Health inequities faced by sex workers

Stark health inequities persist for sex workers globally-particularly in the areas of mental health, sexual and reproductive health, and harm reduction. To inform this Series paper we reviewed epidemiological studies published over the past decade to describe the burden of key health outcomes among sex workers and associated factors contributing to these disparities. Within the mental health literature, we estimate at least one in four and as many as four in five sex workers experience depression. Within sexual and reproductive health literature, at least one in three sex workers are estimated to experience an unmet need for contraception. Using a Health Equity framework, we contextualise evidence gaps related to these health areas across multiple levels of influence (eg, systems of power, relationships and networks, physiological pathways, and individual factors) and offer recommendations to advance an agenda of health equity for sex workers in future research and programmes. Priority programme and policies include upholding the autonomy and dignity of sex worker communities, ensuring the inclusion of gender diverse populations in research, addressing structural determinants of health, and fostering meaningful community engagement and collaboration.