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Reasons for Entering into Sex Work in Iran: A Comparison Between Women Who Initiated Sex Work as Minors and Those as Adults

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Abstract

This study explored reasons for women’s entry into sex work using data from the national bio-behavioral survey of female sex workers (FSWs) in Iran. We also compared FSWs’ reasons for those who entered sex work as a minor (< 18) versus those as an adult (≥ 18). We recruited 1347 FSWs who reported having sex in exchange for money, goods, services, or drugs with at least two clients in the previous year in 13 large cities. Participants were asked about their main reason for entering into sex work. Overall, economic hardship was the main reason for entry into sex work (56.2%), followed by personal choice (20.2%), environmental forces (16.6%), and drug use (7.0%). While economic hardship was the main reason in all birth cohorts, it decreased from 68.3% among FSWs born before 1970 to 39.6% among those born in 1990 or later. Compared to women who began sex work as adults, women who entered sex work as minors were more likely to report environmental forces (31.5% vs. 15.2%, P < 0.001) and less likely to report economic hardship as reasons for beginning sex work (36.2% vs. 58.7%, P = 0.003). Our data suggest that the engagement of women in sex work in Iran is multi-factorial. The main factor is dependence on sex work for income which highlights the need for economic empowerment programs. Programs should also target environmental forces and provide access to social support services for those who have entered sex work as minors.

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Data Availability

Data are owned by the Ministry of Health (MOH) of Iran and are available from the HIV/STI office located at Iran’s MOH (E-mail: aids@behdasht.gov.ir; Tel: +98-21-81455055) for researchers who meet the criteria for access to confidential data. The authors of this research were the implementers of the survey and had access to the data with permission obtained from the HIV/STI office.

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Acknowledgements

We would like to thank all participants for their valuable time participating in the survey. We also wish to thank all the research staff and stakeholder at national and subnational organizational levels for their significant contribution to the study preparation and implementation. MK is supported by the Vanier Canada Graduate Scholarship and the Pierre Elliott Trudeau Foundation Doctoral Scholarship. MS is supported by a Canadian Institutes of Health Research (CIHR) Postdoctoral Fellowship.

Funding

The FSW survey 2015 was funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria through UNDP Iran, and Ministry of Iran. For this paper, we also received support from the University of California, San Francisco’s International Traineeships in AIDS Prevention Studies (ITAPS), U.S. NIMH, R25MH064712.

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Authors and Affiliations

  1. HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran

    Mostafa Shokoohi, Mehrdad Khezri, Mohammad Karamouzian & Ali Mirzazadeh

  2. Dalla Lana School of Public Health, University of Toronto, Toronto, Canada

    Mostafa Shokoohi

  3. School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada

    Mohammad Karamouzian

  4. Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA

    Ali Mirzazadeh

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  1. Mostafa Shokoohi
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  2. Mehrdad Khezri
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  3. Mohammad Karamouzian
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  4. Ali Mirzazadeh
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Contributions

MS, MKH and AM contributed to the study design, analysis, write and edit the manuscript. MS analyzed the data. MS wrote the initial draft of the manuscript and MKH finalized it. MK and AM reviewed and edited the manuscript critically. All authors read and approved the final manuscript.

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Correspondence to Mehrdad Khezri.

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The authors declare that they have no conflict of interest.

Ethics Approval and Consent to Participate

The study received ethics approval from the REB of Kerman University of Medical Science, Iran (Code: K/93/209). Verbal informed consent was obtained from all participants prior to commencing the survey.

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Shokoohi, M., Khezri, M., Karamouzian, M. et al. Reasons for Entering into Sex Work in Iran: A Comparison Between Women Who Initiated Sex Work as Minors and Those as Adults. Sexuality & Culture 26, 762–775 (2022). https://doi.org/10.1007/s12119-021-09918-6

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