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COUNTRY REPORT OF DENMARK

PROSTITUTION AND ITS CONTEXT IN DENMARK

Extent, organisation and legal issues

Reliable estimates of the number of prostitutes in Denmark do not exist. But one estimate from 1990
calculates that 1500 prostitutes were active nationally each day. Most of these worked in massage
parlours (700) or bars (600), while 150 - primarily drug using prostitutes - worked on the streets.
Another 125 worked as escort prostitutes. These numbers only count women who offer services to
men during the course of one day and the total number of prostitutes is therefore much higher.

The picture changes if the extent of prostitution is measured by the number of client-prostitute
contacts. The primary role of massage parlours then becomes obvious: 70% of all contacts take
place there. Fifteen percent of all customers have contact with street prostitutes, another 12% with
bar prostitutes and 3% with escort girls.

There have been no major changes in this picture during the last four years though non-Danish
prostitutes now comprise a larger part of the prostitutes in massage parlours than before. One way
of monitoring changes in the prostitute population is to follow the changes in the adverts offering
sexual service which are published in the daily newspaper, Ekstra Bladet.

The ethnic make-up of the prostitutes has changed slightly during the last 14 months according to
the advertisements. The percentage of adverts that mention Thai women, 'black'/'brown' women
and other immigrants rose from 8-10 % to 13-15 % of the total. None of these indicate that they
come from the former Soviet Union or Eastern Europe. A few prostitutes (less than 1 % of all
advertisements) claim to come from other EU countries.

Another change was noticed during the project period. The mobile telephone became increasingly
popular, first within escort bureaux, but lately also among massage parlours. Mobile phones provide
an effective guarantee against identification of the people involved in the business, especially for
escort activity where the prostitute visits the customer. Also the escort bureau itself becomes
mobile; the bureau is to be found wherever the manager is located at any particular time. The
introduction of mobile phones then is the latest stage of a long process of withdrawal of the
prostitute from public view in a known geographical area /street to an indoor location.

Danish prostitutes do not travel across the country's border to work, while inside Denmark the
experience of working in different parts of the country varies. Copenhagen prostitutes have seldom
worked in other parts of Denmark, except for escort girls who might cover most parts of Zealand
(Sjælland). But in Jutland (Jylland) and Funen (Fyn) prostitutes usually have worked in cities other
than their home city. Women in Jutland especially travel a lot to other cities in the region, partly
because many cities are too small to provide anonymity vis-a-vis the clients, partly because
prostitutes who are 'new' to a small area attract more customers.

Numbers for male prostitutes in Denmark are not available. Researchers and service providers have
been in contact with 30 male prostitutes who have male clients in Aarhus and with more than 100 in
Copenhagen. A recent round table discussion between the police, social workers in contact with the
prostitution milieu, and the social counsellors for parents and children in crisis, concluded that there
is no child prostitution involving children below the age of consent (15 years) in Denmark. The flow
of teenagers into street prostitution is rather limited, especially for teenagers under 18. The owners
of bars and massage parlours are generally very careful not to let in persons younger than 21 years,
as this is illegal and might give the police an opportunity to intervene. Thus, most prostitutes start
work after they reach 20 in massage parlours or bars. A relatively small group start at a younger age
and do so on the streets.

Pimping (in the sense of a man who in one way or another forces a person to take customers and
hand over the money to him) is extremely rare in Denmark. The absence of a large group of very
young girls (Lolitas) partly explains this lack of pimps. Another reason is that sexual transactions as
such are legal and the police do not conduct raids among prostitutes who work indoors. Finally, the
very liberal advertising policy in the sex industry enables individual prostitutes to advertise in
newspapers or magazines without fearing economic reprisals. (In reality, they do commit social
security fraud if they are also claiming welfare but the authorities do not track them down). It is not
illegal in Denmark to provide sexual services for money or goods as long as this sex work is not the
main source of income for the prostitute. The police otherwise might arrest the person on charges of
vagrancy. This is one good reason for a prostitute to be claiming social welfare. Aside from this,
prostitution is not as lucrative as it might have been earlier. Prices for sexual services have been
stable during the last decade while, for instance, advertising fees and expenses have increased just
as have living expenses in general. Many prostitutes therefore also claim benefits because they need
the money and they avoid giving any information about their prostitution to the social worker.

The extent of procuring is more difficult to assess. Most bars and massage parlours are owned by
one or a few persons who organize the work, procure the women and take a larger or smaller part
of their earnings. A small part of the growing number of prostitutes from the Third World have
entered Danish bars and massage parlours through business channels. For instance, this is the case
for some of the Thai women in Aarhus. It is likely to have happened in other major cities too, but no
evidence is available at present. Aside from this, it is a matter of definition whether one would judge
some of the massage parlour owners to be procurers. Unless the prostitute owns the massage
parlour herself/himself (or together with a few colleagues), the user must pay a fee to the owner for
each day's work. This fee varies greatly, ranging from 300 kr to 1400 kr (40-185 ECU) or even
more. An amount at the upper end of the scale covers more than the expenses of the owner. In
comparison, the price for 'Danish' intercourse (vaginal intercourse) ranges from 300 kr to 400 kr
(40-50 ECU) among those working in massage parlours in Copenhagen. Other intermediaries also
claim part of the money earned by the prostitutes, notably the newspapers which are used by almost
all massage parlours and escort prostitutes in Denmark to advertise their services.

Brothels are not allowed in Denmark, and neither is pimping or procuring. But except for routine
visa checks on immigrant prostitutes the police has not initiated investigations into possible cases of
procuring over the last decade. One bar owner was prosecuted a few years ago and cases against
massage parlour owners occasionally arise. The police only intervene if a complaint has been
received; if they encounter a prostitute below the age of sexual consent; if they find women younger
than 21 years at the bars or massage parlours; or, if they discover an immigrant prostitute who has
no valid permit to stay in Denmark.

To sum up: at least 5.000 sexual transactions involving female prostitutes take place in Denmark
every 24 hours, corresponding to 1.5 million transactions per year (+/- 0.3 million; activity level
decreases during weekends and holidays). This results in a total payment far in excess of 525 million
kr (70 million ECU; this amount is arrived at by multiplying the mean price for 'Danish' intercourse
by the number of transactions). Most clients have contact with massage girls, some of whom are
'imported' from the Third World, especially Thailand, but quite a few 'black'/'brown' women work
in the massage parlours, too. Most of these stem from Africa and they are apparently not controlled
by a third party. The organization of prostitution in Denmark differs from many EU countries in its
lack of pimps, a situation partly caused by the restructuring of prostitution that began back in 1973
after the prohibition on 'immoral' advertising was repealed.

