Method
“We included quantitative, qualitative, and mixed-methods studies published in English, Russian, or Spanish, and included data specific to the experiences of sex workers. We included papers that measured quantitative associations between criminalisation or decriminalisation of sex work, or repressive policing practices within these contexts, and the following outcomes: threatened or enacted violence, STIs, HIV, hepatitis B/C, overdose, stress, anxiety, depression, risk practices/management (e.g., working with others, reporting violence, condom use, sharing needles/syringes), and access to health/social care services (HIV/STI/hepatitis prevention, testing, and treatment; contraception; abortion; opioid substitution therapy and other drug/alcohol services; mental health and counselling; primary and secondary care; psychosocial support services; housing; and social security). We also included studies that reported qualitative data on the relationships between experiences of criminalisation or decriminalisation and policing and sex workers’ experiences of violence, safety, health, risk management, and/or accessing health or social care services, from the perspectives of sex workers themselves.”
Findings
“The public health evidence clearly shows the harms associated with all forms of sex work criminalisation, including regulatory systems, which effectively leave the most marginalised, and typically the majority of, sex workers outside of the law. These legislative models deprioritise sex workers’ safety, health, and rights and hinder access to due process of law. The evidence available suggests that decriminalisation can improve relationships between sex workers and the police, increasing ability to report incidences of violence and facilitate access to services.”
“Considering these findings within a human rights framework, they highlight the urgency of reforming policies and laws shown to increase health harms and act as barriers to the realisation of health, removing laws and enforcement against sex workers and clients, and building in health
and safety protections.”
Conclusion
“Together, the qualitative and quantitative evidence demonstrate the extensive harms associated with criminalisation of sex work, including laws and enforcement targeting the sale and purchase of sex, and activities relating to sex work organisation. There is an urgent need to reform sex-work-related laws and institutional practices so as to reduce harms and
barriers to the realisation of health.”
Citation: Platt L, Grenfell P, Meiksin R, Elmes J, Sherman SG, Sanders T, et al. (2018) Associations between sex work laws and sex workers’ health: A systematic review and meta-analysis of quantitative and qualitative studies. PLoS Med 15(12): e1002680. https://doi.org/10.1371/journal.pmed.1002680