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Health inequities faced by sex workers
Katherine Rucinski1, Mary Anne Roach1, Anna Shapiro2
1Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
The Lancet. Public Health
|July 24, 2026
Summary
Sex workers globally face significant health inequities, with high rates of depression and unmet contraceptive needs. Addressing structural factors and community engagement is crucial for improving health equity.
Area of Science:
- Public Health
- Health Equity Research
- Epidemiology
Background:
- Persistent health inequities disproportionately affect sex workers worldwide.
- Key areas of concern include mental health, sexual and reproductive health, and harm reduction.
Purpose of the Study:
- To review epidemiological studies from the past decade on health outcomes among sex workers.
- To identify factors contributing to health disparities.
- To contextualize evidence gaps using a Health Equity framework.
Main Methods:
- Systematic review of epidemiological studies published over the last 10 years.
- Analysis of health outcomes and associated factors.
- Application of a Health Equity framework to identify evidence gaps.
Main Results:
- High prevalence of depression among sex workers (1 in 4 to 4 in 5).
- Significant unmet need for contraception among sex workers (at least 1 in 3).
- Identified evidence gaps across multiple levels of influence.
Conclusions:
- Urgent need to address structural determinants of health for sex workers.
- Recommendations include upholding sex worker autonomy, including diverse populations in research, and fostering community engagement.
- Advancing health equity requires integrated research and programming.
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