Psychosocial distress of female sex workers in China: A qualitative investigation

Introduction: Commercial sex creates specific mental health concerns for female sex workers (FSWs), but most existing studies on this population have focused on their HIV/STI risks. Data are limited regarding their psychosocial wellbeing; data are further scarce in developing countries. China is one of such countries where flourishing commercial employs millions of FSWs. The current study will provide a thick description of the FSWs in China and the major psychosocial stressors in their work and life. Method: Individual in-depth interviews were conducted with 36 FSWs recruited from community outreach in Guangxi, China. All interviews were audio-taped and transcribed verbatim. Transcripts and field notes were uploaded to Atlas ti for analysis. All qualitative data were analyzed using thematic content analysis methods. Results: Our data revealed that FSWs have suffered emotional trauma in different levels, they need to hide their true occupation from their friends and families, make higher income to support families and unstable working conditions. They also need to endure not only threats of arrests or other police harassment but also abusive clients and violent partners. A sense of helplessness and hopelessness prevails among these women, and most adopt maladaptive coping strategies such as substance abuse. Conclusion: Psychosocial problems are prevalent among FSWs in China, which are mainly attributed to severe stigma attached to commercial sex and a lack of legal protection of these women. Decriminalization of commercial sex is urgently needed. Social interventions to bridge gender inequalities and create more employment opportunities for women are also necessary.