviews with women involved in or exiting prostitution, and describes the factors identified as barriers to exiting prostitution: problematic drug use; problems with housing; physical and mental health problems; having had experiences of violence as a child; criminalisation; the role of money; coercion from others to remain in prostitution; lack of qualifications; and entering prostitution at a young age. Identifies a series of stages for women exiting prostitution: readiness and engagement; treatment and support; transition and stabilisation; reconstructing and rebuilding; and new roles and identities. Describes the changes experienced by women exiting prostitution, including development from the personal to the social and a change of vision and perspective. Concludes that exiting should be openly discussed by all those providing support to women involved in prostitution and that training and awareness raising should be undertaken to support those offering exiting services. 
• A short and easy-read article discussing the barriers and process of change to exiting sex work. Service recommendations see on page 15 and page 18.
• One of the authors of the article, Helen Easton worked closely with charities in Glasgow to develop programmes to support sex worker exiting. Introduction to her work is attached here: The challenges of supporting women who want to exit prostitution | London South Bank University [https://www.lsbu.ac.uk/stories-finder/exiting-prostitution]. [google search result]

Encompass (2021) ‘Exiting prostitution: what next? Encompass network 2021’. Available at: Exiting Prostitution, Encompass [https://www.encompassnetwork.info/uploads/3/4/0/5/3405303/exiting_prostitution_what_next.pdf] (Accessed: 4 Dec 2025). [google search result] 

• Background: The Women's Support Project, on behalf of the Encompass Network, has written this paper because systematic action is needed to support women who want to leave (exit) prostitution. Although the focus is on prostitution, women want to leave other forms of CSE (commercial sexual exploitation) and need similar support to do so. 
• Direction: This document also includes Brief context about prostitution in Scotland and the implications of the pandemic for exiting; Some context on progress to date relevant to exiting; Main issues women face in exiting prostitution; Examples of exiting models; Components of a multi-agency approach in a local authority area; Recommended actions. 
• A very detailed report introduces the actions of Encompass to support people exit sex work in Scotland. Please use the table of content on page 3 to guide your reading. Effective reading around ‘leaving prostitution’ and ‘models of exiting’ can be found on page 30, and page 49 onwards, respectively.  

Routes Our Service in Glasgow was mentioned in the report. More resources about the Routes Out Service can be found on:  

• Routes Out Service - Community Justice Scotland [https://communityjustice.scot/community-support-service/glasgow/routes-out-service/] 

• ROUTES OUT [https://www.encompassnetwork.info/routes-out.html] 

Glasgow City Council. (2024) ‘TARA and Routes Out Services Response’. Available at: Glasgow City Council - TARA and Routes Out Services response [https://www.glasgow.gov.uk/media/12386/240131-NRS-Input-to-the-Report-of-the-Special-Rapporteur-on-Prostitution-and-VAWG-UNHRC/pdf/240131_NRS_Input_to_the_Report_of_the_Special_Rapporteur_on_Prostitution_and_VAWG_UNHRC.pdf?m=1718206402600] (Accessed: 8 Dec 2025). [google search result] 

• Following the source above, this paper explored the effectiveness of both services in reducing the harm associated with sex work against sex workers.
• Introduction: Glasgow City Council’s Neighbourhoods, Regeneration and Sustainability Department’s TARA and Routes Out Services provide specialist support to adult women exploited in the commercial sex trade. Since 1999 Glasgow City Council’s policy (Appendix 1) on commercial sexual exploitation has held that it is a form of male violence against women, is driven by male demand, is both a cause and consequence of women’s inequality and should be understood as survival behaviour reflecting the lack of meaningful choices and pathways out of poverty for women.
• Search keyword ‘exit’ to be swiftly guided to relevant reading.

Cusick, L., Brooks-Gordon, B., Campbell, R. and Edgar, F. (2011) '"Exiting" drug use and sex work: Career paths, interventions and government strategy targets', Drugs: Education, Prevention & Policy, 18(2), pp. 145-156. Available at: "Exiting" drug use and sex work: Career paths, interventions and government strategy targets. [https://psycnet.apa.org/record/2011-04524-009] (Accessed: 8 Dec 2025).

• Abstract: Current British government policy on sex work aims to reduce prostitution, challenge its inevitability and in terms of support services for sex workers is heavily focused towards exiting strategies for those in sex work. Exiting programmes are complex, often lengthy and need to meet a range of holistic needs in order to assist individuals who want to leave sex work and problematic drug use. Addressing drug use has been to the fore as part of exiting programmes due to the very high rates of problematic drug use reported amongst female street sex workers and drug use being identified as a key factor shaping routes into and sustaining involvement with street-based sex work. This contrasts with the much lower levels of problematic drug use found amongst indoor sex workers.
• This article brings together findings from a 2002 Home Office funded study of sex work and drug use careers and a 2007 UK Network of Sex Work Projects review of specialist services for sex workers which looked at the provision of "exiting services" within projects. The principle of sex worker choice united all of the surveyed projects so that irrespective of whether exiting was seen as a vital goal or a potential end point, choice was seen as crucial for client engagement and for the ethics of service delivery. Findings suggest that current government policy focused on exiting is unlikely to meet its aims and whilst exit support is a vital part of holistic needs, an emphasis on exiting at a strategic level can endanger and erode other vital aspects of support.

Lindsay, J., Watson, S. and Nilsson, D., 2018, July. Assisting female sex-workers to exit prostitution. Report of an evaluation of a successful community-based initiative. In World Conference on Social Work, Education and Social Development (SWSD) 2018. Available at: Assisting female sex-workers to exit prostitution. Report of an evaluation of a successful community based initiative. - Kingston University London [https://researchinnovation.kingston.ac.uk/en/publications/assisting-female-sex-workers-to-exit-prostitution-report-of-an-ev-2/] (Accessed: 8 Dec 2025). The link to full text is currently missing, only the abstract is available. Eve Wang can contact the authors for a copy if interested. [google search result]

• Abstract: A number of recent UK studies and reports have identified a plethora of barriers female sex-workers face should they wish to exit prostitution (including problematic substance abuse, violence, abuse and coercion, mental health problems, housing and financial issues and criminalisation). Exiting sex-work is increasingly seen as an iterative, phased, staged and often lengthy process. This presentation will report on a participative evaluation of a successful community-based initiative in South London which aims to enable sex-working women (both street-based and women working from their phones and flats) overcome these barriers and support them to exit prostitution, should they wish, as well as providing support and advice on harm minimisation and how to work safely and within the law. The evaluation approach included journey mapping with service users, interviews with staff and volunteers, a survey of other local service providers and analysis of data.
• Findings identified the strength of deploying multi-faceted, broad and inclusive approaches and staged activities and interventions and the necessity of building trust with service users through consistent, principled and value-led action. Casework undertaken with women needed to be highly flexible, catering to the breadth of individual need and their different stages of readiness to effect change. Relationship building and enhancing social connectedness appeared to be critical factors in success of the project, from the perspectives of service users, volunteers and project staff. We contend that the approach taken by this community-based organisation would be replicable globally.

Breslin R. (2023) ‘Pathways to exit: A study of women’s journeys out of prostitution and the response to their complex support needs’. Available at: SERP_PathwaystoExit_FULL_Final.pdf [https://serp.ie/wp-content/uploads/2023/12/SERP_PathwaystoExit_FULL_Final.pdf] (Accessed: 8 Dec 2025).  [google search result]

• Introduction: Ruhama has been supporting women in prostitution6 in Ireland for over thirty years and has developed significant expertise in this area. But the model of practice on which their work is based has never been formally documented outside the organisation, until now. This study is the result of a unique research partnership between Sexual Exploitation Research Programme researchers and Ruhama service users and staff to explore in greater depth what exiting entails, both for women embarking on this journey, and for those professionals who support them along the way.
• Read the table of content on page 2 and 3 to guide reading. Effective reading about ‘exit models’ are on page 22 to 26. Barriers to achieving and sustaining exit are on page 56 to 66.

Pro Bono Economics. n.d. ‘Summary report of the Toynbell Hall Project’, Toynbee Hall. Available at: download-this-report-264ff5fc.pdf [https://pbe.co.uk/wp-content/uploads/2025/03/download-this-report-264ff5fc.pdf] (Accessed: 8 Dec 2025).  [google search result] Please note that the summary is the only available copy online, full text may need to be requested from Toynbee Hall.

• Introduction: The Safe Exit project, part of Toynbee Hall’s Wellbeing Programme, aims to reduce the scale of street-based prostitution and to improve outcomes for those involved. Safe Exit brings together service providers to take a holistic approach to reduce the harm that women face and support them to change their lifestyles whilst seeking to reduce the impact of prostitution on local communities.

Changing Lives (2024) “‘It’s all I know’: experiences of sex work, survival sex and sexual exploitation in Doncaster. Findings from the Amber project”. Available at: Ztrv4hoQrfVKlyYP_It'sAllIKnow-AmberReport.pdf [https://changinglives.cdn.prismic.io/changinglives/Ztrv4hoQrfVKlyYP_It%27sAllIKnow-AmberReport.pdf] (Accessed: 8 Dec 2025).  [google search result]

• Introduction: This paper sets out the results of a survey completed with women with experiences of sex work, survival sex or sexual exploitation who have received support from the Amber Project in Doncaster. The survey explores reasons why women enter, remain in or return to sex work and highlights gaps in support that prevent women fleeing sexual exploitation or leaving sex work if that is what they want.
• An easy-to-read evaluation report. Effective reading from page 10 onwards. Search keyword ‘exit’ to guide reading.

