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These high levels of sexual violence suffered by sex workers have very traumatic effects on the men and women working as prostitutes.
High levels of rape other forms of sexual violence while working as a prostitute have been linked to higher levels of Post Traumatic Stress Disorder (PTSD).
These particular murders are distinguished from other murders of sex workers during the same time period due to the post-mortem mutilations that occurred, and it is for that reason that other murders of prostitutes are not usually attributed to the Ripper, or are disputed.
Peter Sutcliffe (aka the Yorkshire Ripper) murdered 13 women, some of whom were sex workers, from 1975-1980 in Northern England. Robert Hansen murdered between 15 and 21 sex workers, near Anchorage, Alaska, between 19.
According to a study conducted on one hundred and thirty people working in San Francisco as street sex workers, 82% had been physically assaulted, 83% had been threatened with a weapon and 68% had been raped while working as prostitutes.
In countries such as the United States sex work is illegal, and so sex workers are not able to report violence done against them in fear of being arrested themselves.
Physical violence is defined by the World Health Organization as "the intentional use of physical force or power, threatened or actual, against oneself, another person, or against a group or community, which either results in or has a high likelihood of resulting in injury, death, psychological harm, maldevelopment, or deprivation".
In certain states anti-prostitution mandates carry a minimum sentence and can increase to felony charge after multiple arrests, which leads to difficulty finding housing and employment, and disqualification for welfare benefits.
As one sex worker in South Africa reports "to gather evidence of a crime against a sex worker, they have to first take it seriously,”.
This figure is considerably higher than that for the next riskiest occupations in the United States during a similar period (4 per 100,000 for female liquor store workers and 29 per 100,000 for male taxicab drivers).
The prevalence of violence against prostitutes varies by location.
A study of sex-workers in Phnom Penh, Cambodia found that half of the women had been beaten by police and about a third had been gang-raped by police.