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BMJ. 2007 April 14; 334(7597): 767.
PMCID: PMC1852051

BMA public health doctor is accused of stigmatising sex workers

A senior BMA figure has come under fire for claiming that rates of infection of sexually transmitted diseases in the United Kingdom would fall by 50% if the sex trade were legalised and rigorously regulated.

Chris Spencer Jones, chairman of the BMA's public health committee, told the association's annual public health conference last week that focusing on prostitutes, particularly immigrant and drug addicted sex workers, would also save the NHS £330m (€485m; $650m) a year.

Sexual health specialists immediately accused Dr Spencer Jones of making unsubstantiated claims that might further stigmatise sex workers.

Dr Spencer Jones told the conference: “In Birmingham it has been reported that 70% or more of STIs [sexually transmitted infections] are circulated in a pool of prostitutes and their clients.

“If prostitution were legalised and regulated, you wouldn't get an exact 70% drop in STIs, but I would be confident in saying that you would get a 50% drop.

“What I am told is that this is a widespread picture, so I would be happy to say that you would get the same results anywhere else in the country.”

He later admitted to the BMJ: “The figures are a bit rough and ready, to be honest.” But he added: “As chairman of the BMA public health committee I have a duty to ensure that important public health issues that are not being talked about are actually discussed. What I've said is not really disputed.”

He said that regulation of the sex trade would probably require mandatory health checks and that this would “clean up” and even destigmatise the industry. He added that, in turn, more prostitutes would be encouraged to become registered and would practise safe sex to attract clients.

“We're not talking about high class hookers earning £100 an hour from businessmen,” he said. “Anecdotally, at least, I'm hearing of young Somali women having unprotected sex practically on street corners for a fiver. It's horrible for them, and we should be trying to help them have something better.”

However, Helen Ward, an epidemiologist at Imperial College London and a leading authority on the sexual health of prostitutes, described Dr Spencer Jones's comments as “scurrilous.”

She said, “He is suggesting that sex workers are responsible for much of the STIs and HIV in Birmingham and possibly the rest of the country. He does not appear to have cited any of the research on sex work—hardly the dizzy heights of evidence based practice that we should be aspiring to in public health and the BMA.

“The problem with what he said was that it increases stigma against sex workers—and foreigners while he was at it—and argues for mandatory testing, which is an extreme abuse of human rights in the opinion of most people.”

Michael Goodyear, an assistant professor of medicine at Dalhousie University in Canada, who has a special interest in sexual health of prostitutes, said: “Virtually everything he said was wrong.

“The most egregious comment was that prostitutes and their clients accounted for around 70% of STIs. Anyone who has studied the evidence would know this is nonsense.

“Sex workers have a relatively low prevalence of STIs and are most at risk from activities unconnected with their work. The major health problems amongst sex workers are related to stigmatisation, which this report contributes further to.”

He added that mandatory health checks for sex workers would see their industry “driven further underground.”

But Dr Spencer Jones was unrepentant. “The motion that I put up for debate called for proper school based sex education for children before they were sexually active and for the legalisation and regulation of prostitution. My aim was to destigmatise sex and reduce the rates of sexual infections.”

He then rounded on his critics. “The people who work in sexual health don't like the idea of other people having opinions. They are rather territorial,” he said. “I'm not sure that they want to look at this objectively. But the important point about public health is that we need to look at things objectively.”

The BMA has no official position on whether prostitution should be legalised.


Articles from The BMJ are provided here courtesy of BMJ Publishing Group