Interventions focusing on housing and homelessness

McNaughton, C. C. and Sanders, T. (2007) 'Housing and transitional phases out of 'disordered' lives: the case of leaving homelessness and street sex work', Housing Studies, 22(6). Available at: Housing and Transitional Phases Out of ‘Disordered’ Lives: The Case of Leaving Homelessness and Street Sex Work: Housing Studies: Vol 22 , No 6 - Get Access [https://www.tandfonline.com/doi/full/10.1080/02673030701608043] (Accessed: 27 Nov 2025).   

• Abstract: Examines the experiences of women making the transition from the 'disordered' life of homelessness and street prostitution to 'ordered' lives, through state welfare mechanisms. Looks at recent government policy responses to homelessness and street sex work, discussing the role of the concept of 'deserving' and 'undeserving' citizens. Describes the two research studies which inform the article. Considers the triggers and barriers to making the transition away from homelessness and sex work, including welfare services, social networks, housing and psychological factors. Identifies three key factors which are crucial to generating change but can also act as barriers to it: access to social services; the presence of social networks; and the housing obtained after a period of homelessness. 
• Excerpt: “the complex ontological processes that occurred as the women made their transitions out of sex work or homelessness have been identified here as barriers to developing transitions further. Coupled with these subjective insecurities, women often remained in precarious material situations, still lacking housing security, employment or education opportunities, with low incomes, even once they exited sex work or resolved their homelessness.” 
• Search keyword ‘exit’ to explore relevant findings. Try to access this paper via Open Athens, contact Eve Wang for a copy if having access issues. 

Johnson H. (2016) ‘Exit closed? Accessing the policy landscape for services seeking to support women to exit prostitution.’ Available at: 2d8661_9f69c1f1a83b47e3b145d199904eb714.pdf [https://2d866107-f4ba-408e-9c7e-8c933d69106b.usrfiles.com/ugd/2d8661_9f69c1f1a83b47e3b145d199904eb714.pdf] (Accessed: 8 Dec 2025). [google search result]

• Background: The Chrysalis Project is a partnership between Commonweal Housing and St Mungo’s. It was developed to respond to the very real need for support for women leaving prostitution who are at a stage where they are able to move on from hostel accommodation. Practitioners reported that many women returned to their former lives and were unable to sustain their lifestyles beyond the support of the hostel and intensive service provision. In response, Chrysalis developed a staged model of exit that included a phase of mixed independent and supported living, where women moved on into independent accommodation but were supported in the running of their daily lives with a gradual move into total independence. Some important findings were documented that indicated the need for a more general change in the way services are provided to sexually exploited women and suggested that the Chrysalis model and the key principles could and should be replicated elsewhere.
• This evaluation report established the practical knowledge base for the evaluation of the Amari Project – the source below. Please read both reports.
• Use the table of content on the second page to guide reading.

Johnson H. (2019) 'Evaluation of the Amari Project: supporting women exiting prostitution and sexual exploitation'. Available at: Amari-Main-Report-FINAL_0.pdf [https://www.solacewomensaid.org/wp-content/uploads/2023/11/Amari-Main-Report-FINAL_0.pdf] (Accessed: 28 Nov 2025). 

• This report was produced under the strategic partnership between the Amari Project and Commonwealth Housing, funded by London Councils. Amari Project is a housing project provided by Solace Women’s Aid, based in London, that supports women who have been sexually exploited through trafficking or prostitution to become independent. 
• Abstract: An independent evaluation of Amari, a Solace Women's Aid housing project that supports women who have been sexually exploited through trafficking or prostitution to become independent. The service provides to women who have already accessed crisis accommodation and are ready to move on to step-down support and more independent living. The evaluation explores outcomes of the project over 12-18 months, the impact on participants and the extent to which the model is replicable and sustainable. The research included interview with tenants and practitioners and a desk-based review. In total, 11 of the 17 tenants using the service were interviewed. Key findings show that the emotional and practical needs of those using the service were being well met by the project, due to having stable accommodation and support; tenants were able to more proactively manage their own tenancies and finances; and the majority of women within the project reported improved quality of life. The report makes recommendations for the Amari project and those seeking to adopt or adapt the model. 
• I highly recommend reading the details of the project, including intervention set-up and delivery (pp. 8-17). Read the table of content to guide reading (p. 3). Recommendations and key learnings are from page 47 onwards. 

The same author as the two sources above, Johnson H. also drafted a document titled ‘exiting good practice guide: how to effectively support women who are leaving prostitution’ for Stand Against Sexual Exploitation (SASE). The link to the document is EXITING GOOD PRACTICE [https://1425f57e-5a05-4bdc-8183-747efed61d9f.filesusr.com/ugd/7f14e6_9a9b1581a89d4b288038c46211d0bc0a.pdf]. [google search result]

Hankel, J., Heil, M., Dewey, S. and Martinez, N. (2016) 'Characteristics of women seeking services at a transitional housing facility for women leaving street-based sex work: Implications for social service providers', Journal of Social Service Research, 42(1), pp. 41-56. Available at: Full article: Characteristics of Women Seeking Services at a Transitional Housing Facility for Women Leaving Street-Based Sex Work: Implications for Social Service Providers [https://www.tandfonline.com/doi/full/10.1080/01488376.2015.1077188#abstract] (Accessed: 5 Dec 2025). 

• Background: Women who decide to leave street-based sex work often struggle with addiction, trauma-related mental health consequences, and exclusion from employment and housing. To offer recommendations for social service providers, this article draws upon primary data from interviews and surveys with 87 residents at a transitional housing facility for women leave sex work to elucidate: 1) a demographic profile of the women, 2) life history patterns and circumstances that encourage women to leave street-based sex work and 3) recommendations for service providers. Results indicate the need for service providers to assist women with basic needs, strengthen referral networks, and extend trauma-informed services.

Parker S. (2021) ‘No way out and no way home: Modern slavery and homelessness in England, Wales and Northern Ireland’, Crisis as part of Project TILI. Available at: no-way-out-and-no-way-home-final-designed.pdf [https://www.crisis.org.uk/media/245122/no-way-out-and-no-way-home-final-designed.pdf] (Accessed: 8 Dec 2025). [google search result]

• Introduction: Everybody has the right to be treated with dignity. Yet through Crisis’ services we hear of people experiencing homelessness who have faced exploitation – forced to take part in sex work, work as a live-in servant or take part in crippling manual labour, working all hours of the day for little to no money, scared and feeling there is no way out. No-one should be forced to live like this. Until now, the links between homelessness and modern slavery have been mostly anecdotal with very little research in this area. This report provides us with the clear evidence to show how the two drive one another and more importantly, what we need to do to prevent them both and end the cycle of people trapped in dangerous and isolating circumstances. The report found that a staggering two thirds of the survivors stayed in accommodation provided by their perpetrators during their exploitation, and a similar proportion were already homeless when they were recruited. There cannot be a clearer demonstration that housing and homelessness are central to modern slavery: all people who are exploited are put at risk of homelessness, and everyone who is homeless is at risk of exploitation.
• Use table of content on page 2 to guide reading. Search keyword ‘sex work’ to be swiftly directed to relevant content.

Interventions focusing on psychological (trauma) recovery

Roe-Sepowitz, Dominique E., Kristine E. Hickle, and Andrea Cimino. 2012. “The Impact of Abuse History and Trauma Symptoms on Successful Completion of a Prostitution-Exiting Program.” Journal of Human Behavior in the Social Environment 22 (1): 65–77. doi:10.1080/10911359.2011.598830. Available at: Full article: The Impact of Abuse History and Trauma Symptoms on Successful Completion of a Prostitution-exiting Program (Accessed: 28 Nov 2025). 

• Abstract: This study examines the trauma symptoms and life experiences of 49 women in a residential prostitution-exiting program and identifies differences among women who complete 90 days of the program and women who drop out of the program prior to completing 90 days. The majority of the women reported childhood abuse, adult abusive relationships, and victimization. Women who completed 90 days of treatment were found to be older than the non-completers. Non-completers were more likely to report clinically significant trauma symptoms including dissociation, poor coping behaviors, sex-related issues, and dysfunctional sexual behavior than completers. These findings suggest the importance of incorporating trauma-focused intervention early in the services provided in the exiting programs as well as the need to address the traumatic symptoms related to childhood and adult trauma histories. Findings also indicate the importance of clinically addressing trauma-related sexual issues, concerns, and behavior. 
• Excerpt: “The findings of this study lead us to suggest some specific program recommendations. First, a mental health counsellor should be available to address trauma symptoms, including dissociation, and coping skills with the women who have recently entered the program ... Second, a rapid and sustained involvement in individual and group therapy is recommend for all participants entering the prostitution exiting program ...  Finally, all program staff should be trained in a method such as motivational interviewing to work with participants on their motivation to change, reduce their ambivalence to change, and increase their therapeutic relationships ... Staff should also be trained in recognizing symptoms of dissociation and negative coping strategies among program participants.” 

