Objectives
Sex workers are vulnerable to adverse health and well-being outcomes and are therefore considered a public health priority. Collecting health and well-being data of sex workers is key to understand the impact of this work. To do this, a core outcome set for this population would be valuable however, this does not currently exist. The aim of this scoping review is to address a key step in developing a core outcome set; to identify the health and well-being outcomes for sex workers that have been reported in the existing literature.
Methods
A rapid scoping review was undertaken (PROSPERO registration number: CRD420261422246). Eligible studies were systematic reviews, scoping reviews, umbrella reviews, and integrative reviews reporting health and/or well-being outcomes of adult (=18 years) sex workers. MEDLINE, PsycINFO, and Epistemonikos were searched from 2016–2026, and citation searching was conducted on the included reviews. The selection process is reported in a PRISMA diagram. Outcomes in the included reviews were extracted using a predefined framework of outcomes.
Results
In total, 42 reviews were included in this rapid scoping review. These reported 264 unique health and well-being outcomes of sex work. Outcomes were identified in physical health (n=55); health behaviour (n=93); mental health (n=40); and well-being (n=76). Physical health outcomes included reproductive, sexual health, and other (e.g. blood borne viruses). Health behaviour outcomes consisted of substance use, healthcare use, sex risk/protection, and other (e.g. harmful vaginal washing). Mental health outcomes comprised mood and anxiety disorders, substance use disorders/symptoms, and other (e.g. suicide ideation). Well-being outcomes included personal well-being and relationships/interactions with others.
Conclusions
These findings represent a key stage in developing a core outcome set for sex worker health and well-being. Using a core outcome set would build a consistent evidence base which is essential to inform health policy for this population.
Other relevant ongoing/developed core outcome sets: HIV/AIDS (ongoing, Engler et. al) mental health (ongoing, Juul et. al), substance-related and addictive disorders (Farrell et al., 2024), reproductive health (ongoing, Mann et. al). However, sex workers are a particularly vulnerable population with increased adverse mental and physical health risks due to specific factors such as unprotected sex, unsafe work environments, difficulty accessing healthcare, and sex work regulation. Therefore, a health and wellbeing core outcome set specifically for this population is needed.
Dr Jane Murphy, corresponding/lead author, jamurphy@hrb.ie, Health Research Board Evidence Centre, Dublin, Ireland
Ms Louise Farragher, Health Research Board Evidence Centre, Dublin, Ireland
Dr Áine Teahan, Health Research Board Evidence Centre, Dublin, Ireland
Disease Category: Public health
Disease Name: N/A
Age Range: 18 - 120
Sex: Either
Nature of Intervention: Any
- Policy makers
- Researchers
- Systematic review of outcomes measured in trials
- Systematic review
A rapid scoping review is being conducted (PROSPERO registration number: CRD420261422246). Eligible studies are systematic reviews, scoping reviews, umbrella reviews, and integrative reviews reporting health and/or well-being outcomes of adult (=18 years) sex workers. MEDLINE, PsycINFO, and Epistemonikos were searched from 2016–2026, and citation searching was conducted on the included reviews. The selection process is reported in a PRISMA diagram. Outcomes in the included reviews were extracted using a predefined framework of outcomes. This review is conducted and reported in line with established guidance on rapid scoping reviews, and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR).