Violence prevention and support interventions for sex workers.

Abstract

Violence against sex workers can be substantial, with severe physical and mental health consequences. In this Series paper, we review the global evidence on violence prevention and support interventions by and for sex workers, and focus on violence reduction, mental health, and access to services. We found that peer-reviewed evidence focused on client-perpetrated violence, whereas non-peer-reviewed evidence focused on broader human rights abuses and police violence. The central involvement of sex workers in intervention design and delivery resulted in improved engagement and effectiveness in terms of reducing violence. Interventions that reduced violence from clients did not affect intimate partner violence, and vice versa. Peer networks strengthen agency through collective safety planning, information sharing, and emotional support, yet access is limited for migrant and street-based sex workers. Broader stakeholder engagement-including from police, policy makers, health and social services, and third parties such as managers and security-is essential for addressing structural determinants of violence, although reliance upon these same stakeholders can reinforce systems that perpetuate violence. Addressing violence requires interventions that recognise the diverse forms and perpetrators of violence, alongside broad structural reforms to tackle its root causes.