Theme 3: Frameworks, guidance, and recommendations for designing and sustaining interventions (14 references)

Insights from statutory organisations

Northern Ireland. Department of Health, S. S. and Public, S. (2015) 'Leaving prostitution: a strategy for help and support'. Available at: Microsoft Word - revised-leaving-prostitution-strategy [https://www.health-ni.gov.uk/sites/default/files/publications/health/revised-leaving-prostitution-strategy.pdf] (Accessed: 27 Nov 2025).   

• This is a governmental strategy report published by the Northern Ireland government. 
• Abstract: Sets out the actions to be taken to develop a Programme of Assistance and Support (PAS) for people who want to leave prostitution. In doing this, this strategy: provides a background to prostitution in Northern Ireland; identifies and considers the barriers to leaving prostitution and the services currently available to those who want to do so; and sets out the DHSSPS proposal for the PAS, including how the PAS will be monitored and evaluated. The document identifies key needs and areas of support and services that through agencies' collaboration and joint working have the potential of helping those involved in prostitution overcome the barriers they face in leaving prostitution. These include: health; housing; employment and training; justice systems; domestic and sexual violence services; outreach and drop-in services; and counselling. 
• Excerpt: “It is important to realise that the needs of those wishing to leave prostitution could be complex and require the services of a range of providers in the statutory, voluntary and community sectors. While some voluntary and community groups may have a role in signposting to other agencies, others will have a significant role in assisting and supporting those involved in prostitution to leave. Strong relationships between all sectors will be key to helping those involved in prostitution overcome the barriers they face in leaving prostitution.” (p. 16) 
• Search keyword: “leave” to explore relevant findings. Effective reading from page 16 onwards.  

National Offender Management, S. (2015) 'Better outcomes for women offenders'. Available at: Title [https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/457922/Better_Outcomes_for_Women_Offenders_September_2015.pdf] (Accessed: 27 Nov 2025).   

• Abstract: Summarises principles, based on evidence of 'what works', to help women offenders live safe, offence-free lives, promote desistence, manage the effects of domestic violence, and exit sex work. Identifies priority needs, such as substance misuse, mental health, emotion management, and improving family contact. Presents a hierarchical model of women's rehabilitation including safety and decency, achieving personal change, and settlement/resettlement. Suggests that gender-based approaches built on theories of women's crime, and taking account of the characteristics of women who offend and factors affecting their response to interventions, have good outcomes. 
• Recommendations include: “iv. Helping women development and maintain a pro-social identity” (p. 10) “v. Helping women to believe in their ability to control their lives and achieve their goals” (p. 11) “vii. Helping women to settle and build their social capital” (p. 12)  
• Search keyword: “exit” to explore relevant findings.  A figure showed the factors enabling women to reduce their reoffending, exit from sex work, and live safer lives on page 13.  

Jennifer, S. (2006) 'Cleaning up the streets', Local Government Chronicle, 27(04), pp. 16-17. Available at: BEST PRACTICE - CLEANING UP THE STREETS | Local Government Chronicle (LGC) [https://www.lgcplus.com/archive/best-practice-cleaning-up-the-streets-26-04-2006/] (Accessed: 28 Nov 2025).   

• This report was jointly developed under consultations with Nottingham City Council, Westminster City Council, Glasgow City Council, Liverpool City Council. However, be aware that the political landscapes and intervention focus back then may differ from those in the presence.  
• Excerpt: “Nottingham City Council believes stopping children from entering the sex trade is one of the most important ways of rooting out prostitution. With the focus being to promote the welfare of children involved in the sex industry, the council views them as victims of abuse, coercion and exploitation, and offers support to discourage them from returning to the streets. Meanwhile, the pimps and kerb-crawlers who prey on them are criminalised ... Nottingham City Council conveyed messages about the dangers of prostitution through schools and engaged with youngsters to find out how and why children were becoming prostitutes. It also set up a drop-in base for vulnerable children in need of general advice or a medical check.”  

Home Office. (2016) ‘The government response to the third report from the home affairs select committee session 2016-17 HC 26: Prostitution.’ Available at: Cm 9361 [https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/573937/57531_Cm_9361_Accessible.pdf] (Accessed: 8 December 2025). [google search result]  

• Search keyword ‘exit’ to read relevant content.

Scottish Government. (2024) ‘Prostitution – challenging and deterring men’s demand: strategic approach.’ Available at: Annex - Prostitution - challenging and deterring men's demand: strategic approach - gov.scot [https://www.gov.scot/publications/scotlands-strategic-approach-challenging-deterring-mens-demand-prostitution-supporting-recovery-sustainable-exit-those-involved-prostitution/pages/9/] (Accessed: 8 December 2025). [google search result]  

• Please use the table of content on the left-hand side to guide reading.

Scottish Government. (2017) ‘Exploring available knowledge and evidence on prostitution in Scotland via practitioner-based interviews.’ Available at: Exploring Available Knowledge and Evidence on Prostitution in Scotland Via Practitioner-Based Interviews [https://www.gov.scot/binaries/content/documents/govscot/publications/research-and-analysis/2017/02/exploring-available-knowledge-evidence-prostitution-scotland-via-practitioner-based-interviews/documents/00514437-pdf/00514437-pdf/govscot%3Adocument/00514437.pdf] (Accessed: 8 December 2025). [google search result]  

• Introduction: This is a summary of findings from research conducted by Justice Analytical Services (Scottish Government) into available knowledge and evidence on the scale and nature of prostitution in Scotland focussing predominantly, though not exclusively on women involved in prostitution. The project gathered evidence and views from professionals with knowledge and expertise on prostitution.
• Use the table of content to guide reading on page 2. Effective reading regarding support to exit sex work are on page 9-11, page 55-65.

Published papers  and reports

Cusick, L. (2002), Youth prostitution: a literature review. Child Abuse Rev., 11: 230-251. Available at: Youth prostitution: a literature review - Cusick - 2002 - Child Abuse Review - Wiley Online Library [https://onlinelibrary.wiley.com/doi/abs/10.1002/car.743?msockid=3ed276130558652304b962f904e364fd] (Accessed: 28 Nov 2025).  [google search result]  

• Abstract: This article reviews the academic literature on young people involved in prostitution. The prevalence and aetiology of youth prostitution and its links with drug use and criminal careers are explored. It argues that whatever the power of personal experiences which incline a person towards prostitution, prostitution can still only be possible in specific cultural conditions. The phenomenon of prostitution has the sexual double standard, poverty and an unequal labour market as prerequisites. We should not expect prostitution to either disappear or occur with equal frequency in men and women while these aspects of inequality continue. This article reviews debates on the particular challenges for service delivery and working together with this vulnerable group. In a civilized society, we should organize that the burden of inequalities which underlie prostitution should not be carried by children. 
• Excerpt: “The multiagency group should devise a support and exit strategy tailored to each child’s needs. The strategy should include providing accommodation; therapy, leisure, education and training” (p. 231) 
• Search keyword: “exit” to explore relevant findings. Try to access this paper via Open Athens, contact Eve Wang for a copy if having access issues.

Jane, S. and Maggie, O. N. (2007) 'Regulating prostitution: social inclusion, responsibilisation and the politics of prostitution reform', British Journal of Criminology, 47(5), pp. 764-778. Available at: REGULATING PROSTITUTION: Social Inclusion, Responsibilization and the Politics of Prostitution Reform on JSTOR [https://www.jstor.org/stable/23639305?seq=1] (Accessed: 28 Nov 2025).   

• Abstract: In an examination of prostitution's changing regulatory framework, the authors offer a critical account of the move from 'enforcement' (punishment) to 'multi-agency' (regulatory) responses as, in part, a consequence of new forms of governance. The authors focus on the increasing salience of multi-agency interventions designed to exit women from prostitution through techniques of risk and responsibilization. By exploring the moral and political components of these techniques, the authors demonstrate how they operate to privilege and exclude certain forms of citizenship, augmenting the on-going hegemonic moral and political regulation of sex workers. 
• This paper presents critical discussions of sex work regulations and exiting programmes. In-depth discussions of exiting sex work are from page 767 to page 771. A diagram shows needs and support of women on page 770.

Brennan, D. and Macleod, J. (2010) 'A good practice guide for organisations working with women in prostitution'. Available at: Layout 1 [http://www.wdhscp.org.uk/media/1039/prostitution-guidelinesprintersversion_2.pdf] (Accessed: 4 Dec 2025) 

• Background: Addresses issues relating to women in street prostitution, and issues for workers and agencies. Examines ways for workers to work safely on the streets and shows examples of good practice of women-centred work. Discusses prostitution as a child protection issue. Suggests strategies to support women to exit prostitution, involving a multi-agency approach. Explores general good practice under specific policy headings: safety, harm reduction, confidentiality, self-esteem, choices and decisions. Offers detailed guidance, on developing work with women. Focuses on the development of face-to-face support work with women working in prostitution. Provides information on resources and services; available. 
• Use the table of content on page 3 to guide your reading. Effective reading regarding ‘prevention and early intervention’ can be found on page 22.  

Sagar, T. (2007) 'Tackling on-street sex work anti-social behaviour orders, sex workers and inclusive inter-agency initiatives', Criminology & Criminal Justice: An International Journal, 7(2), pp. 153-168. Available at: Tackling on-street sex work - Tracey Sagar, 2007 [https://journals.sagepub.com/doi/10.1177/1748895807075568] (Accessed: 5 Dec 2025).

