Sex work is defined as the use of sexual activity for income or employment or for non-monetary items, such as food, drugs, or shelter (“survival” sex). Sex work can increase a person’s risk of becoming infected with or transmitting HIV and other sexually transmitted infections (STIs) by engaging in unsafe sexual behaviors and/or substance use.
Sex work crosses many socioeconomic groups. Adults who engage in such activities include high-end escorts; people who work in massage parlors and the adult film industry; exotic dancers; state-regulated prostitutes (in Nevada); and street-based men, women, and transgender people who participate in survival sex.
Reaching sex workers is a critical effort for public health. Not only are sex workers at risk for higher rates of HIV and other STIs, sex workers who are unaware of their HIV status can endanger their own health and increase their risk of transmitting HIV or STIs to others.
Prevention Challenges
Lack of Data
There are few population-based studies of sex workers in the United States or globally because sex work is a stigmatized occupation and is illegal throughout most of the United States and the world. Further, sex workers who work in settings where sex is encouraged and indirectly sold, such as massage parlors, the adult film industry, and exotic dance clubs, are often not included in studies. This lack of data and understanding around sex work creates a significant barrier to HIV prevention efforts and other services.