Social and medical services available to prostitutes

Prostitutes enjoy the same welfare rights as all other residents. However, non-resident prostitutes
have no welfare rights. Those who are entitled to welfare have access to unemployment benefits,
education, health care etc, as long as this is unconnected to their sex work. If prostitutes, however,
wish to join an unemployment insurance fund, they will not be allowed to if they reveal that they are
also prostitutes. Neither is any insurance company willing to insure massage parlours. When a
prostitute applies for benefits at her/his local social service department s/he runs the risk of being
accused of fraud. In line with this, a prostitute does not discuss her/his experiences with the social
worker. Prostitution thus acts as barrier - effective if invisible - to receiving help to solve
prostitution-related social problems. This counts as true for non-prostitution related problems as
well. This issue is further discussed in connection with the outreach project in Aarhus. All medical
services are free of charge to Danish residents. (An insignificant number of private clinics provide
treatment of special diseases; but treatment for these diseases is also available within the public
health system). Consultation and treatment of STDs or HIV is provided by the 'family doctor' or by
one of the 10 venereal clinics in the country. The patient is free to choose which one to go to. HIV
tests - but not STD examinations - can be made anonymously. If a patient is found HIV seropositive
and wishes to receive treatment, he/she has to give up their anonymity.

The AIDS epidemic and HIV prevention in Denmark

It is very important to assess the need for prostitution-related HIV prevention. Only then can steps
be taken to evaluate existing efforts at prevention and whether to initiate new interventions. Three
aspects are discussed below:

what is the level of HIV transmission among prostitutes so far?
what is the rate of HIV seropositivity among clients and prostitutes?
does client-prostitute sex lead to HIV transmission? In particular, are condoms used?

As in other European and North American countries, the AIDS epidemic in Denmark originated in
the homosexual population and then spread to the IVDUs. Sex between men continues to be the
main way the infection is transmitted. Of the heterosexuals who are infected, the number of women
surpassed the number of men in 1994, but almost half of these women were immigrants. A total of
1446 people with newly diagnosed HIV infection were reported between August 1990 and
December 1994. Of these 322 were women. Seventeen (7%) of the male heterosexuals with HIV
reported sex with a prostitute as the way they were infected with HIV.

As compared to the much higher numbers of men who acquired the virus from prostitutes in some
other countries, 17 men over a period of 4 years does not appear to be many. In addition, it is
unlikely that all of them acquired the virus from female prostitutes in Denmark. Some may have
provided misleading responses (concealing their homosexual activities), others may have acquired
HIV during tourist travel (Thailand has been a popular location for vacations for some years). But
information on these issues is not available. It is possible to approach the question of HIV
transmission via prostitutes in two ways. First, the fear that prostitutes might function as 'vectors' for
disease transmission seems to prevail in most epidemiological studies. In the Third World this has
often led to the scapegoating of prostitutes. But there has been no tendency at all in Denmark to
stigmatize prostitutes in connection with the HIV epidemic.

A second, more balanced, approach would be to investigate the interaction between prostitutes and
their clients, as well as seroprevalence in both groups. As will be apparent below, with one
exception no data exists for clients in Denmark. There are two key questions to be asked in
assessing HIV transmission through prostitution. Firstly, is one of the partners already infected?
Secondly, do they use a condom? The rate of condom use is difficult to assess. To begin with,
he/she may claim condom use just to please the interviewer (or to avoid being reprimanded).
Moreover, to admit to using condoms is to break a professional ethic, a directly punishable act
among some groups of prostitutes. Self-reported condom use therefore should always be treated
with some scepticism. According to behavioural data, Danish prostitutes who work in bars or in
massage parlours use condoms consistently with their clients. But many express uncertainty as to the
risk of transmission through certain sexual practices. Condoms also frequently break and the
response is not always appropriate. Use of and/or the attitude towards condoms has changed
radically among prostitutes since the late 1980s when a minority still claimed to not always use
condoms with clients. The clients also seem to have learned to accept condoms as part of the trade
though middle aged men and the clients of street prostitutes may still occasionally ask for sex
without a condom (according to the EUROPAP investigations).

Very little is known about the behaviour of escort girls because they are very difficult to get access
to; the manager in most cases obstruct all contacts between the girls and field organizations. The
interviews by EUROPAP suggest that a few of the escort bureaux might persuade a girl to allow a
client not to use a condom if he insists. Some of the young escort prostitutes are also rather
inexperienced and simply forget to bring a condom to work. Those who are a little older are more
consistent in their condom use. The nature of the relationship between street prostitutes and their
clients increases the risk of these women of acquiring HIV and STDs. They also experience more
violence. The issue is further discussed in connection with the description of Reden. In-depth
interviews with male prostitutes make it reasonable to assume that condoms are usually - but not
always - used by male prostitutes. But a concrete assessment of the sexual practices of male
prostitutes and their clients does not exist. Available information on the contact between Danish
clients and immigrant prostitutes is insufficient. Condom use increased in the Thai massage parlours
in Aarhus after the local authority started an outreach program. According to the prostitutes in some
of the Thai parlours in Copenhagen who are in contact with the outreach workers condoms are
available at these places and are used with the customers.

Epidemiological data is fragmentary. In Copenhagen, none of the 213 female prostitutes tested in
1990/91 were HIV positive nor were the 160 tested during 1993/94. But it is noteworthy that the
prostitutes tested in 1990/91 had a much higher level of self-reported STDs for the preceding 6
months than the population in general, even higher than among clinic attenders at the STD clinic in
charge of the investigation. Approximately 40 street prostitutes (all intravenous drug users)
participated in an HIV test project in the autumn of 1994 but the results are not yet available. All
three investigations and HIV test groups were a result of outreach projects. In Aarhus, none of the
53 female prostitutes tested between 1988 and 1990 was HIV seropositive (test group membership
was based on clinic attendance and outreach). Non-Danish clinic attenders in Aarhus were HIV
tested in the autumn of 1994; 1 out of 32 was HIV seropositive. In addition, the level of STDs was
very high.

Sero-epidemiological data on immigrant prostitutes does not exist. Neither does data on Danish
male prostitutes. In a recent (unpublished) study the presence of HIV has been measured in semen.
This technique makes it possible to measure the HIV status of a man by investigation of his semen.
Thus, semen collected from approximately 325 clients at massage parlours in Copenhagen January
1994 all failed to reveal HIV among the men. The semen specimens also will be tested for hepatitits
B antibodies in the near future. No other data on the level of HIV among clients exists for Denmark.

