Tricks of the Trade: DIY Harm Reduction for Sex Workers, by Sex Workers
Thursday, 15 May, 2025
Credit: manuesf, flickr
Throughout history, sex workers have been involved in the global harm reduction movement.
People who use drugs and those who engage in sex work can face similar challenges; stigma, discrimination, lack of access to non-judgemental support, denial of health care, and an increased risk of experiencing violence.
Because of this overlap, our community often advocates alongside the harm reduction community, providing peer led support, services, and community outreach with a compassionate and understanding approach.
When both sex workers and people who inject drugs were identified as high-risk groups for transmission during the first stages of the HIV epidemic, the sex work community stepped up and assisted in pioneering the first needle exchange programs in Australia and the Netherlands.
During the 1980’s, sex workers played a role in the development of the Mersey Model – the first adopted model of harm reduction in the UK.
Sex workers were invited to a public meeting to discuss and become involved in AIDS prevention, though when no one turned up, it was clear that traditional invitations were inadequate. This highlighted the need for tailored outreach efforts, not only for sex workers, but for all other marginalised groups.
These events lead to the first International Harm Reduction conference in Liverpool (UK) in 1990, one of the first instances where practical information, tailored to people who both use drugs and sell sex, was shared.
As most adult establishments stigmatise workers and clients who use drugs, and the wider community demonise both sex workers and drug users, it can be difficult to access support or information aimed at this specific overlapping group.
However, sex workers are a crafty bunch. We’re adept at finding DIY solutions to work-related challenges, especially when it concerns keeping safe and healthy, and circulating this information amongst the community.
In the spirit of community, sex worker peers have shared with Users News their tips and tricks for harm reduction on the job.
Alcohol
Sometimes, the easiest thing to do while working is to either not use drugs or consume alcohol at all, or just pretend. Excuses as to why you don’t want to participate are usually enough to keep clients off your back, but sometimes they’re a little more pushy.
Some establishments have fake cocktail-like code names for non-alcoholic drinks that workers can order on shift, this way you can keep up appearances and your clients will be none the wiser.
If your establishment doesn’t have code names, Indigo tells us “I’d order drinks but quietly tell the bartender to make mine sans alcohol or weak.” - there’s no shame in it!
If you’re offered a drink and don’t particularly want to consume it, but don’t want to reject it for fear of losing out on a client, Chloe says “Always take your drink to the bathroom with you for safety; it’s also the perfect opportunity to pour it out, then come back out sipping the last bit.”
“Myself and a couple of older gals would sometimes bring our own bottle of wine to certain topless/nude jobs so we won't be perceived as ‘boring’ by not drinking, but also keeping safe by bringing our own. I've been spiked a few times in these types of jobs, so I didn't mind looking like a weirdo doing that for my own safety”, says Arizona.
Most establishments have no qualms with workers bringing their own alcohol on shift, some workers may even share theirs with clients to avoid drinking the sometimes awful ‘brothel pop’ as it’s affectionately called.
Drugs
If you choose to opt out of using drugs while on the clock, there are endless excuses you can use.
Chloe says she’ll tell clients “Coke makes me sleepy because I have ADHD”, and Indigo will say she gets heart palpitations to avoid using – she’s never had a client cancel a booking or tell her to leave using that excuse.
If the client is particularly pushy, she’ll say “oh I'd rather x (other girl who is using drugs) does mine off me”, which she says clients always get excited about.
For the times when you decide pretending is the easiest option, Angel’s favourite tricks are to put a damp cotton ball in your nose to catch any substance snorted, or lick the side of your hand and use it to sweep powder away while you fake snort.
Unfortunately, these methods aren’t foolproof.
“Overall I found it pretty hard to be honest, and I always ended up consuming a bit of whatever even if I was trying to fake it,” she says.
Nova incorporates her fake consumption into her whole working act.
“I love pretending to snort coke and sniff amyl with clients. I love drugs, but there’s no fucking way I’m gonna do it with clients”, she explains.
“I’m guessing they’re either too high to realise I’m faking it, or they don’t care coz in the end they have more for themselves. It gives me a rush to act. Fuck them for pressuring me to do drugs with them, witness my leading lady performance.”
Veteran sex worker ‘B’ has a wealth of lived experience in the industry – she generously shared her in-depth advice on looking after both yourself and your clients if there is drug use involved pre, during, and post shift.
For Clients:
Make a little dedicated space for any gear and equipment, on the cuck chair, bench, bedside table, hell even on the floor in the corner. Doing this makes it way easier to not knock over or roll onto. Keep it in vision of yourself and the client.
If you have a reg who knowingly injects every booking, carry sterile fits in case they ever need it – or anyone else!
If your client enters a paranoid or delusional state, affirm their reality and assure them that you know what’s up and that you are both safe. Hidden cameras are often a major worry for clients (tell me about it). Tell them you’ve already scanned the room for bugs at the start of your shift... let’s be real, this isn’t even a lie for most workers.
If your client has any open wounds or abscesses, be empathetic – encourage them to get it cleaned and bandaged. Play nurse and use a dental dam and a little bit of sterile lube to stick it down to cover any open wounds during your booking, e.g. when giving oral and not wanting to come into contact with wounds on thighs. Carrying a little first aid kit in your work bag is always a smart idea anyway, maybe you can help out with some clean bandages. Always be vigilant in your own hygiene protocols and remember to practice with every client, not just clients with wounds. If you are uncomfortable working with clients with open wounds, know you can decline service if you wish. Keep it polite and professional, and refer them to another worker if they’re comfortable for you to do so.
