Supplementary file 2_Quality of life, mental health, and socio-demographic differences across sex work settings: implications for specialized healthcare and support services.pdf

BackgroundExisting research shows that quality of life (QoL), mental health, and working conditions vary widely across sex work settings. Street-based work, for example, involves different risks than, for example, online sex work. Little is known about what drives individuals into specific environments. This study examines whether work setting predicts working conditions, QoL, mental health, and reported socio-medical needs, and explores factors predicting the work setting. The aim is to inform recommendations for more tailored healthcare and support services.
MethodsData come from PSYCHSEX, a cross-sectional study conducted at the Department of Psychiatry and Neurosciences, Charité University Hospital Berlin (August 2021–August 2024), funded by the German Research Association (DFG). Structured quantitative interviews were conducted with 403 sex workers recruited through quota sampling to represent diverse settings, including private apartments, studios, brothels, massage parlors, clubs, clients' homes, vehicles, guesthouses/hotels, outdoor locations, and online platforms.
ResultsWork setting was significantly associated with QoL, mental health, and working conditions. Specific settings (e.g., studios, escort work, and online platforms) were linked to better QoL, mental health, and working conditions than others. Socio-demographic factors like migration status and homelessness, along with distinct self-reported reasons for entering sex work, such as personal preference, lack of alternatives, or funding one's education, predicted work setting. Reported socio-medical needs differed across settings.
DiscussionSex work is shaped by diverse settings, conditions, and individual pathways. Variation in QoL, mental health, working conditions, and unmet support needs underscores the need for setting-specific healthcare and social services. Structural factors such as housing instability and migration status play a key role and should be addressed through targeted policies and interventions. These findings highlight the importance of context-sensitive, evidence-based support to improve the wellbeing of sex workers across different environments.

现有研究表明，性工作者的生活质量（quality of life, QoL）、心理健康状况与工作条件在不同工作场景中存在显著差异。例如，街头性工作与线上性工作所面临的风险各不相同，但目前学界对个体选择特定工作场景的驱动因素仍知之甚少。本研究旨在验证工作场景是否会对工作条件、生活质量、心理健康及自我报告的社会医疗需求产生预测作用，并探究影响工作场景选择的相关因素，以期为制定更具针对性的医疗与支持服务方案提供依据。
本研究数据来自PSYCHSEX——一项由德国研究协会（German Research Association, DFG）资助、于2021年8月至2024年8月在柏林夏里特大学医院精神病学与神经科学系开展的横断面研究。研究采用配额抽样法招募了403名性工作者，覆盖私人公寓、工作室、妓院、按摩店、俱乐部、客户住所、车辆、宾馆/酒店、户外场所及线上平台等多样化工作场景，并对其开展结构化定量访谈。
研究结果显示，工作场景与性工作者的生活质量、心理健康状况及工作条件存在显著关联。特定工作场景（如工作室、陪护性服务及线上平台）相较于其他场景，与更优的生活质量、心理健康状况和工作条件相关。社会人口学因素（如移民身份、无家可归状况）以及个体选择从事性工作的特定自我报告动因（如个人偏好、缺乏其他谋生选择、需筹措学费等）均可预测工作场景的选择。不同场景下性工作者报告的社会医疗需求亦存在差异。
性工作的形态受多样化的工作场景、工作条件及个体从业路径影响。生活质量、心理健康、工作条件以及未被满足的支持需求方面的差异，凸显了针对特定工作场景制定医疗与社会服务方案的必要性。住房不稳定、移民身份等结构性因素发挥着关键作用，需通过针对性政策与干预措施加以应对。本研究结果强调，需采取贴合场景、基于证据的支持措施，以改善不同工作环境中性工作者的福祉状况。