Introduction

In recent years, academic interest in the exchange of sexual services for payment has grown, with numerous studies examining sex worker populations in various countries (Febres-Cordero et al., 2018; Gülçür & İlkkaracan, 2002; Mai, 2011, 2013; Plambech, 2016; Vuolajärvi, 2019a, 2019b). However, our understanding of public perceptions of sex work remains limited. Only a handful of studies have attended to individual-level attitudes towards this activity (Hansen & Johansson, 2022a, 2022b; Jakobsson & Kotsadam, 2011; Johansson & Hansen, 2023; Lo & Wei, 2005; Powers et al., 2023; Räsänen & Wilska, 2007; Valor-Segura et al., 2011; Vlase & Grasso, 2021; Yan et al., 2018). Notably, several of the existing attitudinal studies narrowly explore the acceptability of “prostitution”, a term imbued with negative connotations (Hansen & Johansson, 2022b; McMillan et al., 2018). A recent study highlights the significance of positive and negative associations in predicting overall attitudes towards sex work (Hansen & Johansson, 2022b), but there has been no attempt thus far to predict variations within these associations. Existing studies have mainly offered theoretical explanations for potential relationships without directly testing them. For example, studies argue that women will find sex work less acceptable than men because women are more likely to reflect on the negative aspects of exchanging sexual services for payment. However, hypotheses related to these types of relationships, such as a gender gap in negative associations, remain unspecified in many instances and assertions have gone untested. We seek to fill this research gap by predicting individual-level associations with the exchange of sexual services for payment in the United States (U.S.). We specifically explore the extent to which individuals associate these exchanges with different positive and negative concepts.

More research on public perceptions is needed since studies find that negativity towards exchanging sexual services for payment has adverse effects on sex workers’ lives, impeding access to healthcare, justice, safety, and social support (Febres-Cordero et al., 2018; Platt et al., 2018; Scambler & Paoli, 2008; Vuolajärvi, 2019a, 2019b; Weitzer, 2017). Sex workers’ rights organizations also point to the negative effects of sex work stigma, which remains throughout the world (Global Network of Sex Work Projects (NSWP), 2013). Meanwhile, sex workers' rights advocates have made strides in destigmatizing sex work, successfully challenging repressive prostitution policies and emphasizing its positive aspects in certain countries (Abel et al., 2010; Armstrong, 2016; Östergren, 2020). These developments underscore the importance of our research agenda, aimed at uncovering the factors that influence both positive and negative individual-level associations with sex work.

Using an original survey, we ask respondents their level of associations with three positive and three negative concepts commonly thought of as causes or consequences of exchanging sexual services for payment: sexual freedom, companionship, women’s empowerment, poverty, women’s exploitation, and human trafficking. The respondents are asked to place their level of associations with the concepts on a 0–10 continuous scale from “0—not at all” to “10—to a great degree”. The analysis is predominately exploratory since little is known about public perceptions in this regard. Two questions guide the research: (1) What level of associations do respondents have between exchanging sexual services for payment and concepts representing positive and negative causes and consequences of the activity? (2) What variables predict the level of associations with exchanging sexual services for payment and these concepts? Using OLS multiple regression analyses, we uncover five main findings.

First, we find that women are more likely than men to associate the exchange of sexual services for payment with the negative concepts. Second, more education leads to a greater association between the exchange of sexual services for payment and the positive concepts. Third, Republican partisans have a lower level of association with the exchange of sexual services for payment and positive concepts. Fourth, the findings reveal that liberals have a higher association between the exchange of sexual services for payment and both positive and negative concepts. Finally, the results reveal that views on acceptability are important. Respondents that view the exchange of sexual services for payment as acceptable were much more likely to recognize the positive concepts.

The findings add to our understanding of public perceptions and offer valuable insights that could complement the ongoing efforts of sex workers' rights advocates who are fighting repressive prostitution policies globally. Our findings underscore the importance of tailoring advocacy strategies to specific target audiences. For instance, when engaging primarily with female audiences, it becomes imperative to consider the heightened negative associations that women may have with the exchange of sexual services for payment. Furthermore, organizations working to support sex workers should actively contribute to fostering a more positive perception of sex work. This recommendation aligns with the study's findings, which highlight that increased acceptance of exchanging sexual services for payment is closely associated with more positive associations.

Positive and Negative Associations with Sex Work

Positive associations with the causes and consequences of exchanging sexual services for payment, while salient among sex industry participants and researchers, may be less recognized among the public. We highlight three positive associations in this study, drawing on existing literature: (1) sexual freedom, (2) companionship, and (3) women’s empowerment.

