Sexual violence, post-traumatic stress disorder, depression: a survey published Tuesday sheds light on the "alarming" state of health of prostitutes in France, an aspect that has been little documented until now.
Conducted in partnership with Inserm and Sorbonne University, the Aspire study (Access to care, Health and Prostitution) was carried out with 258 adults in prostitution or who had been in prostitution in about thirty cities.
The results are unequivocal: of the 258 people who responded (including 238 women, 12 trans people and 8 men), almost all (95%) reported having suffered violence, sexual in 85% of the cases.
85% reported having been forced into acts by a client at least once and 65% reported having been physically assaulted and forced by their pimps into acts they did not want to do.
Sixty-eight percent of those surveyed revealed having between one and six health problems, including hypertension, diabetes, stomach aches, and urinary tract infections.
In terms of mental health, 62.51% of T3Ts exhibit symptoms of post-traumatic stress – compared to 5 to 12% of T3Ts in the general population or compared to a quarter of military personnel who have participated in a war.
Half suffer from depressive disorders and 72% suffer from at least one eating disorder and sleep disorder, according to this study led by the Mouvement du Nid, which has long campaigned for the abolition of prostitution.
– Sleep disorders –
"People involved in prostitution really have deteriorated physical and mental health compared to the general population," emphasizes Fabienne El Khoury, a social epidemiology researcher at Inserm who contributed to the study.
However, for a long time, their "state of health, which is alarming, has often been reduced to their sexual health and the fight against sexually transmitted infections and diseases; there is an urgent need to look at their needs as a whole and better support them," she adds.
In terms of sexual health, 66% of those interviewed said they get tested at least once a year, 59% have had at least one voluntary termination of pregnancy (abortion) compared to 22% in the general female population, and 27% have undergone excision.
Only 5.5% reported using psychoactive substances (excluding tobacco, alcohol and cannabis) in the past year.
On the ground, access to care remains a path fraught with obstacles, including language barriers (96% of those interviewed are of foreign origin), economic insecurity and medical violence.
In addition to this, there are psychological barriers (shame, fear of being judged, cultural taboo on mental health, psychological infiltration by aggressors which makes them feel guilty…).
– Training –
Now 29 years old, Alexine, who worked as a student prostitute for two years, initially to pay her rent, did not speak about her situation "neither at the time nor to the doctors who are treating me today for my thyroid inflammation."
During her time in prostitution, the young woman saw "her depression worsen", "started drinking heavily, cutting herself" but only managed to put words to it once she "got out of it".
The study makes a series of recommendations, notably calling for training healthcare professionals "on the traumatic consequences" of prostitution.
"Professionals need to be able to read the situation in which the rescued person or the person still in a situation of prostitution finds themselves," emphasizes Pauline Spinazze, coordinator of the study for the Mouvement du Nid.
"Perhaps she is in a state of traumatic dissociation, perhaps there is a psychotraumatic mechanism of denial or avoidance behavior or endangerment that will be applied," she adds.
Other measures recommended include access to state medical aid (AME) – “still too often refused” – an increase in the number of psychologists and psychiatrists and an increase in the number of regional psychotrauma centers.
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