Commercial sexual exploitation (CSE) includes a wide range of often linked sexual activities which typically men profit from, or buy from women and which objectify and harm women.

Examples include

  • prostitution
  • phone sex, internet sex or chatrooms
  • stripping, pole dancing, lap dancing, peep shows
  • pornography
  • trafficking, sex tourism and mail order brides.

These can be in exchange for things such as

  • drugs
  • food
  • shelter
  • protection

Here you can find information on the link between CSE and health inequalities, as well as actions that can be taken to address this.

  • Many dancers begin working in lap-dance clubs through lack of real choice.
  • 70% of those in street prostitution became involved as children or teenagers.
  • Many people involved in prostitution have previous experience of neglect, violence and abuse.
  • In a local study 57% of those surveyed in street prostitution and 22% of those involved indoors had experienced childhood sexual abuse.
  • Physical assault, rape, attempted rape and sexual assault are commonly reported by those involved in prostitution.
  • High levels of alcohol and/or drug use are reported as a common coping strategy among women involved in prostitution.
  • 1,744 potential victims of trafficking for sexual exploitation were referred to the National Referral Mechanism in 2017, which represented one third of all referrals.

CSE and health inequalities

The Scottish Government includes prostitution, pornography and other forms of involvement in the sex industry within its definition of violence against women. The exploitation of women in such ways legitimises negative attitudes towards women and is inextricably linked to gender inequality and sexual violence.

While women and girls are at the greatest risk of being abused through CSE, men are also affected and can become involved in prostitution for similar reasons to women. Often the adverse impact of male prostitution is belittled or overlooked since it is more likely to be wrongly considered consensual, rather than recognised as exploitative.

For many, it is through a lack of choice and a need for survival in response to their social and economic environment. They may

  • come from vulnerable backgrounds
  • live in poverty or with financial difficulties
  • feel they have few realistic or viable alternatives
  • have addiction or substance misuse services
  • experience other forms of violence or abuse.

Based on a lack of alternatives and often on coercion, such activities are rarely a free or vocational choice.

Coping with the consequences of CSE and exposure to violence and other forms of abuse can have a profound impact on physical, sexual and mental health and the adoption of negative health behaviours.

We have created guidance and information that explains the nature of CSE, its impact on health, and how staff can respond to those who have experienced it.

Go to our guidance on CSE for health workers

National actions

The Scottish Parliament has a cross-party CSE group which promotes the pursuit of legislation to prevents CSE and challenge demand.

In 2017, the Scottish Government published research on the available knowledge and evidence on the scale and nature of prostitution in Scotland. The research gathered evidence and views from professionals with knowledge of prostitution and considered

  • scale of prostitution
  • impact on and support for those involved
  • organised crime and human trafficking
  • impact on local communities.

Visit the Scottish Government site to access the report

Local actions

Women's Support Project and Encompass Network

Women’s Support Project is the national development lead for CSE. Its role involves capacity building and delivery of training. This is done via violence against women networks at the local level to improve knowledge and understanding of CSE within mainstream services.

It has established the Encompass Network, made up of agencies across Scotland that work with women, girls and vulnerable men who are currently involved, have exited or who are at risk of involvement in commercial sexual exploitation.

It aims to share and develop good practices in preventing CSE, in supporting those involved in selling or exchanging sexual activity and in supporting those planning to exit or who are exiting.

Local contacts

Each local NHS Board has an Executive Lead and Operational Lead for gender based violence (GBV). You can contact your local lead for information on local policies, training opportunities and support for staff.

Support services for the public

Members of the public can be directed towards Scotland's Service Directory on NHS inform which provides information on

Last updated: 02 October 2023
Was this page helpful?