Contrary to outdated stereotypes, sex workers in the UK have a proactive approach to sexual health. Both independent and agency sex workers use a combination of safe sex practices, preventative vaccines, routine screening, and a supportive network to minimise risks because staying healthy is pivotal to their work and well being. Over recent decades, research and public-health programmes show that condom use has risen in many sex-work settings. Together with targeted healthcare and outreach services that help keep testing regular, this professionalised approach to health is born out of necessity and a strong sense of personal and communal responsibility by sex workers.
Understanding STD types and Trends
Sexually transmitted diseases (STDs) are infections that are transmitted from one person to another through sexual contact, including oral, anal, and vaginal sex. Some can also be transmitted through other intimate physical contact. Common bacterial STDs in the UK include Chlamydia, Gonorrhoea, and Syphilis; these can be cured with antibiotics. Viral STDs, which are manageable but not curable, include Human Papillomavirus (HPV), Genital Herpes, and HIV.
According to the latest data from the UK Health Security Agency (UKHSA), chlamydia and gonorrhoea cases have fallen significantly in 2024; however, there is a concerning 2% rise in syphilis cases. Most significantly, antibiotic-resistant gonorrhoea is a major concern globally. In the first five months of 2025, there have been 14 cases of resistance to ceftriaxone, the primary antibiotic treatment for gonorrhoea. Although testing rates are stable, untreated STIs can cause serious issues, and to combat this the NHS has increased its efforts in making STI screening more accessible.
Extensive free testing is a cornerstone of the NHS. Sex workers heavily rely on institutions such as Sexual Health Clinics (GUM Clinics). These specialist clinics are freely accessible to the public and do not require an NHS number or proof of address. They provide the most thorough STD testing—including swabs for chlamydia and gonorrhoea, and blood tests for HIV and syphilis—as well as immediate, free treatment.
Charities such as the National Ugly Mugs (NUM) and the English Collective of Prostitutes (ECP) provide excellent sexual health resources for sex workers and can advise on the best local clinics. They also advocate for the rights of sex workers within the healthcare system.
What are the safest forms of protection?
- Pre-Exposure Prophylaxis (PrEP): PrEP is an oral medication taken by HIV-negative people to drastically reduce the risk of contracting HIV. It is over 99% effective when taken correctly. Many sex workers, particularly those in higher-risk groups, use PrEP as a reliable backup. It is freely available on the NHS through sexual health clinics for those who meet the criteria.
- Internal and external condoms: Correct and consistent use of condoms is the most effective method to prevent the transmission of most STDs.
- Dental Dams: A latex or polyurethane sheet used during oral sex to protect against STDs.
- Vaccinations: In the UK, many sex workers are fully vaccinated against Hepatitis B and HPV.
These are not the only ways to protect against STDs. The most robust approach to sexual health is a strategic combination of using the right tools (condoms, PrEP, vaccines), getting tested regularly, and treating infections. This includes having open and honest conversations with sexual partners and knowing how to access emergency services.