Scholars have described sex work as a potential expression of sexual freedom (Armstrong, 2016; Bernstein, 1999; Brison, 2006; Fahs, 2014) and found that views on the acceptability of exchanging sexual services for payment are closely tied to more liberal attitudes towards sexual behavior in general (Hansen & Johansson, 2022a, 2022b). The notion of sexual freedom is further brought to the fore by the increasing presence of sex worker peer communities requesting recognition and rights in many places around the world (Abel et al., 2010; Doezema, 2002; Sagade & Forster, 2018). Sex workers’ organizational and political efforts come together around the call to decriminalize and destigmatize adult consensual sex work, so that sex workers can be free to exchange sexual services for payment without suffering legal and social penalization (NSWP, 2013).

Another positive association noted by researchers is that the exchange of sexual services for payment can generate a sense of companionship. Interview studies with men who seek out sex workers suggest that emotional intimacy is a common desire (Johansson & Östergren, 2021; Jones & Hannem, 2018; Milrod & Weitzer, 2012; Sanders, 2008). Likewise, sex workers describe emotional engagement with clients as a prevalent part of the job (Bernstein, 2007; Brennan, 2004; Sanders, 2005). Services with the explicit aim of eliciting companionship feelings are generally marketed as the “Girlfriend Experience (GFE)”, but may arise from other arrangements as well, especially long-term term arrangements between clients and sex workers (Johansson & Östergren, 2021; Snow et al., 2022). Another notable example of renumerated companionship where sex is often part of the deal is “sugar dating” (Gunnarsson & Strid, 2021).

Further, sex work has been described in terms of women’s economic, political, and social empowerment. Empirical research shows that women turn to sex work to improve their lives and provide for their families, but also to rid themselves of various constraints, including financial dependency and poverty (Brennan, 2004; Chuen-Juei Ho, 2000; Khan et al., 2010; Szablewska & Bradley, 2015). Sex work also plays a role in women’s migration (Brennan, 2004; Lowthers, 2018; Plambech, 2016; Vuolajärvi, 2019a, 2019b). Female sex workers capitalize on sexual and social norms to increase their marketability, monetary gains, and prospects, e.g., by developing a persona adhering to the erotic expectations and ideals of the male clientele (Brennan, 2004; Sanders, 2005). Moreover, the collective efforts of sex worker organizations who have successfully implemented sex worker centered programs and lobbied for necessary policy changes are notable instances of empowerment (Abel et al., 2010; Cornwall, 2016; NSWP, 2020; Sagade & Forster, 2018).

In contrast, negative associations with the causes and consequences of exchanging sexual services for payment are more likely to be recognized by governmental entities, as well as the public. We highlight three negative associations within this study, based on the literature: (1) poverty, (2) women’s exploitation, and (3) human trafficking.

Poverty has been identified as a driving force behind engagement in sex work (Brennan, 2004; Khan et al., 2010; Plambech, 2016). Although individuals may start selling sexual services to rid themselves of economic deprivation and improve their financial situation, sex work does not necessarily result in the desired changes, especially not when the starting point is a life in severe poverty. Poverty is especially common among street-based sex workers (Monroe, 2005), many of whom are migrants and ethnic minorities in precarious positions in terms of citizenship and residency status. Poverty restricts sex workers in many ways, limiting their marketability, mobility, and negotiation power over matters such as working conditions and condom use (Choi & Holroyd, 2007; Lowthers, 2018; Monroe, 2005). Poverty has also been linked to harassment and violence against sex workers as well as human trafficking (Armstrong, 2016; Plambech, 2016; Ratinthorn et al., 2009).

The notion of female sex workers as exploited has gained ground in contemporary debates, partly substituting prior notions of sex workers as disreputable deviants and immoral women (Gerassi, 2015; Kulig & Butler, 2019). Repressive measures like client-criminalization have been promoted by latching on to the paradigm of women’s exploitation (Östergren, 2020). Scholars have long debated if women’s sex work can be an autonomous choice, with naysayers arguing that it is inherently exploitative, allowing men to exercise temporary ownership over women’s bodies (Brison, 2006; Day, 2010; Fahs, 2014; Nagle, 2010).

Another negative association that has received considerable attention over the past two decades is the issue of human trafficking (Fedina, 2015; Johansson & Östergren, 2021; Östergren, 2020). Narratives of sex workers as trafficking victims have become common (Gerassi, 2015; Kulig & Butler, 2019). Today, anti-trafficking campaigns and calls to action can be found in airports as well as cinemas, but dramatic narratives of criminal organizations forcing trafficking victims to provide sexual services under slave-like conditions have pressed the moral buttons of activists and observers since the 1800s, when concerns about the trafficking of women into the sex industry first arose (García, 2012). Nowadays, the term “human trafficking” refers to a variety of criminal acts in several sectors, but “sex trafficking” may resonate more strongly with the public given the notable attention it receives (Cockbain & Bowers, 2019; Fedina, 2015; Heber, 2020; Hughes, 2000; Sibley, 2020). Some radical feminist groups have gone so far as to argue that all forms of sex work should be defined as human trafficking, regardless of sex workers’ consent (Doezema, 2002). That said, scholars have noted that reliable prevalence data on human trafficking is lacking and estimates vary substantially (Barrick & Pfeffer, 2021; Fedina, 2015).