In conclusion: though the level of STDs are higher among prostitutes than in the population in
general, the transmission of HIV from clients to prostitutes and vice versa seems to be rare in
Denmark. This is partly due to a low prevalence of HIV among prostitutes and clients (at least those
clients who frequent massage parlours), partly because condoms are used quite regularly. But
among some prostitute groups condoms are not used consistently and these groups of clients and
prostitutes might include HIV seropositive individuals. Thus, there is a need to provide programmes
to prevent HIV transmission among prostitutes and their clients but their content and methods need
to be appropriate to the target groups in question. At present, too little is known about the sexual
practices and levels of HIV seropositivity among immigrant prostitute women and male prostitutes.
Further, we know almost nothing about the clients of all types of prostitutes. The AIDS secretariat
at The Ministry of Health has co-ordinated and initiated HIV prevention programmes for a decade.
Initially, the focus was on non-stigmatizing national campaigns. But as early as 1987 efforts were
made to stimulate local initiatives. 'Key persons' from all over the country and from various public
sectors were educated by the Health Department in collaboration with the counties. From 1990
onwards the strategy of the Department has been to stimulate central-local (CEN/LOK) preventive
activities, public as well as private, and to co-ordinate these with the national AIDS campaigns.
Most counties today have an AIDS consultant. Several target groups are mentioned within the
CEN/LOK strategy, among them prostitutes. None of the national campaigns have dealt explicitly
with HIV transmission in prostitution but several of the AIDS consultants in the counties have taken
the initiative to send pamphlets and condoms to prostitutes in their county. A few do so periodically
but most have sent materials only once. Response from the prostitutes have been sparse or
nonexistent and the effect of this distribution of information is unknown.

Other AIDS preventive initiatives are decentralised. For instance, most counties have some
arrangement enabling IVDUs to get access to clean needles. In Copenhagen, distribution of needles
free of charge began in 1986 and special needle-disposal outlets were installed in the 'drugs area' of
the city.

Existing service provision for prostitutes and the promotion of new initiatives

Projects aimed at the needs of prostitutes have mostly emerged within the last five years. They have
focused on HIV prevention or on social problems, often combining both objectives. There is no
doubt that some of these projects would not have emerged if money had not been made available
for AIDS prevention; part of the nationally available money for AIDS goes towards prostitution
projects. In the long-term AIDS prevention directed at prostitutes should continue and be better
developed. But there can also be little doubt that the social problems faced by prostitutes are
severe. Decent resources and planning are needed to solve the social problems of prostitutes, either
tackled on discretely or in combination with general health prevention programmes.

The Social System and processes of decision making have been a focus of EUROPAP Denmark
because one of our main objectives has been to motivate local authorities to initiate prostitution
related projects in their city/community. Our approach has been to combine medical and social
issues in the program outline. Trends in Danish social policy are described below. There have been
drastic cuts in the Danish welfare system during the last decade. The policy of the
conservative/liberal government during the 1980s was to increasingly leave the provision of social
services to private initiative. This policy was promoted through 'social development projects',
financed by the government. The resulting 'project culture' has in fact developed a range of new
approaches to social issues. Old questions have been dealt with in a new manner and new issues -
like counselling for prostitutes - have been taken up. But there have been clearly negative
consequences of this approach. Among these is the imposition of a two to three time limit on any
social project. Also the tendency to leave some problems to 'free social enterprise' have left some
issues untouched. All of the projects described below have been effected by this. They also have
had to deal with frequent neglect or resistance from politicians and suffer from a lack of private
funds when it came to finding solutions to the prostitution related social problems. Furthermore, in
the wake of sexual liberation, prostitution is generally not thought of as something problematic.
Withdrawing prostitutes from public view after 1973 has also seen them disappear from the public
mind; prostitution was acknowledged as a private sexual matter for people and the authorities are
expected not to intervene in the private life of people.

These attitudes towards prostitution have had a major influence on the (lack of) social research and
intervention. Thus, little money has been released for scientific research on prostitution for over 15
years. Legal aspects of prostitution have been debated several times in Parliament during the last
three decades but revision of the relevant legislation (dating back to 1930) has not taken place.
Neither has enough money been set aside to deal with the problems during the last decade. But the
situation seems to be changing now! The Ministry of Social Affairs decided in January 1995 to
make prostitution one of several priority areas for funding and social development. There is a further
aspect of social policy in Denmark which has a major influence on projects and initiatives drawn up
to tackle the social and medical needs of prostitutes. Danish counties and local authorities have a
high degree of autonomy. They are free to decide local policies within the framework of guidelines
issued by the state - as long as local initiatives do not lead to an increase in the level of tax.
Responsibility for the provision of health services and disease prevention lies with the counties while
local authorities are the major social service providers. In both cases, the major part of any
expenses incurred are reimbursed by the state as a result of annual negotiations. In recent years, a
restructuring of work tasks and models of co-operation has taken place in the administrative
systems of counties and local authorities. It has given rise to a very heterogeneous structure of local
decision making, types of public departments and patterns of client-social worker interaction. In
some instances, new models of collaboration between public and private institutions have also
emerged.

In conclusion: in the future money should be made available for those providing services to
prostitutes as well as for further needs assessment and targeted interventions aimed at the prevention
of HIV transmission through prostitution. It might be an advantage for such initiatives to combine
social and health elements. If so, they need to participate in the process of social development.

PROJECTS AND SERVICES DEALING WITH HIV PREVENTION FOR
PROSTITUTES

Review: prostitution related initiatives, 1985-1995

There have been very few services or projects dealing with HIV prevention for prostitutes in
Denmark during the last ten years. The few projects in existence mostly have dealt with the social
aspects of prostitution. After a major debate in Parliament in March 1990 the DAPHNE centre was
established for a period of 3 years. The centre's brief was to investigate social problems surrounding
prostitution and inform public and private agencies about how they could prevent young people
from entering prostitution. In addition the centre was to formulate ways of preventing 'social
damage' to active prostitutes and find means to support those who wished to stop their sex work.

A service centre for male prostitutes, PAF (Prostitution af Fyre: prostitution of gays), was
established in 1991 with the main objective of supporting male prostitutes by individual councelling
and by outreach work in the respective milieus. In 1994, the HIV prevention efforts of PAF were
limited to a monthly social gathering in which an employee from the gay and lesbian movement also
participated.

The PRO-line (a national HOT-line for prostitutes) was started 1993. The main objective of this
telephone councelling service is to provide welfare support to female prostitutes.

