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Drug use in street sex workers (DUSSK) study protocol: a feasibility and acceptability study of a complex intervention to reduce illicit drug use in drug-dependent female street sex workers
  1. Nicola Jeal1,2,
  2. Rita Patel2,3,
  3. Niamh M Redmond2,3,
  4. Joanna M Kesten2,3,4,
  5. Sophie Ramsden1,
  6. John Macleod2,5,
  7. Joanna Coast3,6,
  8. Maggie Telfer7,
  9. David Wilcox8,
  10. Gill Nowland9,
  11. Jeremy Horwood3,5
  1. 1 University Hospitals Bristol NHS Foundation Trust (UHBT), Bristol, UK
  2. 2 Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
  3. 3 The National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West (NIHR CLAHRC West), University Hospitals Bristol NHS Foundation Trust (UHBT), Bristol, UK
  4. 4 The National Institute for Health Research Health Protection Research Unit in Evaluation of Interventions, University of Bristol, Bristol, UK
  5. 5 Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
  6. 6 Health Economics at Bristol, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
  7. 7 Bristol Drugs Project, Bristol, UK
  8. 8 Avon and Wiltshire Mental Health Partnership NHS Trust, Bristol, UK
  9. 9 One25, The Grosvenor Centre, Bristol, UK
  1. Correspondence to Dr Nicola Jeal; nikki.jeal{at}bristol.ac.uk

Abstract

Introduction Poor health of sex workers continues to be a source of international concern. Sex work is frequently linked with problematic drug use and drug-dependent sex workers typically work on the street, experiencing the greatest risks to health compared with the general population. Street sex workers (SSWs) are much more likely to have experienced incidences of physical and sexual assault, increasing their risk of developing post-traumatic stress disorder (PTSD). We have developed a novel complex intervention designed to reduce illicit drug use in drug-dependent female SSWs which involves: female SSW drug treatment groups (provided by a specialist charity) in a female SSW setting (female sex worker charity premises) provided by female-only staff, PTSD care with eye movement desensitisation and reprocessing (EMDR) therapy provided by female staff from National Health Service (NHS) mental health services.

Methods and analysis A mixed methods study investigating the feasibility and acceptability of this intervention to inform the design of a future randomised controlled trial. The study aims to recruit up to 30 participants from November 2017 to March 2018 at a single site, with the intervention being delivered until December 2018. It will gather quantitative data using questionnaires and group attendance. Drug treatment group observations and in-depth interviews undertaken with up to 20 service users and 15 service providers to examine experiences and acceptability of the intervention. Study feasibility will be assessed by evaluating the recruitment and retention of participants to the intervention; the feasibility of NHS and third sector organisations working closely to coordinate care for a SSW population; the potential for specialist NHS mental health services to screen and provide EMDR therapy for drug-dependent SSWs and potential costs of implementing the intervention.

Ethics and dissemination This study was approved by South West–Frenchay Research Ethics Committee (REC reference: 17/SW/0033; IRAS ID: 220631) and the Health Research Authority (HRA). Findings will be disseminated through research conferences and peer-reviewed journals.

  • feasibility studies
  • substance abuse
  • sex workers
  • trauma treatment
  • qualitative research

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

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Footnotes

  • Contributors NJ, JM, NMR, JH, JMK, RP, SR and JC are responsible for the study design and collection of data. NMR, NJ and JH are responsible for study management and coordination. NJ, RP and JH drafted the paper. MT, DW and GN contributed to the design of the intervention. All authors read, commented on and approved the final manuscript.

  • Funding The research is supported by a National Institute for Health Research (NIHR) Clinic Trials Fellowship awarded to NJ, the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West (NIHR CLAHRC West) at University Hospitals Bristol NHS Foundation Trust (UHBT) and Research Capability Funding awarded by UHBT. JMK is partly funded by NIHR Health Protection Research Unit in Evaluation of Interventions.

  • Disclaimer The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval South West-Frenchay Research Ethics Committee (REC reference: 17/SW/0033; IRAS project ID: 220631).

  • Provenance and peer review Not commissioned; peer reviewed for ethical and funding approval prior to submission.