Social change and health promotion among women sex workers in London

The evidence of unmet health needs among women sex workers in London is briefly reviewed as are the problems associated with health promotion and service initiatives in this area. It it argued that the principal obstacle facing both women sex workers and those tiying to deliver health promotion programmes is sex workers' social marginalizauion. Health promotion, interpreted as covering health education, prevention and health protection, it conddered in relation to social change at operational, political and structural levels. Special attention is paid to the relevance to health work of political change, through the decriminalization of sex work, and to structural change, through the reduction of gender inequalities. It is contended that ii is irrational and unacceptable to ignore the importance of political and structural change for health promotion in this field.