14th of October 2020

The discussion about homeless individuals and people that don’t have secure housing has been gaining traction recently and their voices have finally gotten a well deserved place in the media.

Homeless individuals are a varied population, but most of them have something in common, and that is that they have a history of trauma and difficult experiences.

Another thing that homeless individuals have in common is that they are less likely to seek healthcare services, when they need it, than individuals that are not homeless. There are several reasons for that, for example access to the service they need due to costs, opening hours and transportation and as a result of prejudice and a lack of communication by healthcare workers (Herdís Rannveig Eiríksdóttir & Kristrún Marvinsdóttir, 2009).

This additionally applies to healthcare services related to sexual health. Sexual health concerns, that homeless individuals don’t seek health care services for, are for example, infections, sexual transmitted infections, contraceptives, discomfort they experience during intercourse and assistance after sexual abuse etc.. Homeless individuals who menstruate often don’t have access to menstrual products and some even don’t have access to a bathroom to dispose of, and change the menstrual products that they are using. Many homeless individuals have not, and will not receive, appropriate sex education that serve their needs.

Research has shown that a majority of the homeless population has a low level of education (Ambar Aleman, 2016). We can then assume that these individuals have not received much formal sex education and don’t have access to reliable information about sexual health matters.  There has been a lot of discussion about the lack of sex education in the school system and a call for better sex education. However we cannot forget the population that doesn’t seek traditional education, but homeless individuals with low level of education, and don’t seek healthcare services, don’t get the sexuality education they need and suits them.

Due to the lack of education, they don’t know where they can seek the appropriate sexual health service, and some don’t know when and why they should.

Many individuals that are homeless do sex work. Overall, there are numerous reasons for doing sex work and the reasons why homeless individuals do sex work can vary. For instance, sex work often is low skill work and doesnt require specific education or training. Each job can take a short time and the pay can be substantially more than other work for the short amount of time that it can take. Another advantage to sex work is that it is not confined to specific hours of the day and sex workers can often have access to clients 24 hours a day.

When we talk about sex work, it is very important distinguishing between abuse and work. Sex work in itself is not abuse, even though people have often conflated those two when talking about sex work. Calling sex work abuse can create victim shame for those who do experience abuse in their work. Victims of abuse can experience, when all sex work is called abuse, that the abuse is their fault because they looked for a client or went somewhere where abuse then occurred. Therefore it is important to distinguish between servicing a client, where consent and pre established contract has been made, and when a client abuses the sex worker.

Clients of those who do sex work are a varied population and like in other service jobs, a client is not an abuser before they abuse.

However, homeless individuals who do sex work are more exposed to abuse in their work. One reason, and perhaps the most obvious one is the homelessness. They might not have access to a safe place to service clients and are more exposed to abuse if they have to go to a safe location, where they don’t know the exits and it can be more difficult to seek help if they are abused.

When individuals do not have their own secure location to work, it can be more difficult to get clients. They can experience more stress and be less careful than if they had their own home and therefore their own secure location. In some situations, sex workers can get paid less for their services than if they provided a location and the client has to provide the location themselves.

Homeless individuals often experience more desperation than individuals that have secure housing, which also makes them more exposed to abuse. The payment for sex work is not always money but can also be a roof over their head or substances. The desperation can make it more difficult to set boundaries or deny certain services. It can additionally be more difficult for homeless individuals to do a background check on their clients, which comes with an increased risk and makes the job more dangerous. Homeless individuals that are substance users are less likely to use condoms because they haven’t received adequate education about condom use, can’t afford them and don’t have access to contraceptives.

Additionally, homeless individuals that experience abuse in their work, are less likely to report that abuse, due to what the discussion of sex work often looks like, in additional to victim blaming. Prejudice and previous experience with relevant parties, for example health care workers and police, can be a huge obstacle for this group to use the services they need and have the right to use.

It is important for us who are more privileged and have the opportunity to, to fight for housing for everyone.

It is also crucial to support projects, such as Frú Ragnheiður. Frú Ragnheiður is an outreach program that serves homeless individuals and individuals that inject substances. They seek to improve wellness, including the sexual health, of their clients. We need to listen to voices of marginlized populations, such as homeless individuals and people that do sex work, about their status. We should use neutral language about sex work instead of the negativeley loaded language that has previously been used. We can support and follow Rauða Regnhlífin (Red umbrella) on facebook, but it is an association of activists that fight for sex workers’ rights and saftey.

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The author of this article is a sexologist, a former employee of an emergency shelter and a volunteer at Frú Ragnheiður.

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Lets face it: Homelessness is a Sexual Health Matter