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

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 to 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 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 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 co-ordinate 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 (17/SW/0033). Findings will be disseminated through research conferences and peer-reviewed journals.