Sex work is a complex topic with multiple perspectives. We begin this chapter with definitions of and perspectives on sex work, pathways into sex work, and overlapping pathways of sex work and drug use. We then discuss the legal aspects of sex work and adverse impacts of criminalization, decriminalization, legalization, and sex work regulations and provide a description of sex work and sexuality.We also describe the theories and conceptual frameworks applied to sex work. We discuss structural theories and frameworks, including the risk environment heuristic, which includes interacting social, policy, physical, and economic influences at macro and micro levels, the social ecological model, and theories of structural violence. Interpersonal theories described in this chapter include feminist theories and the theory of gender and power. Individual-level theories included are social cognitive theory and the theories of reasoned action and planned behavior.Next, we describe research methods such as survey research methods and sampling strategies (venue-based random sampling, time-location sampling, and respondent-driven sampling). Community-based participatory methods and mixed methods are also described, using case study examples from the Philippines and Mexico.We then discuss applications of these theories and methods to real-world issues facing sex workers, including reproductive health (pregnancy, contraception, and abortion), HIV/AIDS and other sexually transmitted infection (STI) risks, mental health, substance use, and violence. We also highlight the unique nature of these issues among hidden populations, such as male, transgender, and underage sex workers. We conclude the chapter with a discussion of knowledge gaps and recommended research directions.
DEFINITIONS OF AND PERSPECTIVES REGARDING SEX WORKBecause definitions of sex work and its related harms are often rooted in debates in which moral arguments and health and criminal justice policies compete for priority (Cusick, 2006), we begin this chapter with a review of these perspectives, the current research, and their implications for public health.