Only two service providers in Copenhagen actually dealt with HIV prevention among prostitutes. In
Reden (The Nest) - a drop-in centre for drug using prostitutes - the main objective was and remains
to help the women get off drugs and stop prostitution. But the staff also handed out condoms to the
prostitutes and aimed to expand the safer sex education they could offer by undertaking further
training. Their HIV prevention activities were therefore evaluated. The evaluation is summarised
below. The other service provider, RAP (Rådgivning af Prostituerede: prostitutes council
prostitutes) has as its main objective to councel prostitutes about HIV and AIDS. This project
started February 1994 after preparation of the project in the 'prostitution and drug use' subgroup of
WOMEN AND AIDS. The co-ordinator followed RAP during the start-up phase but since the
staff needed to establish the content and method of work themselves they found it disruptive to be
part of an evaluation scheme at the same time. The co-ordinator therefore decided not to evaluate
RAP. However, the project is described below.

Initiatives aimed at the self organisation of prostitutes were taken in 1991. The interest organisation,
VI STÅR SAMMEN (Stick Together), has succeeded in editing a bimonthly periodical for its
members and it also runs a hot-line on any prostitution related issue. But it has no systematic
HIV/STD prevention programme.

Outside Copenhagen, only three initiatives have been taken to support female prostitutes. No
services exist for male prostitutes but preparation for a project has been undertaken in one city.
Aalborg was the first city to run a project, NATSVÆRMERNE (The Moths). The project ran in
1990-91 and focused on social aspects of prostitution. The municipality of Aarhus developed and
implemented a project which combined social support and health counselling for prostitutes. The
project ran during 1992 and outreach work in the risk groups continued after the project period as
a part of the work of the social services department. A recent investigation by FIP (Fyre i
Prostitution: guys in Prostitution) among male prostitutes in Aarhus points to the need to provide
support for male prostitutes also. But until now there has been little interest among officials in
establishing outreach work and councelling male prostitutes. Finally, a drop-in centre for drug using
female prostitutes was established in Odense in 1993 by KFUK. Its aims and methods correspond
to those of Reden in Copenhagen.

This section of the report thus first describes the activities of RAP in Copenhagen. The HIV
prevention outreach work in Aarhus municipality is also described at some length as Aarhus is the
only city in Denmark so far to have implemented outreach work aimed at HIV prevention in
collaboration with the STD clinic in the city. Next, the evaluation process and its outcome in Reden
in Copenhagen is summarised. Finally, the results of an EUROPAP investigation on the social and
medical needs of 'indoor' prostitutes in Copenhagen are summarised. The focus is partly on the
encounter between prostitutes and the health sector, partly on the interest among the prostitutes for
a centre which could deal with health and social problems of individual prostitutes.

RAP (Prostitutes Council Prostitutes)

RAP started in February 1994 with the aim of contributing to the prevention of HIV and STDs
among female prostitutes in Denmark. This was achieved by a combination of outreach work in the
different milieus, telephone counselling and training prostitutes themselves in peer support and
counselling. To secure the start-up phase of RAP, money was found by WOMEN AND AIDS to
employ a former prostitute who was experienced and trained in HIV counselling. RAP has been
supported by the national AIDS secretariat and by the PUF-pulje (a pool for support to self-help
organisations and initiatives). A range of activities has been carried out by RAP during its first year.
A pamphlet on HIV/STDs and prostitution - Safe sex: Avoid working hazards - was finished and
translated into English and Thai. The telephone line was opened for two hours each week and
arrangements were made for five prostitutes to take part in telephone counselling. Training in
counselling those with or who may have HIV/STDs was arranged. The attendance at training and
phone counselling sessions was expected to be unstable or low, as prostitutes do not like to lose
their anonymity, not even towards other prostitutes. They also lack sufficient spare time. At the
training sessions one of the five peer counsellors showed up. Moreover, they all showed up
regularly for their monthly day on 'duty'. Outreach work started in June 1994 with the project
worker and a few prostitutes. Total anonymity was perceived as a precondition for contact building
between the project worker and the prostitutes. She was well received at the massage parlours. Her
former experience in the field enabled easy access and almost all the prostitutes appreciated her
visit. The pamphlet was received with great interest. The Thai prostitutes especially appreciated the
discussions on safer sex. The employee also frequently phoned the parlours and counselled the
women about HIV/AIDS. But the prostitutes rarely called the hot-line. This was partly due to the
lack of problems with HIV, partly due to the method chosen to advertise the existence of the
hot-line. In order to secure anonymity, the hot-line was not advertised generally but cards with
information on RAP and the phone number were handed out whenever the project worker visited
the prostitutes. RAP also organised three evening gatherings on special topics with invited lecturers.
The themes chosen were: the legal rights of prostitutes; keeping ones limits; spanking. Only two to
five prostitutes attended the sessions. RAP has therefore decided to suspend these gatherings and
use the resources for outreach work. The project worker visited bars and massage parlours which
had Thai prostitutes throughout the period and established good contact with some Thai women,
especially in one bar and half of the parlours with Thai prostitutes (8-10 parlours). The experience
proved that contact needs to be developed during a prolonged period. To help these women, RAP
has organised and secured money for teaching in Danish on the subjects of client negotiation and
safe sex. The last major area of RAP work has been the organisation of a weekend for drug using
prostitutes. The theme of the weekend was 'prostitution, violence and HIV' and besides direct
teaching a lot of effort was put into providing care and support for the women. The major
conclusion to be drawn from the first year's work by RAP is that getting in contact with various
parts of the target group takes time, especially due to the high degree of discretion needed and the
very few prostitutes involved in the work. As anticipated, the attendance at activities and training
sessions was low. Very few also took the initiative to call the hot-line. But the outreach work aimed
at both Danish and Thai prostitutes seems to be successful. Thus, outreach work has been much
more appropriate than counselling by phone.

HIV Prevention Among Female Prostitutes in Aarhus: an Outreach Programme of the
Municipality of Aarhus

In 1991, DAPHNE and the Municipality of Aarhus assessed the intervention needs in three areas of
female prostitution in Aarhus:

psycho-social counselling and treatment;
special support to very young prostitutes who wish to leave the business;
AIDS/HIV prevention by means of an outreach information campaign among prostitutes.

