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In this paper, academics and managers of specialist services reflect on the shifting policy and funding landscapes that shape service provision for drug‐using sex workers in England and Ireland. The paper outlines the harm reduction and holistic principles that underpinned much original service provision concerned with public health in the face of an HIV epidemic and the limitations of services that equate drug use minimisation with sex work minimisation. It concludes that an ‘exiting’ and victim discourse dovetails with the well‐funded crime and disorder agenda, and that lobbyists on these issues are proving to be natural allies against harm reduction.

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