• Abstract: This article considers the deployment of anti-social behaviour orders (ASBOs) against female sex workers in light of the UK government's quest for the development of coherent legal and policy frameworks to tackle the problem of on-street sex work. First, it seeks to critique the exclusionary ASBO as an inappropriate approach to tackle sex work. Next, it discusses the pre-ASBO consultation procedure, which was meant to bring welfare agencies to the consultation table prior to the issue of an ASBO. Finally, it considers the ASBO as a mechanism of control capable of working 'in tandem' with local inclusive initiatives that aim to provide practical, material and emotional assistance to enable sex workers to exit the streets. It is concluded that ASBOs should not be issued against sex workers, particularly given their potential to impact negatively on social/welfare work

Rule, R. and Twinley, R., 2021. Developing an occupational perspective of women involved in sex work: A discussion paper. Journal of Occupational Science, 28(1), pp.133-143. Available at: Rule_and_Twinley_Developing_an_occupational_perspective_of_women_involved_in_sex_work_a_discussion_paper.pdf [https://cris.brighton.ac.uk/ws/portalfiles/portal/11168383/Rule_and_Twinley_Developing_an_occupational_perspective_of_women_involved_in_sex_work_a_discussion_paper.pdf]  (Accessed: 28 Nov 2025).  [google search result]  

• Abstract: Sex work is a commonplace form of work that is variably tolerated, or not, worldwide. Perceived by many to be a complex social issue, sex work is interpreted and performed differently, depending on the political, religious, cultural, and legal context - all of which shape the dominant cultural narrative regarding stigmatising perceptions of sex workers. The aim of our discussion paper is to outline reflections and to offer some arguments on the challenges and opportunities of addressing sex work from an occupational perspective. We focus on three issues: the push and pull factors of sex work, a critical consideration of the common assumption that health can be promoted through occupation, and the contribution that occupational science can provide for sex workers

Sanders, T., 2007. Becoming an ex–sex worker: Making transitions out of a deviant career. Feminist Criminology, 2(1), pp.74-95. Available at: Becoming an Ex–Sex Worker - Teela Sanders, 2007 [https://journals.sagepub.com/doi/abs/10.1177/1557085106294845?casa_token=BD4hAiGh4SQAAAAA:evODDPXStRV2Y_T2hQc6ce2VdhmmbKx7ytPVC2wqstVvAIKhs-47Vgx4T_9s-_x_W59UssngusO01_0] (Accessed: 8 Dec 2025).  [google search result]  

• Abstract: This article has four core aims. First, to identify the processes of change women undertake to leave sex work through a typology of transitions. The typology suggests four dominant ways out of sex work as reactionary, gradual planning, natural progression, and “yo-yoing.” Second, the article argues against the low self-control theory by asserting that sex workers engage in specific deviant “careers” rather than stable deviant roles and, therefore, exit to “complete conformist” once sex work is ceased. Third, it rejects Mansson and Hedin’s claim that the “emotional commitment” of individual women is the key factor to leaving but instead argues that structural, political, cultural, and legal factors as well as cognitive transformations and agency are key determinants in trapping women in the industry. Fourth, the article challenges the U.K. policy context that reinforces “exiting” through compulsory rehabilitation and the criminalization of sex work.
• Great paper, please read!

“‘I’m no criminal’: Examining the impact of prostitution-specific criminal records on women seeking to exit prostitution”. Eaves & nia (2017). Available at: Microsoft Word - 008310_NIA Report.docx [https://niaendingviolence.org.uk/wp-content/uploads/2020/02/Im_No_Criminal.pdf] (Accessed: 9 Dec 2025). [google search result]

• Background: This report arose out of an earlier research project conducted jointly by Eaves and London South Bank University which examined women’s experiences in prostitution and, specifically, their experiences in trying to exit prostitution. That research found nine common barriers to exit, one of which was criminal records. In the course of that research, the team found that that there was a considerable body of evidence that examined the limiting impact of criminal records on the rehabilitation and reintegration of ex-offenders generally. There was, however, significantly less research looking at the impact for female ex-offenders and still less which examined the impact of prostitution-specific records on women’s experiences of building a new life. As such, the team embarked on a more detailed study to this effect and was fortunate in obtaining funding from Lankelly Chase to do so. This report presents the findings of that research and argues that prostitution-specific criminal records are uniquely discriminatory, arbitrary, irrational and disproportionate for women involved, or formerly involved, in prostitution.
• Search keyword ‘exit’ to be directed to relevant reading. Table of content is on page 3 – 4.

Insights from individuals with lived experience

Tracey, S., Debbie, J. and Katrien, S. (2015) 'Sex work, drug and alcohol use: bringing the voices of sex workers into the policy and service development framework in Wales'.  Available at: sex-work-drug-and-alcohol-use-bringing-the-voices-of-sex-workers-into-the-policy-and-service-development-framework-in-wales.pdf [https://www.gov.wales/sites/default/files/publications/2019-02/sex-work-drug-and-alcohol-use-bringing-the-voices-of-sex-workers-into-the-policy-and-service-development-framework-in-wales.pdf] (Accessed: 27 Nov 2025).   

• Abstract: Reports on the second stage of a research project to provide a better understanding of the connections between sex work and drug and alcohol misuse in Wales. It details and discusses the results of a questionnaire carried out with 40 sex workers in South Wales. The interviews covered pathways into sex work; health and safety; the needs of drug and/or alcohol using sex workers; barriers in accessing support; and perceptions on service provision. The results are presented across the following themes: socio-demographic characteristics; organisation of the work; pathways into sex work; partners, family and friends; experiences with the care system; accommodation and homelessness; safety; mental and physical health; prison and probation; alcohol and substance use; stopping taking drugs; and services. For the majority of sex workers who took part in the research problematic drug use and sex work were re-enforcing. Respondents identified several obstacles to them accessing the support that they feel they need. They wanted to see reduced waiting times for methadone prescriptions, more flexibility in service provision and particularly drug treatment services, more professional staff, the opportunity to receive treatment away from other substance users, staff not to judge and stigmatise them, and for multiple issues to be addressed simultaneously. The report makes recommendations for improving service provision for sex workers in Wales. 
• Excerpt: “A harm reduction approach rather than an exit focused approach (assisting women to step out of sex work) is more likely to offer greater support to sex workers – this has however to be tailored to individual need.” (p. 104) 
• Search keyword ‘exit’ to explore relevant findings. 

Theme 4: International evidence (29 references)

Facilitators and barriers to exiting sex work

Cronley, C., Cimino, A. N., Hohn, K., Davis, J. and Madden, E. (2016) 'Entering Prostitution in Adolescence: History of Youth Homelessness Predicts Earlier Entry', Journal of Aggression, Maltreatment and Trauma, 25(9), pp. 893-908. Available at: Full article: Entering Prostitution in Adolescence: History of Youth Homelessness Predicts Earlier Entry [https://www.tandfonline.com/doi/full/10.1080/10926771.2016.1223246] (Accessed: 5 Dec 2025). This study was conducted in the United States. 

• Abstract: The effect of youth homelessness on age of entry into prostitution was tested, controlling for other known covariates using a multivariate model. Women (N = 96) who self-identified as having engaged in prostitution completed cross-sectional standardized questionnaires (Mage = 42.6, SD = 9.18; 62% African American). Women with a history of youth homelessness entered prostitution nearly 8 years earlier than their peers without this history (at 18 vs. 25 years old). Lack of a high school degree or equivalent also predicted an earlier age of entry (at 20 vs. 28 years old).
• Findings highlight the poverty dynamics that underlie the relationship between early entry into prostitution and homelessness. Young women, living on the street or in shelters, with limited education and employment opportunities, are at high risk of entering prostitution when they are barely out of adolescence. Future research will be better able to design age-specific prevention strategies.

Manopaiboon, C., Bunnell, R. E., Kilmarx, P. H., Chaikummao, S., Limpakarnjanarat, K., Supawitkul, S., St Louis, M. E. and Mastro, T. D. (2003) 'Leaving sex work: barriers, facilitating factors and consequences for female sex workers in northern Thailand', AIDS Care, 15(1), pp. 39-52. Available at: Leaving sex work: Barriers, facilitating factors and consequences for female sex workers in northern Thailand [https://www.tandfonline.com/doi/epdf/10.1080/012021000039743?needAccess=true] (Accessed: 5 Dec 2025)

• Abstract: Factors facilitating or inhibiting women's ability to leave sex work are still poorly characterized, and little is known about women's lives after they leave the profession. This paper presents findings from a qualitative study about factors affecting women's ability to leave sex work and influencing their lives after leaving. Women's ability and decisions to leave sex work were determined primarily by four factors: economic situation, relationship with a steady partner, attitudes towards sex work and HIV/AIDS experience. Economic concerns, ranging from survival needs to materialistic desires, had the strongest influence. Most women perceived their risk for HIV infection to be lower after leaving sex work, but three of the 17 HIV-infected women acquired infection after having left, presumably from their steady partners. Prevention efforts should guide women as they transition out of commercial sex work. Interventions aimed at assisting women wanting to leave sex work need to address the role of economic factors.