The local authority decided to start a project to deal with these issues. Staff were selected and
relocated among persons already employed by the departments of health and social welfare. A
small amount of money (25,000 D.Kr) (3,300 ECU) was donated by the local authority's AIDS
prevention fund. The AIDS prevention programme was developed and implemented in 1992 by
two social workers. They identified a profound lack of materials dealing with the issue of 'safe sex
for prostitutes' and therefore produced a video tape on the issue. Outreach work took place over
the following eight months. At the beginning co-operation was initiated with the section of the social
services department that provides anonymous counselling for people experiencing a social crisis.
Co-operation also began with the STD clinic at Marselisborg Hospital. In accordance with the
wishes of some prostitutes, special opening hours at the clinic (4 hours a week) were introduced for
prostitutes and a psychologist was assigned to the clinic during these hours. The project found that
more than 125-150 prostitutes worked in massage parlours, 20-30 women worked from one of the
city bars, and an unknown number worked as street prostitutes (16 were contacted during outreach
work on the streets). Occasionally, prostitutes also worked from inns and cafes, or they had clients
referred to them by taxi drivers. Three of the massage parlours were staffed by Thai or African
women. Only 4 of the 16 street women were IVDUs. Thus, the overwhelming majority of the
prostitutes were Danish, not on drugs, and worked in massage parlours. The project did not attempt
to reach male prostitutes but the social workers were told by people engaged in the 'Stop AIDS
Campaign' of the Gay and Lesbian Movement that more than 25 male prostitutes worked in the
area. Eighty prostitutes were counselled about HIV and STDs during the outreach period. With one
exception the social workers managed to reach all of the 27 massage parlours in the city. They were
well received by the prostitutes who showed great interest in the information provided about HIV
and 'safe sex', although they were already very knowledgeable. The prostitutes reported a high rate
of condom use with clients. However, condoms were not used with private partners, and the
women were uncertain about the risk of acquiring HIV or STDs through oral sex or S.M. Also, they
were not familiar with the appropriate response to condom breakage. All contacts were offered the
'safe sex' video tape, pamphlets and free condoms, and they were informed about the service for
prostitutes at the hospital. Psycho-social problems often came up during visits to the massage
parlours, especially where visits were repeated. The woman was then referred to the anonymous
social counselling service. But in most cases, the woman expressed distrust of the social system, and
the prostitutes seldom made use of this opportunity to get help. Two concrete factors were
identified as barriers in the way of their contact with the social security system. First, the women
were worried that their children might be taken away from them by the authorities. Secondly, as
most prostitutes received some kind of social benefits, they were afraid of being charged with fraud.

Other major conclusions:

it is possible to communicate information about AIDS and STDs to prostitutes in all of the
settings, provided that outreach work continues for a prolonged period of time;
the prostitutes were very content to receive the information on HIV, STDs and 'safer sex'.
They were asked to pass on the information to their colleagues and to their customers but
they seldom did so;
many of the women expressed a wish to discuss their prostitution related experiences with
others but found it difficult to do so in the work setting; furthermore, communication or social
contact with other prostitutes outside the work place was rare;
drug using street prostitutes did not carry condoms when at work;
the prostitutes from Thailand and Africa were vulnerable to acquisition and transmission of
HIV and STDs as they did not speak the language, had no access to the medical system, had
no social security rights due to their 3 months tourist status, or due to a lack of residence
permit. They claimed to use condoms but appeared inexperienced in the handling of condoms
and condoms were not always available at their workplace. Among the Thai prostitutes in the
massage parlours a 'third person' negotiated the concrete details of their sexual service to
clients.

Recommendations:

staff from the district offices of the social services department should be educated about
tell-tale signs of prostitution among social clients and how best to support these clients;
employees at clubs and homes for young people should have a similar offer of education;
active support should be considered for prostitutes who wish to start self-help groups and
peer education;
an alternative to counselling at 'the acute centre' for people in a social crisis should be
investigated;
AIDS /safe sex information and other services for male prostitutes should be initiated;
a delivery system for free distribution of condoms to street prostitutes should be arranged;
continued outreach work and counselling among prostitutes from the Third World is essential.
Materials informing them about HIV and STDs should be produced in their native language.

Most of these proposals have yet not been taken up by the local authorities. But the social services
department decided to make the outreach counselling on HIV/STDs permanent and it is now
integrated as part of the work of the centre for young people. Periodic outreach work took place in
1993 and 1994. Recently, the outreach team was changed. A former prostitute was trained in HIV
prevention and started to visit prostitutes with one of the social assistants. All prostitutes contacted
during October and November 1994 were unknown to the assistant, pointing to the importance of
frequent recurrent outreach work in the milieu. The offers of free access to a psychologist and the
possibility of anonymous counselling at the acute centre have not become more popular. As a
consequence, the social services department is considering the inclusion of a social worker in the
outreach team. The intention is to make the social worker a familiar face in the milieu. It is a moot
point whether a social worker (representing the social system) can create an atmosphere in which
prostitutes are confident enough to discuss their situation with their district office. This is especially
so since there is no common response throughout the social system to fraud. Thus, a month ago, a
former prostitute was charged with fraud and tried in a major Danish city after being reported to the
police by her social worker. The woman was sentenced to 200 hours community service and to
repay the full amount of the social benefits she received during the time that she also worked as a
prostitute. This does not occur very often since many social workers are more flexible and
supportive and both types of reaction are allowed for by the law. But the point is that a prostitute
does not know in advance, how her (his) social worker will respond.

The STD clinic in Aarhus still has special opening hours for prostitutes. Experience with this service
is mixed. At times outreach work in the milieu leads to more prostitutes showing up for a
consultation. Fifteen prostitutes now have an understanding with the staff that they will be notified
every third month. But they often do not show up, especially in between the outreach periods. This
seems to be because it is inconvenient rather than because of resistance on behalf of the prostitutes.
The number of massage parlours staffed by foreign prostitutes has increased since 1992, especially
those with Thai women (9-10 massage parlours now employ Thai women). Outreach work in these
places a year ago resulted in some turbulent reactions but also led to the establishment of an
agreement between the STD clinic and key contacts in the milieu. The Thai prostitutes now make
regular visits to the clinic for HIV tests and STD checkups. The question arises of what will happen
should one of the women test HIV positive in the future. If the woman stays in Denmark on a tourist
visa she has no right to receive treatment and she is unlikely to receive support and counselling
beyond the counselling provided by the clinic staff who inform her that she is HIV seropositive. She
may have to conceal information about her HIV status in order not to be sent home. In order to
prepare for such an eventuality more information on the living and working conditions of Thai
prostitutes is needed. The purpose and possible outcome of the visits to the clinic should also be
reconsidered. To sum up: Aarhus municipality is the only local authority so far to have set up a joint
project between the social services and a STD clinic in the city. It was and remains possible to
reach women working at massage parlours and on the street through outreach work, while bar and
escort prostitutes were difficult to reach. The prostitutes are very interested in receiving information
about HIV and AIDS. Though their clients are already consistent condom users, they often do not
know what to do if the condom breaks and they often are uncertain about risks associated with oral
sex. Due to the turnover of prostitues and the lack of communication between those working at the
same workplace, repeated visits to each workplace are needed throughout the year. Many
prostitutes seem to use the contact as an occasion to discuss more serious work related problems.
They do not seek help with these problems in the social service departments as they fear being
accused of benefit fraud and some also fear having their children removed.

