We reviewed publications, websites, and field observations to explore the health and welfare impacts and administrative effectiveness of different legal approaches to sex work. We identified three broad legal approaches: (1) prohibition, including the unique Swedish law criminalising sex workers' clients; (2) licensing; and (3) decriminalisation. Each of these models is employed under one or more jurisdictions in Australia. We make preliminary observations on their consequences and conclude that, on initial impression, decriminalisation may offer the best outcomes. However, more rigorous population-based research is needed to properly assess the health and welfare impacts of legal approaches to sex work.

The legal context appeared to affect the conduct of health promotion programs targeting the sex industry. Brothel licensing and police-controlled illegal brothels can result in the unlicensed sector being isolated from peer-education and support.

NSW has a diverse sex industry that is limited in its size by modest demand. There is no evidence that decriminalisation in 1995 increased the frequency of commercial sex in NSW. Though the largest sector, female brothels, is now mainly staffed by Asian women, condom use for vaginal and anal sex exceeds 99% and sexually transmissible infection rates are at historic lows. These gains are attributable to the long-term support of the NSW Department of Health in collaboration with the community-based Sex Workers Outreach Project and sexual health services, facilitated by the removal of criminal sanctions without the expense and access barriers of licensing systems.Just a generation ago sex work in New South Wales (NSW) had been criminalised for many years, linking the sex industry to criminal subcultures and fuelling corrupt behaviour.

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