BackgroundSex workers are at disproportionate risk of violence and sexual and emotional ill health, harms that have been linked to the criminalisation of sex work. We synthesised evidence on the extent to which sex work laws and policing practices affect sex workers’ safety, health, and access to services, and the pathways through which these effects occur.Methods and findingsWe searched bibliographic databases between 1 January 1990 and 9 May 2018 for qualitative and quantitative research involving sex workers of all genders and terms relating to legislation, police, and health. We operationalised categories of lawful and unlawful police repression of sex workers or their clients, including criminal and administrative penalties. We included quantitative studies that measured associations between policing and outcomes of violence, health, and access to services, and qualitative studies that explored related pathways. We conducted a meta-analysis to estimate the average effect of experiencing sexual/physical violence, HIV or sexually transmitted infections (STIs), and condomless sex, among individuals exposed to repressive policing compared to those unexposed. Qualitative studies were synthesised iteratively, inductively, and thematically. We reviewed 40 quantitative and 94 qualitative studies. Repressive policing of sex workers was associated with increased risk of sexual/physical violence from clients or other parties (odds ratio [OR] 2.99, 95% CI 1.96–4.57), HIV/STI (OR 1.87, 95% CI 1.60–2.19), and condomless sex (OR 1.42, 95% CI 1.03–1.94). The qualitative synthesis identified diverse forms of police violence and abuses of power, including arbitrary arrest, bribery and extortion, physical and sexual violence, failure to provide access to justice, and forced HIV testing. It showed that in contexts of criminalisation, the threat and enactment of police harassment and arrest of sex workers or their clients displaced sex workers into isolated work locations, disrupting peer support networks and service access, and limiting risk reduction opportunities. It discouraged sex workers from carrying condoms and exacerbated existing inequalities experienced by transgender, migrant, and drug-using sex workers. Evidence from decriminalised settings suggests that sex workers in these settings have greater negotiating power with clients and better access to justice. Quantitative findings were limited by high heterogeneity in the meta-analysis for some outcomes and insufficient data to conduct meta-analyses for others, as well as variable sample size and study quality. Few studies reported whether arrest was related to sex work or another offence, limiting our ability to assess the associations between sex work criminalisation and outcomes relative to other penalties or abuses of police power, and all studies were observational, prohibiting any causal inference. Few studies included trans- and cisgender male sex workers, and little evidence related to emotional health and access to healthcare beyond HIV/STI testing.ConclusionsT...

This article reports on an ethnographic study of female sex workers inBritain who work in the indoor prostitution markets. The empirical findings contribute to the sex-as-labour debate and add to the sociological literature regarding the gendered and sexualized nature of employment, particularly the aesthetic and emotional labour of service work. Grounding the empirical findings in the theory of identity management and emotional labour and work, the article reviews some of the existing examples of how sex workers create emotion management strategies and describes an additional strategy, that of the 'manufactured identity'. I argue that sex workers create a manufactured identity specifically for the workplace as a self-protection mechanism to manage the stresses of selling sex as well as crafting the work image as a business strategy to attract and maintain clientele. Drawing on comparisons between sex work and other feminized service occupations, I argue that sex workers who are involved in prostitution under certain conditions are able to capitalize on their own sexuality through the construction of a manufactured identity. The process of conforming to heterosexualized images in prostitution is conceptualized as not simply accepting dominant discourses but as a calculated response made by sex workers to manipulate the erotic expectations and the cultural ideals of the male client. Sex work as a service industry?t has been established that in mainstream employment women are part of a work culture where female sexualization is an integral expectation of I