Evaluation: HIV prevention support to the users of REDEN

The Christian Foundation for Young Women (KFUK) has provided social support since 1947 to
prostitutes and other women in the poorer district of Copenhagen, close the central station. In 1983
KFUK opened REDEN, a drop-in centre and a base for outreach work in the area. The centre is
today staffed by a manager, six paid workers and 16-17 volunteers. The salaries of two of the staff
and half of the centre's rent are reimbursed by the public authorities and KFUK itself covers the
remaining expenses. Reden is open to all visitors every weekday between 10am and 10pm
(Sundays 15pm to 10pm), and outreach work is done once a week in the area. Reden has
1000-1200 visits each month and comes into contact with approximately 350 street prostitutes over
the course of a year. The users (note: the clients of Reden will be referred as 'users' in order to
avoid confusion with the clients of the prostitutes) are all drug users, most are IVDUs. Two thirds
are homeless. The prime objective of Reden is to motivate the women to stop their drug abuse (and
thus their need to work as prostitutes) but Reden places no pressure on the users. A drug treatment
programme is run from a separate location in Copenhagen, aiming at detoxification, followed by
residence on a farm and reintegration into social life. Reden also counsels prostitutes who prefer to
continue with their sex work. Finally, Reden offers food and tea to the women and provides a place
of refuge; men are not allowed to enter. Until 1991 Reden was situated right in the centre of street
prostitution but the police started to hound the women on the street three years ago and they now
work in some of the nearby streets. Evaluation of the AIDS prevention activities in Reden took
place between August and November 1994. The evaluation was limited to sexual transmission of
HIV as Reden refuses to allow drug use, drug dealing, or the cleaning of needles inside the house.
Clean needles are available through needle exchange services at several pharmacies in the area. The
prime objective was to help the prostitutes to protect themselves better against infection by HIV and
STDs and to address this issue within a broad approach of client-prostitute interaction. The street
prostitutes are vulnerable to assaults and violence due to their working conditions and due to their
sometimes confused condition when providing a service to a client. 'Safe sex' therefore only
constitutes a part of a broader category of 'safe client contact'. Three concrete objectives for
evaluation were set:

to assess the appropriateness of the remedies (condoms etc.) distributed by Reden;
to assess the extent of safe and unsafe sex by the prostitutes;
to spread the message of safer sex to the users by the staff at Reden.

An active research method was chosen, involving the project workers in the process of collecting
information on the sex work of the women and also involving the staff in decisions about what to
investigate and how to make appropriate changes in getting across their message and the distribution
of their materials. The evaluation had two phases: the first month was used by the evaluator to
conduct participant observation in Reden. During the following three months the staff was involved
in the investigation and in implementation of the changes. Observation of user-employee interaction
in Reden during the first month revealed that condoms were distributed without much information
provided about their use. A prostitute typically might ask for five condoms. When asked about what
type she preferred it was not unusual to hear answers like: "I don't know, the same as last time", or:
"It doesn't matter, just give me five". But most women asked for a special type or a mixture.
Condoms have been delivered free of charge to Reden from the municipal health officer since 1986.
Reden is free to choose among 10-15 different types of condoms, all the same brand. At the
beginning of the evaluation five different types of condoms were distributed to the prostitutes but
lubricants or other contraceptives were not available. Conversation with the staff revealed great
enthusiasm for the message of 'safer sex' to the users. But several employees were uncertain about
specific practices, including the appropriate response when condoms break. Employees already
showed an awareness of the dangers of violence and assault but many did not know where the
women went with their customers and the type of services they usually provided. Concise guidelines
to 'safer sex precautions' were written and handed out to the staff. A short questionnaire on condom
use by the prostitutes was also developed. It was not intended to collect a large number of filled-in
questionnaires. The aim was to let the employees conduct the interviews in order to widen their
knowledge of the issues and the language used. All employees therefore were encouraged to
interview one or more of the prostitutes (one at a time). Three employees conducted 12 interviews.
Many of their colleagues expressed a desire to participate in the interviewing but since it had been a
rather turbulent period at Reden, they had not found time for it. During an organised discussion with
all employees, their experiences with interviewing - especially the more surprising responses - were
related and in this way a collective pool of knowledge emerged within the group. The frequent use
of two condoms at once had been the most surprising revelation to emerge from the interviews. But
rather frequent condom splitting also caused concern. Only one interviewee had never experienced
breakage of a condom and half the women had experienced breakage within the preceding 6
months. Among all the interviewees only two had reacted 'correctly' in that situation. Washing,
sluicing, and insertion of fingers and various objects to clean the vagina was frequently reported by
the prostitutes. Three of the prostitutes used lubricants while the rest used their own saliva - or
nothing at all. Almost all interviewees were keen to get access to lubricants and nonoxynol-9
suppositories.

The discussion led to the following conclusions:

It is a task of all project workers to discuss condom use and other 'safe sex' practices with
the users of Reden.
These issues were already discussed with some users sometimes but in order to ensure
discussions with all users, a more systematic method of communication should be introduced.
Then, for a period, frequency of and response to condom rupture should be discussed with
any woman who asked for condoms.
A pamphlet with information on safer sex practices and response to condom breakage should
be handed out to the prostitutes who only use Reden as a place to pick up condoms (these
women never stay long enough for a conversation).
Several employees felt that they knew too little about the working conditions and experiences
of their users; it was therefore decided to expand the questionnaire on this issue.
Lubricants (without nonoxynol-9) in small tubes and suppositories (containing nonoxynol-9)
for distribution to the users should be arranged.