Arnold, K. A., Turner, N., Barling, J. and Iverson, R. D. (2020) 'Feeling safe while doing sex work: Motivation for entering sex work moderates the relationship between perceptions of physical danger and desire to leave sex work', Safety Science, 129. Available at: Feeling safe while doing sex work: Motivation for entering sex work moderates the relationship between perceptions of physical danger and desire to leave sex work - ScienceDirect [https://www.sciencedirect.com/science/article/pii/S0925753520301922?via%3Dihub#s0055] (Accessed: 5 Dec 2025). This study was conducted based on data in Australia.

• Abstract: Large segments of society stigmatize sex work as 'dirty' because of the moral dubiousness and physical danger associated with its conduct. Drawing on social exchange and self-determination theories, we investigated the relationship between perceptions of physical danger at work and desire to leave sex work as an occupation among 321 female sex workers in Melbourne, Australia. We examined reasons for entering the occupation of sex work as a moderator of this relationship. Under conditions of high perceptions of physical danger, women who cited extrinsic (largely economic) reasons for choosing sex work reported higher desire to leave sex work than women who cited intrinsic (personal) reasons for choosing sex work did. Levels of desire to leave sex work of women who reported intrinsic reasons for choosing sex work did not differ across levels of perceived physical danger. As such, we consider the 'dark side' of intrinsic reasons for choosing work that may inadvertently deter respondents from wanting to leave physically dangerous work.

Preble, K., Magruder, K. and Cimino, A. N. (2019) '"It's like being an electrician, you're gonna get shocked": Differences in the perceived risks of indoor and outdoor sex work and its impact on exiting', Victims & Offenders, 14(5), pp. 625-646. Available at: Full article: “It’s like Being an Electrician, You’re Gonna Get Shocked”: Differences in the Perceived Risks of Indoor and Outdoor Sex Work and Its Impact on Exiting [https://www.tandfonline.com/doi/full/10.1080/15564886.2019.1630043#abstract] (Accessed: 5 Dec 2025). This study was conducted in the United States. 

• Abstract: This study sought to understand differences in risks of indoor versus outdoor sex work and how perceptions of risk influenced sex workers’ motivation to exit. Among the 19 indoor and outdoor sex workers included in this qualitative study, themes of risks included: violence versus death, discovery, romantic relationships, arrest, health risks, loss, and “the unknown”. Results of this study show that sex workers have a nuanced perception of risks and exiting motivations dependent upon the sex trade market. These results offer suggestions for policy and intervention practices uniquely tailored for indoor and outdoor sex workers.

Oselin, S. S. (2014) 'Weighing the consequences of a deviant career: Factors leading to an exit from prostitution', Understanding deviance: Connecting classical and contemporary perspectives. New York, NY: Routledge/Taylor & Francis Group; US, pp. 323-339. Available at: Weighing the Consequences of a Deviant Career: Factors Leading to an Exit from Prostitution - Sharon S. Oselin, 2010 [https://journals.sagepub.com/doi/10.1525/sop.2010.53.4.527] (Accessed: 5 Dec 2025). This study was conducted in the United States. 

• Abstract: Research on how individuals leave sex work examines this transition by focusing on either structural/economic conditions that keep them in the trade or internal changes that prompt exiting. Leaving certain roles, such as those deemed criminal and deviant, may be more challenging due to labeling, stigma, and a lack of resources. In this study, the author analyzes the particular factors that lead women to exit street prostitution via enrollment in “helping” organizations. The author finds extant theories do not fully capture how multiple factors combine to pull women off the streets. Rather, the author contends it is both internal and external factors that lead women to initially exit prostitution. This study draws on interviews with thirty-six street prostitutes from four different U.S. cities to address these concerns.

Gesser, N. (2022) '"I just wanna give myself a chance": A qualitatively-informed simulation model of disengagement from street prostitution', Dissertation Abstracts International: Section B: The Sciences and Engineering, 83(3-B), pp. No Pagination Specified. Available at:  CHAPTER # [https://scholarshare.temple.edu/server/api/core/bitstreams/18000da9-a0fb-4931-b4e2-8d2305ac812c/content] (Accessed: 8 Dec 2025). This study was conducted in the United States. 

• Background:  This study set out to better understand the patterns of exiting street prostitution, to explore the role of support in facilitating successful and long-term disengagement from prostitution, and to determine the more effective time to offer support in the exiting process. The findings of this study have important implications for service providers and policy makers in deciding on how much, when, and what type of support to offer women who are exiting street prostitution—for example, incorporating peer support in programs that assist women. The quantitative inquiry revealed the impact and benefits of offering support in the exiting process; the qualitative inquiry revealed the multidimensional nature this support.

Dinse, L. and Rice, K. (2021) 'Barriers to exiting and factors contributing to the cycle of enter/exit/re-entering commercial sex work', Social Work & Christianity, 48(2), pp. 156-182. Available at: Barriers to exiting and factors contributing to the cycle of enter/exit/re-entering commercial sex work / by Ling Dinse. on JSTOR [https://www.jstor.org/stable/community.31982620?seq=1] (Accessed: 8 Dec 2025). This study was conducted in the United States. 

• Abstract: Commercial sex work is a high-risk job. Individuals who desire to leave the sex industry find exiting complex and full of obstacles. This qualitative study identified barriers to making an exit and factors contributing to the cycle of enter/exit/re-enter that characterize commercial sex work. his study found barriers in the individual, social, relational, and structural domains. The study's results validated the use of the polymorphous paradigm to comprehend the challenges of exit and factors that reinforce the industry's cycle of enter/ exit/re-enter. Social workers may develop appropriate programs and services based on the expanded knowledge and insight from this study. A faith-based organization in the Central Pennsylvania area will be used to illustrate the application of the recommended changes. In addition, the results challenged the faith community's response to individuals engaged in the commercial sex industry.

Blakey, J. M. and Gunn, A. (2018) 'The "ickiness factor": Stigma as a barrier to exiting prostitution', Journal of Offender Rehabilitation, 57(8), pp. 538-561. Available at:  Full article: The “ickiness factor”: Stigma as a barrier to exiting prostitution [https://www.tandfonline.com/doi/full/10.1080/10509674.2018.1549177#d1e352] (Accessed: 8 Dec 2025). Please try to access the paper via Open Athens. Alternatively, please contact Eve Wang for a copy.

• Abstract: Exiting prostitution is an often complicated, arduous process. Many barriers constrain women's movement out of prostitution. Factors such as stigma are rarely examined. Utilizing a case study approach, semi-structured interviews were conducted with 14 SEPP prostitution court participants and eight professionals working with participants, to understand the ways in which stigma affected the exiting process among women with extensive histories of prostitution. Rigorous qualitative analysis revealed three types of stigma: structural stigma, public stigma, and self-stigma. Failing to address stigma can thwart the efforts of prostitution courts and social service program trying to help women exit prostitution.

Dalla, R. L. (2000) 'Exposing the "Pretty Woman" myth: A qualitative examination of the lives of female streetwalking prostitutes', Journal of Sex Research, 37(4), pp. 344-353. Available at: Exposing the “pretty woman” myth: A qualitative examination of the lives of female streetwalking prostitutes: The Journal of Sex Research: Vol 37 , No 4 - Get Access [https://www.tandfonline.com/doi/epdf/10.1080/00224490009552057?needAccess=true] (Accessed: 8 Dec 2025). Please try to access the paper via Open Athens. Alternatively, please contact Eve Wang for a copy.

• Abstract: Ecological Systems Theory provides the foundation for this study examining the unique developmental trajectories of women involved in streetwalking prostitution, in conjunction with illuminating shared experiences and points of convergence. Intensive interviews were conducted with 43 prostitutes (aged 19-56 yrs). Data were analyzed according to Phenomenological Descriptive Analysis, results of which are presented in 2 parts. Detailed accounts of the lives of a subgroup of 5 Ss are described first, followed by a broader discussion of results including the entire sample. Themes common across the larger group are presented in 3 segments: (1) early development, (2) life in "the game," and (c) leaving the streets. Despite their individual circumstances, Ss simultaneously shared common experiences of abandonment, abuse, loss, and exploitation. Childhood sexual abuse was described by the majority of Ss, as were literal (e.g., through desertion) or symbolic (e.g., through parental alcoholism/neglect) abandonment. Other themes included removal from, or intentionally leaving (i.e., running away), their families of origin. Involvement in prostitution for many began out of economic necessity or was due to drug addiction. Implications for advocacy and further research are presented.

Dalla, R. L. (2006) '"You can't hustle all your life": An exploratory investigation of the exit process among street-level prostituted women', Psychology of Women Quarterly, 30(3), pp. 276-290. Available at: “You can't Hustle All Your Life”: An Exploratory Investigation of the Exit Process Among Street-Level Prostituted Women - Rochelle L. Dalla, 2006 [https://journals.sagepub.com/doi/10.1111/j.1471-6402.2006.00296.x] (Accessed: 8 Dec 2025). Please try to access the paper via Open Athens. Alternatively, please contact Eve Wang for a copy.

