JMIR Publications

ABSTRACT

Background:

In many countries sex work is criminalized, driving sex work underground and leaving sex workers vulnerable to a number of occupational health and safety (OHS) risks, including violence, assault and robbery. With the advent of widely accessible information and communication technologies (ICTs), sex workers have begun to use electronic OHS tools to mitigate these risks.

Objective:

The aim of this study was to explore the use of ICTs by sex workers in managing OHS risks and strategies to reduce these risks. This paper aims to answer the following question: What is known about sex workers’ usage of information and communication technologies in the delivery of OHS strategies?

Methods:

A literature review following the methodological framework of Arksey et al and Levac et al was conducted to analyze studies describing the usage of ICTs by sex workers to mitigate OHS risks. Experimental, observational, and descriptive studies, as well as protocol papers, were included in this scoping review.

Results:

Of the 2477 articles initially identified, 41 met the inclusion criteria. 71% of the studies (N=29) were published between 2015 and 2019. In the studies, the Internet was the predominant ICT (58%), followed by text messaging (24%), and assorted communication technologies associated with mobile phones without Internet access (17%) (e.g., interactive voice response (IVR), voice-mail). In 56% of the studies (N=23), sex workers located in high income countries created the OHS strategies (e.g., bad date lists, violence prevention) and shared them via the Internet. In 24% of the studies (N=10), mostly in LMICs, organizations external to sex work developed and sent, via text message, OHS strategies focused on STI/HIV. In 20% (N=8) of the studies, external organizations collaborated with the sex worker community in the development and study of OHS strategies communicated via ICTs; through this collaboration, concerns other than STI/HIV (e.g., sexual and reproductive health, mental health) emerged.

Conclusions:

While there has been an increase in studies on the use of ICTs by sex workers for managing OHS over the past five years, the knowledge around how to optimally leverage ICTs for this purpose remains scarce. Recommendations to further the use of ICTs by sex workers for OHS include (1) that external organizations collaborate with sex workers in the design of ICT interventions to mitigate OHS risks, (2) to examine whether ICTs used in LMICs would have applications in high income countries as a substitute to the Internet in sharing OHS strategies, and (3) to explore the creation of innovative secure online communities using existing or alternative digital technologies that could be used by sex workers to manage their occupational health and safety