Sex work and health: a question of safety in the workplace

Sex work is an occupation or trade involving exchange of sexual services for economic compensation. Although health problems associated with prostitution, such as sexually transmitted diseases and violence, are commonly assumed to be "risks of the trade," the illegality and stigma of prostitution have prevented the medical establishment from viewing it through the lens of occupational safety and health. They have also resulted in a failure to look at such day-to-day conditions and illnesses as repetitive stress injuries and other musculoskeletal problems, bladder infections, and work-related stress that may be of more immediate concern to sex workers. This paper reviews what is known about the safety and health hazards associated with prostitution through some formal research, but primarily through informal discussions with sex workers over two decades. The overarching factor affecting the health of sex workers is the legal context, thus that is reviewed first; then I look at occupational hazards and conclude with some suggestions for immediate action and further research.