• Abstract: Between 1998 and 1999, 43 street-level prostituted women were interviewed regarding their developmental experiences, including prostitution entry, maintenance, and exit attempts. Three years later, 18 of the original 43 participants were located and interviewed. This exploratory follow-up investigation focused on the women's life experiences between the two points of contact, with emphasis on sex-industry exit attempts. Five women had maintained their exit efforts and had not returned to prostitution, nine had returned to both prostitution and drug use, and one had returned to prostitution only. Three additional women had violated parole and been reincarcerated. Themes evident among those who were able to stay out of prostitution and refrain from substance use are compared to those whose exit attempts had not been successful. Suggestions for intervention and outreach are presented, as are directions for future work.

Cimino, A. N. (2021) 'Uncovering intentions to exit prostitution: Findings from a qualitative study', Quitting the sex trade: Why and how pimps and sex workers leave the business. New York, NY: Routledge/Taylor & Francis Group; US, pp. 74-92. Available at: Uncovering Intentions to Exit Prostitution: Findings from a Qualitative Study: Victims & Offenders: Vol 14 , No 5 - Get Access [https://www.tandfonline.com/doi/full/10.1080/15564886.2019.1628144]  (Accessed: 8 Dec 2025). This study was conducted in the United States. Please try to access the paper via Open Athens. Alternatively, please contact Eve Wang for a copy.

• Abstract:  Exiting prostitution is a process for which we have little empirical understanding. This study provides evidence of a process-oriented theory of intentions to exit prostitution that operationalizes key aspects of exiting. Interviews from 16 persons formerly and actively selling sex helped define intentions to exit as a combination of glamorization and risk-recognition attitudes, stigma from significant others, one's own resilient self-efficacy beliefs, and agency. Findings contribute to our understanding of the cognitive changes that occur when a person decides to leave prostitution, which can be used to inform a readiness to exit assessment and interventions that increase intentions to exit.

Mental health needs

Jung, Y. E., Song, J. M., Chong, J., Seo, H. J. and Chae, J. H. (2008) 'Symptoms of posttraumatic stress disorder and mental health in women who escaped prostitution and helping activists in shelters', Yonsei Medical Journal, 49(3), pp. 372-382. Available at: :: YMJ :: Yonsei Medical Journal [https://eymj.org/DOIx.php?id=10.3349/ymj.2008.49.3.372] (Accessed: 5 Dec 2025).  This study was conducted in Korea.

• Purpose: This study compared the mental symptoms, especially symptoms of posttraumatic stress disorder (PTSD), of women who escaped prostitution, helping activists at shelters, and matched control subjects.
• Results: Female ex-prostitutes had significantly higher stress response, somatization, depression, fatigue, frustration, sleep, smoking and alcohol problems, and more frequent and serious PTSD symptoms than the other 2 groups. Helping activists also had significantly higher tension, sleep and smoking problems, and more frequent and serious PTSD symptoms than control subjects.
• Conclusion: These findings show that engagement in prostitution may increase the risks of exposure to violence, which may psychologically traumatize not only the prostitutes themselves but also the people who help them, and that the effects of the trauma last for a long time. Future research is needed to develop a method to assess specific factors that may contribute to vicarious trauma of prostitution and protect field workers of prostitute victims from vicarious trauma.

Krumrei-Mancuso, E. J. (2017) 'Sex work and mental health: A study of women in the Netherlands', Archives of Sexual Behavior, 46(6), pp. 1843-1856. Available at: Sex Work and Mental Health: A Study of Women in the Netherlands | Archives of Sexual Behavior [https://link.springer.com/article/10.1007/s10508-016-0785-4] (Accessed: 5 Dec 2025).

• Abstract: This study examined how characteristics of prostitution and quality-of-life factors related to symptoms of depression and post-traumatic stress among 88 women engaged in prostitution in the Netherlands. Numerous factors were associated with elevated mental health concerns, including the experience of violence in prostitution, engaging in street prostitution, being motivated to engage in prostitution for financial reasons, having less confidence in one’s ability to find alternative work, desiring to leave prostitution, and sense of self-transcendence. In contrast, focusing on achievement, having a sense of fair treatment from others and society, and self-acceptance were associated with better mental health outcomes.
• Finally, mediation analyses indicated that post-traumatic stress associated with engaging in prostitution against one’s deeper desire to exit prostitution was, in part, the result of a lack of self-acceptance. The analyses controlled for relevant demographic factors, including age and level of education. The effect sizes for each of the findings ranged from medium to large. Implications for mental health care and public policy are included.

Cascio, K. A. (2019) 'Providing trauma-informed care to women exiting prostitution: assessing programmatic responses to severe trauma', Journal of Trauma and Dissociation, 20(1), pp. 100-113. Available at: Full article: Providing trauma-informed care to women exiting prostitution: assessing programmatic responses to severe trauma [https://www.tandfonline.com/doi/full/10.1080/15299732.2018.1502713] (Accessed: 5 Dec 2025). This programme was delivered in the United States.

• Abstract: Women in prostitution (WIP) experience extremely high levels of sexual, physical, and emotional abuse and are significantly more likely to experience mental health issues and trauma than the general population. Research that addresses the mental health needs of WIP emphasizes treating trauma, both trauma that predated entry into prostitution and trauma experienced during prostitution. Very little research is available on services for WIP, thus providers have limited guidance on providing effective services, particularly trauma-informed care. Although programs exist exclusively to assist women leaving prostitution, little is known about services they offer or if services are trauma-informed. Given this dearth, this study consisted of exploratory program evaluations of eight agencies that focus primarily on serving WIP to understand how trauma is addressed in their services.

Drug use and recovery

Gesser, N. (2024) '"I was already there once": Cumulative attempt capital of marginalized women exiting substance use and street prostitution contributes to their recovery capital', American Journal of Community Psychology, 73(3-4), pp. 554-567. Available at: “I was already there once”: Cumulative attempt capital of marginalized women exiting substance use and street prostitution contributes to their recovery capital - Gesser - 2024 - American Journal of Community Psychology - Wiley Online Library [https://onlinelibrary.wiley.com/doi/10.1002/ajcp.12736] (Accessed: 5 Dec 2025). This study was conducted based on data in the United States.

• Background: Despite a move to view substance use as a disease of the brain, relapse into drugs is still often viewed as a personal failure. Low recovery capital has been used to explain relapse among certain marginalized populations. Recovery capital is a recent framework that refers to the individual's sum of all internal and external assets that may assist in their recovery process. It includes four categories: physical, human, social, and cultural capital. However, this framework does not relate to the role of actual relapses in the recovery process, despite their common occurrence. 
• Highlights: Cumulative attempt capital should complement other dimensions in recovery capital; Service providers should reframe previous failure as part of recovery capital; Relapses can benefit women in recovery by helping them develop a sense of capability; Relapse also allows women to develop recovery networks and learn from past mistakes; Past recovery attempts improve physical and mental health despite relapse.

White, R. H., Park, J. N., Galai, N., Decker, M. R., Allen, S. T., Footer, K. H. A. and Sherman, S. G. (2020) 'Short-term interruptions to sex work among a prospective cohort of street-based cisgender female sex workers in Baltimore (United States)', International Journal of Drug Policy, 84. Available at: Short-term interruptions to sex work among a prospective cohort of street-based cisgender female sex workers in Baltimore - ScienceDirect [https://www.sciencedirect.com/science/article/pii/S0955395920301985?via%3Dihub] (Accessed: 5 Dec 2025).   

• Background: Street-based female sex workers (FSW) often cycle in and out of sex work engagement. For many FSW, substance use plays a critical role in sex work entry, continuation, and interruptions. We examined individual, interpersonal, and structural correlates of short-term interruptions of sex work among street-based FSW in an urban environment.
• Results: Eighty-two women (40%) reported stopping sex work over the past 3 months at least once during follow-up. Past drug treatment (adjusted incidence rate ratio [aIRR] 1.40; 95% CI: 1.06–1.86) and not having used drugs in the past 3 months (aIRR 2.70; 95% CI: 1.96–3.71) were positively associated with short-term interruption to sex work. Past intimate partner violence (IPV) (aIRR 0.52; 95% CI: 0.31–0.86) and current homelessness (aIRR 0.61; 95% CI: 0.41–0.91) were negatively associated with short-term interruption. Results were inconclusive for the association between recent prostitution arrest and short-term interruptions to sex work (IRR 0.86; 95% CI: 0.40–1.86).
• Conclusion: The study suggests that similar to other professions, women leave sex work for numerous reasons. Substance use cessation and participation in drug treatment programs may contribute to short-term interruptions of sex work by reducing reliance on sex work for income among street-based FSW. Structural vulnerabilities including homelessness and IPV are driving continued street-based sex work, speaking to the need for holistic structural interventions.

Bachman, R., Rodriguez, S., Kerrison, E. M. and Leon, C. (2019) 'The recursive relationship between substance abuse, prostitution, and incarceration: Voices from a long-term cohort of women', Victims & Offenders, 14(5), pp. 587-605. Available at: (PDF) The Recursive Relationship between Substance Abuse, Prostitution, and Incarceration: Voices from a Long-Term Cohort of Women [https://www.researchgate.net/publication/351408486_The_Recursive_Relationship_between_Substance_Abuse_Prostitution_and_Incarceration_Voices_from_a_Long-Term_Cohort_of_Women] (Accessed: 8 Dec 2025). This study was delivered in the United States.

