There are more than 500 women and more than 100 men working as prostitutes on Teesside, according to a report on the sex trade.
Of the women, more than half - 268 - were turning to prostitution to survive, as their only way of making money to pay for food and accommodation. Many were addicted to drugs or alcohol. Many had first been sexually exploited when they were under the age of 16.
The proportion of men forced into "survival sex" was smaller - about 35 men in total.
Researchers spoke to prostitutes in Middlesbrough, Stockton, Redcar and Hartlepool. They found all four areas had a sex market both on the streets and off the street - in brothels.
Researchers said that support for prostitutes was low and there was a need for better provision of accommodation, counselling and drug services.
Their report found that Independent Sexual Violence Advisors on Teesside had spoken to just 10 people involved in prostitution over the last six years.