Global Prevalence of Sexual Violence Among Cisgender Female Sex Workers: A Comprehensive Systematic Review and Meta-Analysis

Arch Sex Behav. 2026 Mar 7. doi: 10.1007/s10508-025-03355-4. Online ahead of print.

ABSTRACT

Female sex workers (FSWs) are vulnerable and significantly exposed to sexual violence, creating a vicious cycle that leads to further violence and health issues. Sexual violence endangers FSWs both physically and psychologically. The aim of this study was to investigate the prevalence of sexual violence among cisgender FSWs through a systematic review and meta-analysis. In this study, the PubMed, ScienceDirect, Web of Science, Scopus, Embase, and Google Scholar databases were systematically searched to find relevant studies. Study heterogeneity was examined using the I² index, and data were analyzed using the random effects model. Data analysis was conducted using the Comprehensive Meta-Analysis (v.2) software. A review of 30 studies with a total sample size of 24,071 found that the lifetime prevalence of sexual violence among cisgender FSWs was 33.4% (95% CI 29.6-37.4). Moreover, to investigate the sexual violence prevalence within 12 months, 19 studies with a combined sample size of 25,556 were included in the analysis, revealing a prevalence of 23.8% (95% CI 17.8-31.1). In the subgroup analysis, the highest lifetime prevalence of sexual violence among FSWs was perpetrated by intimate partners, with a pooled prevalence of 24.3% (95% CI 17.7-32.4). The highest 12 month prevalence of sexual violence among FSWs was perpetrated by clients, with a pooled rate of 33.5% (95% CI 19-52). The findings indicate a high prevalence of sexual violence among female sex workers. Given the negative health consequences of sexual violence against female sex workers and the wider societal impact, such as increased risk of sexually transmitted diseases transmission, health policymakers need to pay more attention to this issue and to the health of these individuals. Increasing access to welfare services, healthcare, and mental health interventions for these individuals should also be considered.

PMID:41794936 | DOI:10.1007/s10508-025-03355-4