• Abstract: Relying on interview data from a cohort of drug-involved women originally released from prison in the 1990s and interviewed between 2010 and 2011, this paper examines the role that prostitution played in their lives. These women were arrested an average of 16 times in their lives, and their criminal records prevented them from obtaining legitimate employment, which resulted in nearly half of the sample engaging in "survival prostitution." Consistent with the Identity Theory of Desistance, narratives from those who successfully exited prostitution reveal the cognitive transformations that began when they envisioned their "feared self" (e.g. dying on the street). This research illuminates the complexities inherent in the desistance process for a contemporary sample of drug-involved adult women entrenched within the criminal justice system.

Exiting interventions and effective practices

Shareck, M., Buhariwala, P., Hassan, M., Balla, E. and O'Campo, P. (2024) 'Supporting Women Exit Sex Work: A Contribution Analysis of the Exit Doors Here Integrated Care Program in Toronto, Canada', International Journal of Integrated Care [Electronic Resource], 24(1), pp. 22. Available at: Supporting Women Exit Sex Work: A Contribution Analysis of the Exit Doors Here Integrated Care Program in Toronto, Canada | International Journal of Integrated Care [https://ijic.org/articles/10.5334/ijic.7700] (Accessed: 5 Dec 2025).   

• Introduction: Exiting sex work is a complex process which can be facilitated by integrated action on health and its social determinants such as housing and employment. Few programs offer such coordinated support, and even fewer have been evaluated. We assessed if and how Exit Doors Here, a program anchored in the Critical Time Intervention (CTI) model [#CTIapproach], facilitated women's progress towards their goals, and exit from sex work.
• Description: We performed a contribution analysis by combining pre-post questionnaire and administrative data from 55 women enrolled in the program (2018-2021), yearly interviews with program staff and peer mentors, and literature reviews to assess program outcomes and mechanisms as described in the theory of change.
• Discussion: We found evidence that the program contributed to participants progressing on their pre-employment, housing, income, and sex work exiting goals. We identified four "key ingredients" facilitating success: trust building, collaborative goal setting, connecting with community supports and weekly drop-in sessions.
• Conclusion: This rigorous theory-based evaluation provides much needed evidence on the process and effectiveness of an integrated sex work exiting program. Findings regarding key program ingredients can inform other interventions serving similarly marginalized populations.

Tsai, L. C., Witte, S. S., Aira, T., Altantsetseg, B. and Riedel, M. (2011) 'Piloting a savings-led microfinance intervention with women engaging in sex work in Mongolia: Further innovation for HIV risk reduction', Open Women's Health Journal, 5(1), pp. 26-32. Available at: Piloting a Savings-Led Microfinance Intervention with Women Engaging in Sex Work in Mongolia: Further Innovation for HIV Risk Reduction [https://benthamopenarchives.com/abstract.php?ArticleCode=TOWHJ-5-26] (Accessed: 5 Dec 2025).   

• Abstract: This paper describes a pilot study testing the feasibility of an innovative savings-led microfinance intervention in increasing the economic empowerment and reducing the sexual risk behavior of women engaging in sex work in Mongolia. Women's economic vulnerability may increase their risk for HIV by compromising their ability to negotiate safer sex with partners and heightening the likelihood they will exchange sex for survival.
• Microfinance has been considered a potentially powerful structural HIV prevention strategy with women conducting sex work, as diversification of income sources may increase women's capacity to negotiate safer transactional sex. With 50% of all reported female HIV cases in Mongolia detected among women engaging in sex work, direct prevention intervention with women conducting sex work represents an opportunity to prevent a potentially rapid increase in HIV infection in urban Mongolia. The piloted intervention consisted of a matched savings program in which matched savings could be used for business development or vocational education, combined with financial literacy and business development training for women engaging in sex work.
• Results of the pilot demonstrate participants’ increased confidence in their ability to manage finances, greater hope for pursuing vocational goals, moderate knowledge gains regarding financial literacy, and an initial transition from sex work to alternative income generation for five out of nine participants. The pilot findings highlight the potential for such an intervention and the need for a clinical trial testing the efficacy of savings-led microfinance programs in reducing HIV risk for women engaging in sex work in Mongolia.

Torri, M. C. (2014) 'Micro-entrepreneurship programs and sexual health prevention among sex workers in Cambodia: Is an integrative approach the way forward?', International Journal of Health Promotion and Education, 52(3), pp. 153-162. Available at: Full article: Micro-entrepreneurship programs and sexual health prevention among sex workers in Cambodia: is an integrative approach the way forward? [https://www.tandfonline.com/doi/full/10.1080/14635240.2014.890346] (Accessed: 5 Dec 2025).   

• Abstract: Improving livelihoods through entrepreneurship activities and program implementation are increasingly considered as key drivers for enhancing health of the participants and reducing their proneness to diseases. Combined programs of entrepreneurship and health education have yet to be widely applied to the practice of promoting sexual health. However, there has been the emergence of small projects focused on both financial and educational aspects of sex workers. The objective of these programs is to favor the empowerment of vulnerable groups through skills training in order to decrease sexual risk among them. Considering the well-known structural links between poverty and HIV/AIDS, combined micro-enterprise development and health educational programs have been implemented among sex workers in order to reduce the risk of HIV/AIDS among these categories of women. This article aims to explore the potential of these combined programs of entrepreneurship and health education to create new models and strategies to improve sexual health among groups at greatest risk of infection such as the sex workers in Phnom Penh, Cambodia.
• Excerpt: “Women who were able to successfully leave the sex industry explained how the final exit was characterized by a period of moving in and out of sex work, struggling to decide what to do next. These data are consistent with the study by Sanders (2007), who explained how former sex workers felt trapped in a cycle of moving in and out of sex work because the money they earned could not be easily substituted by an alternative job in the mainstream labor market.”

Odek, W. O., Busza, J., Morris, C. N., Cleland, J., Ngugi, E. N. and Ferguson, A. G. (2009) 'Effects of micro-enterprise services on HIV risk behaviour among female sex workers in Kenya's urban slums', AIDS and Behavior, 13(3), pp. 449-461. Available at: Effects of micro-enterprise services on HIV risk behaviour among female sex workers in Kenya's urban slums - PubMed [https://pubmed.ncbi.nlm.nih.gov/18998204/] (Accessed: 5 Dec 2025). 

• Abstract: This study assessed individual-level effects of adding micro-enterprise services to a peer-mediated HIV/AIDS intervention among 227 female sex workers (FSWs) in Kenya. Survey data were collected in May-July 2003 and July-August 2005. Two-thirds of participants had operational businesses by end-line survey. Nearly half reported to have stopped sex work. Self-reported weekly mean number of all sexual partners changed from 3.26 (SD 2.45) at baseline to 1.84 (SD 2.15) at end-line survey (P < 0.001). Weekly mean number of casual partners did not change significantly. Weekly mean number of regular partners changed from 1.96 (SD 1.86) to 0.73 (SD 0.98) over the follow-up period (P < 0.001). Consistent condom use with regular partners increased by 18.5% and remained above 90% with casual partners.
•  Micro-enterprise services may empower FSWs by giving them an alternative livelihood when they wish to exit or reduce reliance on sex work. Determinants of successful business operation by FSWs deserve further research.

Shareck, M., Buhariwala, P., Hassan, M. and O'Campo, P. (2020) 'Helping women transition out of sex work: Study protocol of a mixed-methods process and outcome evaluation of a sex work exiting program', BMC Women's Health, 20(1). Available at: Helping women transition out of sex work: study protocol of a mixed-methods process and outcome evaluation of a sex work exiting program | BMC Women's Health [https://link.springer.com/article/10.1186/s12905-020-01086-3] (Accessed: 5 Dec 2025). This intervention was delivered in Canada.

• Background: For women who want to, exiting sex work can be challenging. Numerous programs strive to help women wanting to exit sex work and secure alternative sources of income by providing targeted support at key moments during the transition, yet few of those initiatives are rigorously evaluated. In 2017 “Exit Doors Here”, a 9-month sex work exiting program based on the critical time intervention (CTI) approach, was developed to provide wrap-around support services (e.g., health, addiction, housing, education, and employment supports) to women wishing to transition towards exiting sex work.

Hall, L. D. (2022) 'Former female sex workers' perceptions of spirituality in exiting sex work', Dissertation Abstracts International: Section B: The Sciences and Engineering, 83(9-B), pp. No Pagination Specified. Available at: Former Female Sex Workers’ Perceptions of Spirituality in Exiting Sex Work - ProQuest (Accessed: 5 Dec 2025). This study was delivered in the United States.

• Exiting sex work is extremely difficult. Women trying to exit sex work experience cycles of exit and re-entry until they finally succeed. Spirituality has been identified as one of the factors that contribute to the exiting process or that help in the decision of not returning to sex work. The purpose of this interpretative phenomenological analysis was to explore former female sex workers' perceptions of spirituality during the process of exiting sex work. The integrated model for exiting sex work constituted the theoretical basis for this study. Data were collected from semi-structured interviews with 15 adult former female sex workers who experienced spirituality as a major force for exiting sex work. Results of coding and thematic analysis indicated that former female sex workers entered sex work because of experiencing several vulnerabilities early in life, which led them to involuntary sex work. Engaging in sex work was traumatic. Spirituality was one of the supportive factors that helped participants consider a different life with a renewed sense of self. Spirituality provided hope, meaning, and a sense of peace with how participants saw themselves. It is hoped that the results can be used for positive social change in the creation and implementation of spiritually based prevention and intervention programs for this population.

