Sexual and Reproductive Health Services for Female Sex Workers
Summary
Female sex workers (FSWs) face a complex interplay of biological, social and structural risks that heighten their vulnerability to unintended pregnancy, sexually transmitted infections (STIs), HIV and gender-based violence. Comprehensive sexual and reproductive health (SRH) services for this population encompass prevention (condom distribution, pre-exposure prophylaxis), screening and treatment of STIs, family planning (including emergency contraception and long-acting methods), cervical cancer screening and psychosocial support. Effective programmes combine peer-led outreach, mobile or venue-based clinics and integration of HIV and family-planning services to reduce barriers such as stigma, discrimination and legal restrictions. Rights-based models emphasise informed choice, confidentiality and respectful care, underpinned by policy frameworks that recognise sex work as labour. Community empowerment and partnerships between FSW networks, health providers and policymakers are central to improving uptake, adherence and health outcomes, and to advancing universal health coverage goals in diverse settings.
Research from Nature Portfolio
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Sexual and Reproductive Health Services for Female Sex Workers publication trend
The graph below shows the total number of articles in sexual and reproductive health services for female sex workers across all publications each year (not limited to Nature Index journals).
Technical terms
Dual contraception: Concurrent use of a barrier method (typically condoms) together with another modern contraceptive to prevent both STIs and unintended pregnancy.
Long-acting reversible contraception (LARC): Highly effective, user-independent methods such as intrauterine devices and implants that provide extended pregnancy prevention.
Transactional sex: Exchange of sexual services for money, goods or favours, often reflecting economic necessity rather than formalised sex work.
Stigma: Negative attitudes and discrimination directed at individuals based on perceived characteristics, which can deter FSWs from seeking healthcare.
References
- Dual contraceptive use and associated factors among female sex workers in Gulu City, Uganda in 2023. Tropical Medicine and Health (2023).
- Female transactional sex workers’ experiences and health-seeking behaviour in low-middle income countries: a scoping review. BMC Public Health (2024).
- Meeting the reproductive health needs of female sex workers in Côte d’Ivoire: protecting the human right to dignified health. Reproductive Health (2023).
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