Introduction

This chapter provides a detailed account of the methodological approach and the methods used in carrying out a study at the University of Otago, Christchurch School of Medicine (CSoM) into the impact of the 2003 Prostitution Reform Act (PRA) on the health and safety practices of sex workers. Chapters Eleven to Fourteen draw on the findings from this study. This chapter begins by discussing community-based participatory research (CBPR), which is an approach regarded as best practice when doing research with marginalised groups of people such as sex workers. This approach underpinned all the methods utilised in the research.

Mixed-methods research, utilising both quantitative and qualitative methods, was undertaken and the merits of doing this are described. The description of the methods used in the research begins by discussing the quantitative arm of the research, with the development of the questionnaire, the methods used to sample the survey population, the process of quantitative data collection and analysis of the questionnaire data. A description of the qualitative arm of the research gives attention to the selection of the samples, the semi-structured in-depth interviews undertaken to collect data and the theoretical thematic analysis of the data. The methods to analyse print media are also described.

This study was able to draw some comparisons before and after decriminalisation in health and safety practices of sex workers. In 1999, CSoM had carried out a survey of Christchurch female sex workers. An estimation of the number of workers in the Christchurch sex industry done prior to the survey in 1999 yielded a total of 375 workers (Plumridge and Abel, 2000). The survey sampled to saturation and was able to collect information from 303 sex workers, which represented 81% of the estimated population. Similar techniques were used to sample sex workers in Christchurch in the post-decriminalisation study and some questions in the questionnaire remained unchanged so that comparisons could be made between Christchurch female sex workers’ reporting of health and safety practices before and after the PRA.

The study done in the 1990s cemented a relationship between the lead author and the New Zealand Prostitutes’ Collective (NZPC).

Prior to 2003, although sex work in New Zealand was not illegal, all associated activities, such as soliciting, brothel keeping, living on the earnings of prostitution and procuring, were criminalised. This created an environment in which violence, exploitation and coercion could flourish (Lowman, 2000; WHO, 2005). Sustained social action over nearly two decades, which involved advocacy and lobbying by the New Zealand Prostitutes’ Collective (NZPC), politicians across the political spectrum, women's rights activists, academics and other volunteers, was effective in bringing about legislative change. In June 2003, New Zealand became the first country to decriminalise sex work when the 2003 Prostitution Reform Act (PRA) was voted on and passed by a majority of one vote in Parliament. This legislative approach differs to other international approaches as it represents a shift from regulating sex work from a moral perspective to acknowledging the human rights of this section of the population. Decriminalisation meant that prostitution was acknowledged as service work and sex workers in New Zealand were able to operate under the same employment and legal rights accorded to any other occupational group.

The particular historical, social and cultural context within New Zealand was influential in legislating for the decriminalisation of sex work. New Zealand is a young society and has less strict gendered, class and ethnic social structures than countries such as the United Kingdom. The dominant political ideology of New Zealand from the days of early colonisation has been liberalism and this has shaped the laws of this country (Duncan, 2007). New Zealand women in the 19th century had more freedom socially and physically and, in 1893, were the first to be enfranchised. New Zealand was also at the forefront of a raft of other social reforms such as the 1898 Old Age Pensions Act, which led some commentators to state that New Zealand was the ‘sociological experiment station of the world’ (Le Rossignol and Stewart, 1910, cited in Duncan, 2007, p 18). The principles of liberalism, such as respect for diversity, freedom of choice and human rights, continue to dominate the policy environment in New Zealand in the 21st century.

Introduction

This chapter examines the role of the media in the context of the implementation of the 2003 Prostitution Reform Act (PRA), policy that was developed to protect the human rights of sex workers and minimise the amount of harm incurred by their occupation. As highlighted in previous chapters, the PRA indicated a shift in policy, from a moralistic to a public health and human rights approach. This chapter considers whether the media coverage of the PRA reinforced existing moral discourses of sex work, or developed new discourses in this new policy context. It does this through a content analysis of print media reporting on the PRA, exploring messages communicated in and by print media in New Zealand between 2003 and 2006, and qualitative analysis of in-depth interviews with 58 sex workers about their experiences of the media coverage surrounding the PRA. The chapter highlights how, although most print media was descriptive and neutral, the print media did draw on dominant moral discourses of sex work. Print media reporting that did draw on moral discourses was particularly acknowledged by sex workers and described as reinforcing existing stigmatisation surrounding sex work. A key feature of this chapter is to recognise and describe how sex worker participants resisted dominant discourses in their everyday practices.

Introduction

In many countries, including New Zealand, harm minimisation has been the predominant philosophy informing public health policy and underpinning the control of HIV/AIDS and other sexually transmitted infections (STIs). Among the sex worker population, the priority has been to reduce disease transmission through advice on safe-sex practices and to help in the implementation of such practices. Such traditional harm minimisation approaches assume that educating sex workers on HIV/AIDS and informing them of their responsibility in preventing transmission would mean that they would then make rational choices to protect themselves and others (Chan and Reidpath, 2003). Yet the assumption that sex workers are vectors of diseases serves to marginalise and blame sex workers without taking into account issues of poverty, gender, public fear and the law (Chan and Reidpath, 2003). Such structural and political issues need to be taken into account and integrated with health education for a more effective health promotion approach to the sex industry (Scambler and Scambler, 1995; Chan and Reidpath, 2003; Frieden et al, 2005).

