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Prostitution: a critical review of the medical and social sciences literature
Melissa Farley and Vanessa Kelly
Women & Criminal Justice 2000, Vol 11 (4): 29-64.
Melissa Farley & Vanessa Kelly c 2000 All Rights Reserved.
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ABSTRACT. In the recent literature on prostitution, there has been a focus on HIV which has tended to exclude discussion of the physical and sexual violence which precedes and which is intrinsic to prostitution. The literature of two time periods (1980-84 and 1992-1996) is critically reviewed in order to describe this trend.

The normalization of prostitution in the medical and social sciences literature, the tendency to blame the victim of sexual exploitation, and the ways in which racism and poverty are an inextricable part of prostitution are discussed here. The social invisibility of prostitution, needs of women escaping prostitution, and an overview of recent criminal justice responses to prostitution are summarized.

Introduction
Some laws in USA have been profoundly influenced by social science research - for example, rape law and sexual harassment law. In an era of changing attitudes toward prostitution, familiarity with recent research is essential to those who are a part of the criminal justice system. As psychologists, we hope to see a change in the health professions’ relative silence regarding prostitution’s harm to women, as well as a change in the perspective on prostitution held by the criminal justice system. The social and medical sciences have been limited by a failure to adequately address the harm of prostitution to women. Concerned about the ____________________________________________________________________________ Melissa Farley, Ph.D. is at Kaiser Foundation Research Institute, Oakland, Ca. and Prostitution Research & Education, a project of San Francisco Women’s Centers, Inc.

Box 16254, San Francisco CA 94116-0254
http://www.prostitutionresearch.com
Vanessa Kelly, Psy.D. is Coordinator, University of California at San Francisco Traumatic Stress Treatment Program, San Francisco General Hospital, San Francisco, CA.2
invisibility of prostitution’s harm in the health professions (in addition to its invisibility in the culture at large), we reviewed the literature on prostitution. The authors concur with Vanwesenbeeck (1994, page 33) who wrote: "Researchers seem to identify more easily with clients than with prostitutes...”

Much of what has been written about prostitution in the medical and social sciences fails to address the sexual violence and psychological harm which both precede and are intrinsic to prostitution. A few (see below) have noted that prostitution involves a lifelong continuum of sexual exploitation and violence which begins with sexual assault or prostitution in childhood. Most authors between 1980 and 1998 failed to address the violence in prostitution. Instead, there has been an almost exclusive focus on sexually transmitted disease (STD), especially the human immunodeficiency virus (HIV) in the recent social science and medical literature on prostitution. Although HIV has certainly created a public health crisis, the violence and human rights violations in prostitution have also resulted in health crises for those prostituted.

To describe this trend in more detail, we reviewed the MELVYL Medline and PsycINFO on-line databases on prostitution for 2 time periods: 1980 - 1984, and 1992 - 1996 (MELVYL Medline and PsycINFO, 1980-84 and 1992-1996). Medline lists citations and abstracts of articles in medical and life sciences journals. PsycINFO lists citations and abstracts of articles in psychology journals.

During the decade 1980-1990, there was a pronounced trend in the social sciences literature to view prostitution primarily as a means of HIV transmission, from prostitute to john. We compared the percentages of journal articles which focused primarily on STD and HIV to those articles which addressed prostitution itself as a source of...
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