One recent finding about the prostitution market is the differences in the extent and nature of violence experienced between women who work on the street and those who work from indoor sex work venues.This paper brings together extensive qualitative fieldwork from two cities in the UK to unpack the intricacies in relation to violence and safety for indoor workers. Firstly, we document the types of violence women experience in indoor venues noting how the vulnerabilities surrounding work-based hazards are dependent on the environment in which sex is sold. Secondly, we highlight the protection strategies that indoor workers and management develop to maintain safety and order in the establishment. Thirdly, we use these empirical findings to suggest that violence should be a high priority on the policy agenda. Here we contend that the organizational and cultural conditions that seem to offer some protection from violence in indoor settings could be useful for informing the management of street sex work. Finally, drawing on the crime prevention literature, we argue that it is possible to go a considerable way to designing out vulnerability in sex work, but not only through physical and organizational change but building in respect for sex workers rights by developing policies that promote the employment/human rights and citizenship for sex workers. This argument is made in light of the Coordinated Prostitution Strategy.

This paper describes the findings from a 10-month ethnographic study of the female sex industry in a large British city. I argue that sex workers construct a continuum of risk which prioritises certain types of dangers depending on the perceived consequences and the degree of control individuals consider they have over minimising the likelihood of a risk occurring. Although health-related matters are a real concern to many women, because they generally have comprehensive strategies to manage health risks at work, this risk category is given a low priority compared with other risks. The risk of violence is considered a greater anxiety because of the prevalence of incidents in the sex work community. However, because of comprehensive screening and protection strategies to minimise violence, this type of harm is not given the same level of attention that emotional risks receive. By using a continuum of risk to understand how sex workers perceive occupational hazards in prostitution, further understanding can be gained about the nature of risk in prostitution, sex workers' routines and the organisational features of the sex industry. In addition, the implications for health policy are discussed, suggesting that the emotional consequences of selling sex should be considered as much as the tangible, physical risks of prostitution.

This paper uses empirical data collected from 117 female sex workers living in informal settlements in Nairobi and 15 healthcare providers to highlight specific effects of COVID-19 and related restrictions on healthcare access for the sex workers. We highlight the existing gender and health inequalities that have now been reinforced by the initial outbreak of the COVID-19 pandemic. Specifically, we focus on the most concerning healthcare needs for the sex workers including HIV prevention, care and treatment and sexual and reproductive healthcare. Our study findings reveal that the various restrictions imposed by the government to help curb the spread of COVID-19 to a large extent made it difficult for the sex workers to access their healthcare needs. The paper discusses the challenges of healthcare service delivery reflecting on some innovative and pioneering responses from health care providers to address the emergency situation.

This article explores the processes by which distinctive red-light districts are created in western cities, focusing on the changing location of female prostitution in Birmingham (UK). Adapting Henri Lefebvre's ideas on the production of space, as well as Michel de Certeau's distinction between strategies and tactics, the article argues that the changing location of prostitution in the city is the result of a constant interplay between the ordering strategies enacted by the police, council and community protestors and the resistive tactics adopted by sex workers. The net outcome of this process, it is argued, is that a space is created for prostitution so that its resistive potential can be contained within a heterosexually-ordered city. The article therefore concurs with Lefebvre when he argues that conceptualized space tends to overcode and dominate lived space, but concludes that sex work always threatens to create new 'spaces of representation' that challenge the heterosexual ordering of society. Copyright Joint Editors and Blackwell Publishing Ltd 2003.

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This paper seeks to analyse the expansion of commercial sex through processes of mainstreaming in economic and social institutions. We argue that cultural changes and neo-liberal policies and attitudes have enabled economic mainstreaming, whilst social ambivalence continues to provide the backdrop to a prolific and profitable global industry. We chart the advancement of sexual consumption and sexual service provision in late capitalism before defining the concept of`mainstreaming' applied here. We use the case studies of Las Vegas and Leeds to identify various social and economic dimensions to the mainstreaming process and the ways these play out in law and regulation. While social and economic processes have integrated sexual services into night-time commerce, remaining social ambivalence fuels transgression and marginalization of the industry which in fact assists the mainstreaming process. Finally, we project some implications for gender relations, work, and inequalities as a result of the integration of sexual services into the economy.