Ask them if they want any music and if so what they want to listen to - sensory sensitivity is a major effect for most people when on substances - music could be a trigger for some people, while others rely on background noise to feel safe.
Make sure they are a safe temperature and adjust the air con etc if necessary. You don’t want them to overheat and faint in a spa bath if they are already having big hot flushes, it’s safer to simply not use the bath at all – rather, if they are shaky and cold get a robe, warm them up with your body, make a hot drink like hot choccy or tea (not coffee).
When people are high on substances like ice, they can become very erratic and can jump very quickly from topic to topic, entertain this! Don’t make them feel like shit about it, they could get edgy and feel offended – prepare for it and have fun.
Always carry Naloxone and learn how and when to administer it correctly – even in cases of ‘non-opioid’ drug overdoses it can be lifesaving. Substances like Ketamine can be cut with Fentanyl (or Nitazenes) therefore containing opiates.
I cannot stress enough how important lighting is for people’s mindsets when high. Some people need full overstimulation (every light on so the shadow people don’t come knocking) other people need very minimal lighting such as the glare of a TV. When working in an establishment there are usually at least 2 lights you can use in a booking. A smart tip I got from a working girl at the brothel was to put a light pillowcase or thin towel over the top of a lampshade to diffuse the harshness of the light. Just make sure you don’t start a fire! Keep the fabric away from the bulb and avoid a flammable material like synthetic fabrics, etc.
Make sure they stay hydrated with water, and if on MDMA make sure they don’t over-do it on the water. Don’t encourage mixing alcohol, be sensitive if you are drinking and they aren’t – don’t make drinks in front of them or better yet wait until the booking is over – you don’t want to accidently tempt a client who may have had GHB, for example, as things can become very dangerous VERY quickly.
Ask if they have eaten and have snacks or lollies on hand if need be. Sometimes all it takes is a handful or two of some sour gummies or a lollipop to stop someone from feeling icky.
For Yourself:
Make sure you know your limits and why you have them. Understand the difference between firm boundaries and sliding scale boundaries – sometimes you may decide to only offer certain services to particular clients, on particular days, or when your financial situation calls for it. Stay concrete in your firm boundaries for yourself if and when you are able to apply them.
Try to keep your personal space outside of work welcoming for yourself after a big shift. Having a wind down routine after work is so important and becomes sacred after the first couple of practices. A shower with dim lighting, nice smelling body scrub and your favourite chill out music or podcast, with a fresh rig or pre-plated powder ready for you to go to cloud nine in your bed after a hectic graveyard shift of hustling. Homeless? During my stints, I found scents really had a big impact on me. A single scented candle could help me relax while doing focused breathing. After your last client and before leaving work, have a client-less shower to yourself before leaving if you haven’t got a shower where you are staying.
For heavier/daily users, try to figure out your schedule – do you need to eat before, during or after work? Do you need drugs to eat? How high is too high? One trick that works is measuring out your doses like meal prep. If you are injecting heavily and need intake on shift, measure out an amount and don’t make a mix. Have a bump here and there when you need it.
You can cover up tracks and bruises with waterproof makeup and setting spray, or come up with cute outfits with long sleeves, fishnets and/or dark thigh high stockings. Rotate where you shoot up on your body. Learn about the differences between IM (intramuscular) and IV (intravenous), where is safest and causes less complications. For example – you don’t want to shoot into your thighs/quad before doing an 8-hour shift in 7inch heels.
If you can’t deal with clients that use then don’t. If you can, then do! It’s comforting when a client can depend on a provider who also uses because it makes for far less of a judgmental environment. You might both have totally different picks of poison, either way less stigma in the room is far more freeing.
Try not to mix drugs and drink at work, but if you do then please don’t be experimenting for the first time at work. Try to keep it to a minimum and stay safe.
Virtually all drugs can be taken in a variety of ways – orally, insufflated, injected – how you administer it will have a difference in how long it lasts, how intensely the high hits, and how quickly it will come on. Figure out what is best for you to have more control over your high while working. If taking your drugs 1hr before your shift works best for you then set an alarm! You don’t want to be scrambling 10min to.
If you can, have someone you trust either at work or outside of work that you can contact. Have a lifeline through Signal messenger (or other encrypted messenger app) with a fellow user, find funny substance memes online – a lot of users who inject or use ‘heavier’ substances understand isolation and true loneliness more than most, it’s important to try to be a friend to yourself and try to plan things to look forward to. If you don’t want to interact with the community then don’t. But don’t let that stop you from doing your best to take care of yourself.
There are endless ways to reduce your risk while working, by no means is the above information all inclusive.
If something comes up that you need advice on, don’t be afraid to ask fellow sex workers for support, or do your own research, and if you need advice relating to drug use you can always call PeerLine!
There’s plenty of harm reduction information out there that can be applied to situations faced while working in the industry. The more knowledge you’re armed with, the more prepared you are to look after your clients and yourself.
Note: It’s important to be aware of the legality surrounding the above advice, particularly in relation to providing others with sterile injecting equipment. Stay safe, know your rights, and be cautious of any legal implications that may apply.