ArticleInternational journal of environmental research and public health2021
Intersections of Sex Work, Mental Ill-Health, IPV and Other Violence Experienced by Female Sex Workers: Findings from a Cross-Sectional Community-Centric National Study in South Africa.
Article in International journal of environmental research and public health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 2 of them syntheses that pooled it.
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Who cites it
18 citing papers in PubMed, 2 syntheses or guidelines pooled it, 31 citations in OpenAlex.
- Prevalence, risk and resilience factors of mental health conditions among female sex workers: a systematic review and meta-analysis.Frontiers in public health · 2024Pooled it
- Differentiating the incidence and burden of HIV by age among women who sell sex: a systematic review and meta-analysis.Journal of the International AIDS Society · 2022Pooled it
- Mental health and substance use among women frequenting high-risk venues in Haiphong, Vietnam: findings from an adapted PLACE survey.The International journal on drug policy · 2026Article
- Health inequities faced by sex workers.The Lancet. Public health · 2026Review
- "It would have been easier for me to give up if I were alone": how a pilot individualized case management intervention influenced female sex workers' oral HIV pre-exposure prophylaxis use in eThekwini, South Africa.BMC public health · 2026Article
- Honouring complexity and social justice in mental health: The socio-political economy of global mental health framework.PLOS mental health · 2026Article
- A quantitative study on female sex workers' mental health in Germany.Frontiers in public health · 2025Article
- Nursing team perceptions in caring for sex workers in primary care.Revista da Escola de Enfermagem da U S P · 2025Article
- Prevalence and factors associated with violence against women who exchange sex for money in Gulu City, Northern Uganda: a cross-sectional study.BMJ public health · 2025Article
- Depression and correlates of suicidal thoughts among mothers who are female sex workers in three low- and middle-income countries in Sub-Saharan Africa: a cross-sectional application of the Edinburgh postnatal depression scale.Frontiers in public health · 2025Article
- Exploratory analysis of the potential impact of violence on HIV among female sex workers in Mombasa, Kenya: a mathematical modelling study.BMC medicine · 2024Article
- Determinants of depressive and alcohol use disorders among female sex workers in Ethiopia: evidence from a national bio-behavioral survey, 2020.BMC psychiatry · 2024Article
- Increasing age and duration of sex work among female sex workers in South Africa and implications for HIV incidence estimation: Bayesian evidence synthesis and simulation exercise.Infectious Disease Modelling · 2024Article
- Prevalence of violence victimisation and poly-victimisation among female sex workers in Haiphong, Viet Nam: A cross-sectional study.Global public health · 2024Article
- Self-Reported Adherence to Antiretroviral Therapy (ART) Among Women Engaged in Commercial Sex Work in Southern Uganda.AIDS and behavior · 2023Article
- Intimate Partner Violence and Mental Health: Deepening Our Understanding of Associations, Pathways, and Prevention in Low- and Middle-Income Countries.International journal of environmental research and public health · 2023Article
- The relationship between underage initiation of selling sex and depression among female sex workers in Eswatini.Frontiers in psychiatry · 2023Article
- Temporomandibular Disorders and Bruxism among Sex Workers-A Cross Sectional Study.Journal of clinical medicine · 2022Article
Corrections and comments
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Authors and funding
11 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Female sex workers (FSWs) are at increased risk of mental health problems, including mood disorders and substance abuse, and we need to understand the origins of these to treat and prevent them, and particularly understand how the context in which they sell sex impacts their mental health. We conducted a multi-stage, community-centric, cross-sectional survey of 3005 FSWs linked to SW programmes in twelve sites across all nine provinces of South Africa. We interviewed adult women who had sold sex in the preceding six months, who were recruited via SW networks. We found that FSWs have very poor mental health as 52.7% had depression and 53.6% has post-traumatic stress disorder (PTSD). The structural equation model showed direct pathways from childhood trauma and having HIV+ status to mental ill-health. Indirect pathways were mediated by food insecurity, controlling partners, non-partner rape, harmful alcohol use, substance use to cope with SW, indicators of the circumstances of SW, i.e., selling location (on streets, in taverns and brothels), frequency of selling and experiencing SW stigma. All paths from childhood trauma had final common pathways from exposure to gender-based violence (non-partner rape or intimate partner violence) to mental ill-health, except for one that was mediated by food insecurity. Thus, FSWs' poor mental health risk was often mediated by their work location and vulnerability to violence, substance abuse and stigma. The potential contribution of legal reform to mitigate the risks of violence and mental ill-health are inescapable. Treatment of mental ill-health and substance abuse should be an essential element of FSW programmes.
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