Twis, M. K., Cimino, A. and Plunk, M. (2024) 'Coping self-efficacy and social support as predictors of adolescent sex trafficking exit: Results of a secondary analysis', PLoS ONE Vol 19(1), 2024, ArtID e0291207, 19(1). Available at: Coping self-efficacy and social support as predictors of adolescent sex trafficking exit: Results of a secondary analysis | PLOS One [https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0291207] (Accessed: 5 Dec 2025). This study was conducted in the United States. 

• Introduction: Social work case management services are increasingly available to youth who want to exit commercial sexual exploitation (CSE). However, few empirical studies investigate the efficacy of such services, particularly whether these services promote an exit from CSE. Guided by ecological systems theory and the Intentions to Exit Prostitution (IEP) model, this study investigates the efficacy of social work case management services for youth CSE survivors.
• Implication: Results suggest social work case management services that improve coping self-efficacy and perceived social support can lead to cognitive changes that promote an exit from CSE. Practitioners should target services that adhere to dimensions of the IEP as these improvements are likely to support positive outcomes for youth survivors of CSE.

Praimkumara, S. and Goh, E. C. (2016) 'Understanding the impact of the mother-child relationship on sex workers' decision to enter and leave the streets-Lessons for social work practice', Journal of Social Work Practice, 30(1), pp. 43-58. Available at: Full article: UNDERSTANDING THE IMPACT OF THE MOTHER-CHILD RELATIONSHIP ON SEX WORKERS’ DECISION TO ENTER AND LEAVE THE STREETS – LESSONS FOR SOCIAL WORK PRACTICE [https://www.tandfonline.com/doi/full/10.1080/02650533.2015.1082464] (Accessed: 5 Dec 2025). This study was conducted in the Singapore 

• Abstract: This paper focuses on ‘streetwalkers’ and ‘street sex workers’ who are unlicensed sex workers not belonging to a brothel and subject to criminalization. They often face great stigmatization and are usually considered victims by service providers. Five Singaporean ex-streetwalkers (n = 5), who had left the streets for at least six months and were currently receiving or had previously received skills training at a social service agency, participated in this study. Using an agentic framework and social relational theory principles, this qualitative study explored the impact of streetwalkers’ relationship with their children on their decision to enter and leave the streets and reasons for their successful help-seeking experiences. Findings revealed them to be agents who actively used strategies to meet their goals and to sustain close relationships with their children. The mother–child relationship context was a key influence on their decision to enter and/or leave the streets.
• Social work practice implications include tailoring service delivery to tap into their agentic capacities and identity as mothers; research and training in provision of proactive social services in a non-judgmental manner to preserve the dignity of these women while meeting both their own and their children’s needs.

Cimino, A. N. (2014) 'Developing and testing a theory of intentions to exit street-level prostitution: A mixed methods study', Dissertation Abstracts International Section A: Humanities and Social Sciences, 74(11-A(E)). Available at:  Microsoft Word - 1000604884 Cimino,Andrea Nichole_final.doc [https://files.core.ac.uk/download/pdf/79566865.pdf] (Accessed: 8 Dec 2025). This study was delivered in the United States.

• Abstract:  Prior research has only been iii able to describe, but not explain or predict, the prostitution exiting process. This study fills a gap in literature by providing a quantitative examination of women’s intentions to leave prostitution. The results contribute to our understanding of the cognitive changes that occur when a person leaves prostitution, and the validated instrument may be used as an intervention assessment or an exit prediction tool. Success in predicting an individual’s passage through the exiting process could have important and far-reaching implications on recidivism policies or interventions for this vulnerable group of women.

Bowen, E. A., Canfield, J. P., Trostle, A. and Harley, D. (2015) 'Predictors of stable housing for homeless women leaving a sex work-exiting program', Families in Society, 96(4), pp. 268-276. Available at: Predictors of Stable Housing for Homeless Women Leaving a Sex Work-Exiting Program - Elizabeth A. Bowen, James P. Canfield, Amy Trostle, Dana Harley, 2015 [https://journals.sagepub.com/doi/abs/10.1606/1044-3894.2015.96.36]  (Accessed: 8 Dec 2025). This study was delivered in the United States.  Please try to access the paper via Open Athens. Alternatively, please contact Eve Wang for a copy.

• Abstract: Women who have experienced homelessness while engaging in sex work have complex service needs. A variety of social service programs have been developed to assist women in exiting sex work, but there is little research documenting the outcomes of such programs, particularly with regard to housing. This study examined participant characteristics associated with obtaining stable housing for homeless women leaving a residential sex work-exiting program in Cincinnati, Ohio Though a number of demographic, sex work-related, and participant need characteristics were linked to the likelihood of obtaining housing in the bivariate analyses, only participants' length of stay in the program remained significant in the multivariate model Implications for research, practice, and policy with this vulnerable population are explored.

Karlsson, H. (2024). Turning sex workers into self-caring persons: relying on technologies of the self in social work practice. Critical and Radical Social Work (published online ahead of print 2024). Available at: crsw-article-10.1332-20498608Y2024D000000044.pdf [file:///C:/Users/ph23745/Downloads/crsw-article-10.1332-20498608Y2024D000000044.pdf] (Accessed 8 December 2025). This study was conducted in Denmark. [google search result]

• Abstract: Sex worker exit programmes are designed to help people stop selling sex and find alternative ways of getting by. Currently, there is limited knowledge about how these programmes operate to assist sex workers in adopting societal norms and expectations of a healthy and productive lifestyle. This article explores this question by analysing interviews with key stakeholders in Denmark’s official sex worker exit programmes that ran between 2020 and 2023. The results indicate that outreach work, counselling and therapy were promoted with the aim of turning sex workers into ‘reflective’, ‘knowing’ and ‘self-caring’ persons. By drawing on Foucauldian theory, the article unfolds this transformation as a process by which individuals aligned with and internalised particular subjectivities (subjectification). This practice relied on the sex workers’ competence to devise personal strategies for self-care, that is, technologies of the self, based on critical questions about the possibility of taking care of oneself while selling sex.

Mayhew, P. and Mossman, E., 2007. Exiting prostitution: Models of best practice. Wellington, New Zealand: Ministry of Justice. Available at: EXITIN~1.DOC [https://www.nzpc.org.nz/pdfs/Mayhew-and-Mossman,-(2007c)-Exiting-Prostitution-Models-of-best-practice.pdf] (Accessed 8 December 2025). This study was conducted in New Zealand. [google search result]

• Introduction: We have reviewed literature on overseas best practice in relation to helping sex workers exit the sex industry. The literature is moderately extensive, with the most recent and comprehensive coming from the UK. There was little in the literature that singled out best practice principles with regard to helping underage sex workers to exit. Most attention was on preventing them from engaging in prostitution in the first place. The report strays into literature beyond that simply on best principles for exiting. We felt it necessary to do so to provide a more sophisticated assessment.
• I highly recommend reading this scoping review. It outlined three main types of exiting provision: drug treatment, housing, education, training, and employment (pp. 31-33).  
• Use the table of content on page 3 to guide reading. Search keyword ‘exit’ to be directed to relevant content but be aware that there can be too many results.  

1

sex workers/ or sex work/

9278

2

("sex work*" or prostitu* or transactional sex* or survival sex or sex traffick* or sexual* exploit*).ti,ab,kf,kw.

14446

3

1 or 2

16363

4

((exit* or leav* or transit* or withdraw* or "get* out" or "way out" or "out of" or escap* or integrat*) adj5 ("sex work*" or prostitut*)).ti,ab,kf,kw.

238

5

3 and 4

238

6

limit 5 to yr="2000 - 2025"

173

7

limit 6 to english language

163

1

sex workers/ or sex work/

13847

2

("sex work*" or prostitu* or transactional sex* or survival sex or sex traffick* or sexual* exploit*).ti,ab,kf,kw.

16604

3

1 or 2

20071

4

((exit* or leav* or transit* or withdraw* or "get* out" or "way out" or "out of" or escap* or integrat*) adj5 ("sex work*" or prostitut*)).ti,ab,kf,kw.

279

5

3 and 4

279

6

limit 5 to yr="2000 - 2025"

236

7

limit 6 to english language

221

1

sex workers/ or sex work/

5161

2

("sex work*" or prostitu* or transactional sex* or survival sex or sex traffick* or sexual* exploit*).ti,ab,kf,kw.

9496

3

1 or 2

9936

4

((exit* or leav* or transit* or withdraw* or "get* out" or "way out" or "out of" or escap* or integrat*) adj5 ("sex work*" or prostitut*)).ti,ab,kf,kw.

228

5

3 and 4

228

6

limit 5 to yr="2000 - 2025"

205

7

limit 6 to english language

193

1

("sex work*" or prostitu* or “transactional sex*” or survival sex or sex traffick* or sexual* exploit*).mp.

3221

2

((exit* or leav* or transit* or withdraw* or "get* out" or "way out" or "out of" or escap* or integrat*) adj5 ("sex work*" or prostitut*)).mp.

69

3

1 and 2

69

4

limit 3 to yr="2000 - 2025"

60