The decisions were put into effect and the results evaluated three months later. During this period
there were repeated complaints from the prostitutes of price undercutting and of increased demands
from clients for sex without condoms. One prostitute called for a meeting in order to reestablish a
common price level and a common practice of condom use. Many of the prostitutes claimed to be
interested in the meeting but only two showed up. The meeting led to a stabilisation of the prices
charged due to a minimum prices list put up at Reden - probably because the list also contained
threats to beat up those who undercut prices or offered a service without condoms. A few of the
prostitutes also participated in a weekend seminar on violence and safe sex, arranged by WOMEN
AND AIDS. When asked later about what emerged from the seminar, they agreed that they were in
a better position to protect themselves. But they passed on almost nothing of their experiences to
other prostitutes at Reden. Six of the staff conducted another nine interviews, making use of the
expanded questionnaire. The pattern of condom rupture and use of condoms and lubricants did not
diverge from that of the first 12 interviewees. Four of the nine women had experienced enforced
intercourse without a condom but they all reported attempts by customers to enforce such sex or to
cheat with the condom. Furthermore, five of the women had suffered a severe violent assault at the
hands of a client but only two had reported the episode to the police. To sum up: the prostitutes
might be at risk of exposure to the semen of their clients due to inappropriate condom use. But they
also from time to time encounter a customer who simply enforces his will. Two other factors
influence the risk of exposure to diseases. To begin with, the women who inject drugs need
7.500-14.000 Dkr (1-2.000 ECU) each week to pay for their drugs. With a mean price of 350
Dkr (45 ECU) for 'Danish' (vaginal) intercourse an IVDU requires many clients to cover the cost of
drugs. Desperation is likely on occasion to drive some of the prostitutes to accept different
conditions for their service but this is very difficult to investigate. On the surface, all prostitutes claim
always to use condoms during sex. The last - and perhaps the most important - factor influencing
the risk of exposure to disease concerns how the prostitutes relate to their non-paying partners.
Only one of the 21 prostitutes that were interviewed claimed that she would not have intercourse
with a boyfriend if he refused to use a condom. Six women claimed not to have a boyfriend and
professed a lack of interest in finding one. The remainder did not use condoms with their boyfriend
or had not done so the last time they had a stable partner. In general, the argument went: 'boyfriends
do not have affairs on the side'. In comparison, all the IVDUs claimed never to have borrowed
needles from other IVDUs. Quite a lot of street prostitutes do not have a boyfriend but when they
do, the boyfriend is usually himself an IVDU and might be HIV seropositive. However, the
prostitutes connected the risk of HIV transmission to drug injections and with the prostitution
necessary for buying the drugs. In their private affairs, they did take precaution not to acquire HIV
from the infected equipment of their boyfriend but sex with the boyfriend was seen as quite a
different issue. A pilot distribution of lubricants and nonoxynol-9 suppository free of charge to the
users of Reden was introduced. These items were only handed over after counselling on how to use
them and it was especially emphasised that a suppository is not as safe as a condom and should
only be used in case of an 'emergency'. The staff also checked that none of the prostitutes frequently
received suppositories as this would indicate that they had replaced condoms by suppositories. An
organised discussion with the employees was conducted towards the end of the evaluation. The
discussion picked up on experiences from the new interviews, assessed the efficiency of the
distribution of lubricants and suppositories, and assessed the outcome of safer sex messages on the
users. The staff concluded:

lubricants and suppositories were well received by the prostitutes. Several women had
informed the staff that they had made use of the suppository when a condom ruptured. After
initial success the lubricants became less popular, partly because the tube was unwieldy,
partly because the cream was too fluid;
the users frequently complained of condom breakage and claimed this to be due to the bad
quality of the condoms. The quality of the condoms seemed acceptable, with the possible
exception of the non-lubricated condom (used for oral sex); this condom was frequently
reported to break;
all but one of the condom types were delivered in strips of five and had identical wrapping,
when removed from the 10 piece packet;
the condoms were delivered in strips of five. Perforation between the condoms was poor.
Detachment of one condom from the strip often teared the wrapping of the next condom in
the strip;
the condom delivery system was unstable. Reden ran out of stock for the most popular type
of condoms during the period of evaluation. Such a temporary break in delivery had been
experienced before;
all employees had talked to the prostitutes about 'safer sex' issues and all those receiving
condoms had been informed. The group of prostitutes who made frequent visits to Reden
now had been informed and showed no interest in further discussion of the issue for the time
being;
a few employees stated that it might not be appropriate for all employees to take part in
getting the safer sex message across. They felt that only those interested in this aspect of the
life of the users ought to particpate in this in the future;
the prostitutes had no problem discussing their sex life but there had been a tendency to avoid
discussions on the assaults and violence they had experienced, prefering to forget the
episodes;
interest among the prostitutes in taking part in interviews had reached its maximum and it had
become difficult of late to conduct interviews.

Overall, the staff concluded that they had gained new insight from the evaluation, especially on
concrete issues like what to do in case of condom rupture. Most employees found that they had
been able to pass this information onto the users too. The staff decided to continue distribution of
suppositories and lubricants but to search for a better lubricant in more appropriate tubes. The
municipal officer - or the condom manufacturer directly - should be informed about the problems
experienced with the condom wrapping and quality of the condoms themselves. Thus, information
about the condom should be written directly on the wrapping of each condom, the perforation
should be better, and the supply more stable. It was further decided to stop the safer sex
communication for a period but to repeat it after some months. Recently, better lubricants have been
bought and will be introduced by the staff.

Needs assessment among female bar-, escort- and massage parlour prostitutes in
Copenhagen (EUROPAP investigation)

In several of the EU countries centres have been established for prostitutes, centres that provide a
broad range of services like medical check-ups, social councelling, consultation with a psychologist,
legal advice etc. In order to assess the need for a centre for prostitutes in Copenhagen, in-depth
interviews were planned and carried out. A total of 19 female prostitutes were interviewed: eight
women working at massage parlours, five bar prostitutes and six escort girls. (Note: social worker
Lene Nyvang was the main interviewer. A prostitute conducted the bar interviews, and social
worker Hanne Zahle made a few of the interviews with escort girls). Each interview focused on
working conditions, encounters with the medical system, and the need for services as experienced
by prostitutes, both by women who had no plans to stop and by women who expressed a wish to
end their sex work career.