Public health workers have, therefore, been challenged to take a more holistic approach to health promotion for sex workers (Wolffers and van Beelen, 2003). As well as HIV and other STIs, occupational health and safety issues, which include sexual and mental health, physical violence and coercion, are major health and safety concerns for sex workers and thus the protection of sex workers’ human rights needs to also be addressed for successful harm minimisation. This would necessarily require a harm minimisation approach to also take a human rights approach and encompass law reform to create safer working environments (Sanders, 2004a). Some harm reductionists have endeavoured to take a neutral approach (Lenton and Single, 1998), not taking any stance on decriminalisation or legalisation. These practitioners have, however, tended to take a very narrow view of harm minimisation, focusing on the medical means of promoting health and have been less concerned with structural social issues that also contribute to the overall health and well-being of sex workers (Sanders, 2004a).

It was with a broad and encompassing view of harm minimisation that decriminalisation of the sex industry was advocated by public health workers in New Zealand.

New Zealand was the first country to decriminalise all sectors of the sex industry and in this book we have provided some sound reasoning as to why and how this came about. The chapter on the history of the New Zealand Prostitutes’ Collective (NZPC) highlights the strong non-government organisation sector within New Zealand and how it has been supported by government. The coming together of the original nine founding members and the development of the NZPC, within a non-hierarchical structure, were influential in highlighting the human rights violations brought about by the laws that criminalised sex workers. As an organisation, NZPC created an inclusive atmosphere that provided support for sex workers across all sectors of the industry. The New Zealand government appointed NZPC members on to key committees such as the National Council on AIDS and also provided funding for this organisation from October 1988. NZPC increasingly raised its profile and credibility in the public arena. Its key role in initiating the call for decriminalisation cannot be overstated, as undoubtedly this legislation would not have been on the agenda without its commitment. As NZPC is the only sex worker organisation in New Zealand, it presented a united front for sex workers in campaigning for decriminalisation. Perhaps this can be seen as a particular strength, as in countries such as Canada and Australia there are several sex worker organisations across the different states, some of which are not peer-run organisations. There are philosophical differences between such organisations that might make it difficult for them to work cohesively towards a goal of policy change.

NZPC's drive for decriminalisation was an intellectual one, driven from the boardroom as opposed to the streets. The danger of relying on street protests for law reform is that it could engender a backlash through raising the visibility of sex workers, creating anxiety and moral panic among the general public. Instead, NZPC negotiated at the highest level, often with very conservative organisations and politicians. Through its effective networking, it gathered increasing support for decriminalisation. The women's movement in New Zealand has been influential in the reform of many laws affecting women, including employment, domestic violence, matrimonial property and paid parental leave (Duncan, 2007). Many women's organisations worked alongside NZPC in lobbying for decriminalisation.

This chapter further examines the emotional health of sex workers, as discussed in the previous chapter, in light of the stigma that sex workers continue to experience post-decriminalisation. We draw on and develop theories of stigma and examine how sex workers themselves actively manage stigma through constructing alternative identities.

Experiences of stigmatisation prevail among sex workers, brought about through negative social reactions to their occupation (Vanwesenbeeck, 2001). Moral discourses place sex workers in the category of ‘deviant’ – not conforming to the norms of society. It has been argued that sexuality is able to cause moral panic because it is fundamental to the general population's worldview (Sibley, 1995). Sex workers, and most especially female sex workers, do not conform to ideals of ‘normal’ sexuality with its accompanying presumptions of female passivity in the sexual domain. They are, therefore, as Sibley (1995) has termed, ‘othered’ – different from ‘normal’ decent citizens, framed as ‘deviant’ and generally stereotyped as involved in drug use, gang activity, crime, spread of sexually transmitted infections and with threatening the moral fabric of society. Identifying norms and labelling difference, stereotyping and connecting the labelled to undesirable traits and separating them into ‘others’ – different from ‘us’ – are all part of the process in which stigma is generated (Link and Phelan, 2006). This process has been used worldwide in attempts to exclude sex workers from society, leading to loss of status and the reproduction of inequalities (Link and Phelan, 2006). It is within this milieu that sex workers must justify their actions.

Goffman (1990) argued that if an individual fails to maintain norms, it has an impact on the defaulter's acceptability in social situations. Such difference or ‘deviance’ leads to feelings of shame, which create a ‘spoiled identity’ – stigma being mapped on to people resulting in them being devalued by society (Goffman, 1990). However, in recent years, Goffman has been critiqued as providing an analysis of stigma that is too individualised and fails to account for the structural conditions that lead to the reproduction of inequality and exclusion (Riessman, 2000; Link and Phelan, 2001; Parker and Aggleton, 2003; Scambler, 2007; Scambler and Paoli, 2008).