MAIN RESULTS:
Long term consequences of prostitution were similar to those described by two other recent
investigations in Denmark. They include addiction to drugs and/or alcohol, being in debt, sex
problems with their private partners, and living in social isolation from other people. The longer they
were involved in prostitution the more severe these problems became. But the degree of secrecy
sustained by the women in regard to people outside prostitution , - especially vis-a-vis parents,
children and other family members - also had a major influence on their current experience of
wellbeing. This need for this secrecy is related to the widespread double moral standards in regard
to prostitution in Denmark. The prevailing attitude is that prostitution is a 'natural' phenomenon but it
would in no way be 'natural' for one's own daughter to work as a prostitute. Yet, secrecy is also
forced upon the individual prostitute by the semi-criminalised legal status of prostitutes and by their
fear of prosecution by the authorities for benefit fraud and fear of the state taking away their
children. Consequently, none of those interviewed had told their social security office about their
involvement in prostitution. All the interviewees had been examined for STDs at least once and most
also had had a test for HIV. But only a few had had a medical check up within the last 12 months.
The prevailing attitude of the interviewees was that prostitutes are not at risk of acquiring HIV or
STDs because they protect themselves by using condoms. On the other hand, condoms do break
and most also felt that they ought to have a regular check up. The reason why they had not been
examined for a long time was usually put down to the lack of symptoms. This was much like not
going to the dentist due to not having problems with one's teeth. All the massage parlour prostitutes
said they would be interested in participating in outreach work with a doctor if a project was set up.
So did the bar prostitutes except one. But it may be difficult to arrange a place to carry out a
physical examination in the bars; all available space is usually in use. Escort girls cannot be visited in
this way as they most do not have a regular place of work. Most prostitutes had a preference for
male doctors - whether during outreach or in a clinic - since they were felt to be the most gentle
during a physical examination. The prostitutes were told about the special opening hours at the STD
clinic in Aarhus and asked whether they would like a similar arrangement at clinics in Copenhagen.
None had heard about these special opening hours before and very few found the idea especially
good. When discussing their latest check up, two thirds said they had contacted a STD clinic, the
rest had been examined by their 'family doctor'. One of these women found it reassuring when she
was being treated that the doctor knew about her prostitution but otherwise the prostitutes
concealed their sex work activity when consulting the 'family doctor'. When in contact with a STD
clinic, half had informed the staff about their sex work. None of these had experienced negative
reactions from the staff as a result of this information. All interviews included some kind of
councelling. HIV and STDs were discussed if the interviewee expressed a wish to do so or if
responses from the interviewee revealed a lack of knowledge or inappropriate response in their
dealings with clients. Frequently, interviewees did not know how to protect themselves in case of
condom breakage. Uncertainty also persists on how and whether to use condoms during oral sex.
Interviewees were divided on the usefulness of a centre with services aimed at prostitutes. Slightly
less than half of the women expressed no interest in a centre. The lack of interest was strongest
among escort girls who are also the prostitutes with greatest anonymity, even vis-a-vis other
prostitutes in the milieu. They would not use the centre due to the risk of meeting other prostitutes at
the centre. A few of those who found a centre to be an interesting idea thought that the centre
should only provide professional services (social councelling, legal advice, medical check ups). The
rest of the women (half of those interviewed) appreciated a centre with these functions but also felt
that the centre could provide a space and an opportunity for social meetings, social rights meetings
and self organisation. They all pointed to the importance of involving prostitutes in setting up the
centre and deciding on its function.

AREAS WHERE EUROPAP HELPED PROMOTE HIV PREVENTION FOR
PROSTITUTES

Promoting HIV prevention in Denmark includes applying for money, lobbying politicians, assessing
unmet needs, elaborating models and proposals for intervention. EUROPAP DENMARK has been
involved with all these areas during the last year. Fund raising and the development of a plan to
address the social and health issues of prostitution throughout the country constituted a major task
for EUROPAP, especially in the second half of the project period. The plan proposes to start-up
prostitution outreach projects in several Danish cities. This work was done in collaboration with the
PRO-line. Presentation of the plan to local authorities will hopefully result in a range of local and
regional projects this year - or next year (we are still applying for money). EUROPAP also took
more concrete HIV prevention initiatives. The evaluation of getting the message across and of
condom hand outs at Reden resulted in better practice, sensitive safer sex messages between staff
and users of Reden and introduced lubricants and nonoxynol-9 suppositories for distribution to the
street prostitutes. Reden received the suppositories as a gift for pilot testing and EUROPAP bought
the lubricants. A written report with a recommendation to freely distribute lubricants and
suppositories to street prostitutes is in process and will be delivered to the municipal health officer.
EUROPAP and the PRO-line also have collaborated on the distribution of pamphlets and remedies
to a contact in the escort milieu. This particular person gets in contact with approximately 100
different escort girls in the course of 6 months. These girls will be offered lubricants and
suppositories and instruction in their use as well as pamphlets on HIV and STDs. Condoms also will
be available to those who forgot to bring them.

PROPOSALS FOR INITIATIVES IN DENMARK

A list of proposals for initiatives in Denmark is provided below.

A medical doctor should provide an outreach service in Copenhagen to prostitutes at
massage parlours and bars, preferable in collaboration with a social worker.
A centre in Copenhagen for prostitutes with a range of services is unlikely to achieve success
if established 'top down' but it might evolve from the medical outreach work mentioned
above.
Free distribution of lubricants and nonoxynol-9 suppositories should be arranged for street
prostitutes and escort girls, not only in Copenhagen but also in other parts of the country if
reliable channels of distribution can be identified.
Barriers to anonymous STD check ups should be removed.
Outreach work among female prostitutes with provision for social support and councelling for
HIV/STD prevention should be initiated in the major Danish prostitution cities. Such initiatives
should also aim at establishing revised routines towards social clients active within
prostitution.
Outreach work with provision for social support and councelling for HIV/STD prevention to
male prostitutes in Jutland and Aarhus should be initiated.
The establishment of a new centre for social development and information will have
prostitution as one of its themes. This is a major achievement. The centre should direct
special attention to collecting information on male prostitutes and immigrant female prostitutes
and develop a service for them. Research on clients across the prostitution milieus is also
needed.
The law needs to be revised: prostitutes and their cohabiting family members should be
decriminalised.

ACKNOWLEDGEMENTS

The work of EUROPAP took place as a result of cross-disciplinary collaboration between
teacher/anthropologist Marianne Högsborg, Dr. Med. Anne Marie Worm and social worker Lene
Nyvang. In addition, social worker Hanne Zahle conducted part of the escort interviews while a
prostitute conducted the interviews with bar prostitutes and contributed valuable critical comments
on other parts of needs assessment among female prostitutes in Copenhagen.

We would like to thank the 'Europe against AIDS' programme from the E.U. DG V and the AIDS -
secretariat, the Ministry of Health, for the grant that made it possible to carry out the work of
EUROPAP during the first year. We are also thankful to K›benhavns Venerea Klinik for
collaboration and for providing work facilities.

Finally, we like to thank the prostitutes that participated one way or another in the project.
Hopefully, their contribution will make social and health services better for prostitutes in the future.

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