Attitudes Towards Sex Work

There have only been a handful of studies that explore public attitudes towards sex work and none of these studies specifically predict specific positive and negative associations. Even among studies that explore acceptability, the literature is characterized by more debates than trends. Still, previous studies provide some direction regarding associations and it is important to investigate whether the tangentially related findings hold up in today’s climate where sex work has undergone some degree of de-stigmatization. We quickly summarize some of the findings here.

In terms of sociodemographic trends, studies find mixed support regarding age impacting views on the exchange of sexual services for payment (Cosby et al., 1996; Hansen & Johansson, 2022a, 2022b; Johansson & Hansen, 2023; May, 1999). Similarly, previous research finds both positive (May, 1999; Jakobsson & Kotsadam, 2011) and negative (Hansen & Johansson, 2022a, 2022b) relationships between education and support for this activity. One clear pattern in these studies is that individuals with higher levels of education tend to exhibit a greater awareness of the debates surrounding the exchange of sexual services for payment. Given that negative aspects of this topic are typically more widely recognized by the public, we might expect higher educational attainment to also correspond to an increased awareness of the positive aspects related to these exchanges. One firm sociodemographic finding in the literature is that women are more likely than men to have negative views on the exchange of sexual services for payment (Basow & Campanile, 1990; Cosby et al., 1996; Cotton et al., 2002; Hansen & Johansson, 2022a, 2022b; May, 1999). The reason why women tend to be more negative could be due to prevalent narratives about women’s exploitation. Thus, it is reasonable to expect that women are more likely to associate sex work with negative aspects.

Studies show that a range of attitudes correlate with positive views on sex work. Studies confirm that a liberal ideology broadly, as well as specific liberal attitudes, translate into more positive evaluations (Cosby et al., 1996; Peracca et al., 1998; May, 1999; Valor-Segura et al., 2011; Hansen & Johansson, 2022a, 2022b). For instance, Valor-Segura et al. (2011) uncover that a greater commitment to liberal attitudes towards gender equality is related to positive views on prostitution. Similarly, Hansen and Johansson (2022a, 2022b) find that a liberal placement on a left–right self-placement ideological scale is associated with more acceptable views. Since national and international debates on sex work policy changes primarily occur among liberal groups, one might expect liberal individuals to be more aware of both positive and negative aspects of sex work.

Like political ideology, one would expect partisans to take divergent paths when assessing their associations with sex work (Johansson & Hansen, 2023). The role of partisanship in the U.S. in predicting a range of attitudes and behaviors has increased in importance, from support for the #MeToo movement (Hansen & Dolan, 2022) to behaviors related to COVID-19 (Hansen et al., 2021). Republican partisans are more likely to invoke religious arguments when assessing behavior related to morality and sexual policy (Kreitzer, 2015; Lynderd, 2014). For example, Gaines and Garand (2010) find that moral and religious attitudes are key explanatory variables in predicting Republican opposition to gay marriage. Thus, we would expect that Republican partisans are less likely to associate positive concepts with behaviors they could consider immoral.

Finally, while no study has specifically predicted views on the acceptability of exchanging sexual services for payment and positive and negative associations with the causes and consequences of this practice, we can make some informed expectations based on existing research. Hansen and Johansson (2022a, 2022b) have already established a significant connection between accepting non-committal casual sex and having a more tolerant stance toward exchanging sexual services for payment, demonstrating that liberal attitudes regarding various sexual behaviors tend to align. Considering this finding, we anticipate that acceptability will be closely linked to the positive concepts. Essentially, our hypothesis suggests that individuals who find the exchange of sexual services for payment acceptable are more likely to associate this practice with positive aspects.

Hypotheses

\({H}_{1}\): Women have a greater level of association with negative concepts related to exchanging sexual services for payment when compared to men.

\({H}_{2}\): A greater level of education leads to a higher level of association with positive concepts related to the exchange of sexual services for payment.

\({H}_{3}\): Republicans are less likely than Democrats to associate positive concepts with exchanging sexual services for payment.

\({H}_{4}\): A liberal ideology is correlated with a greater association with positive and negative concepts related to exchanging sexual services for payment.

\({H}_{5}\): Acceptability leads to a greater association with positive concepts related to exchanging sexual services for payment.

Methods

Data

To predict positive and negative associations of the causes and consequences with exchanging sexual services for payment, we conduct an original survey through Amazon’s platform Mechanical Turk (MTurk) in conjunction with Qualtrics survey software. The survey was launched and concluded in a single day on 16 February 2022. Adults aged 18 and older residing in the U.S. were allowed to take the survey after providing informed consent. Respondents were paid $1 for their participation, even if they did not answer all the questions. The average time it took for respondents to complete the survey was 3 min and 35 s. Thus, if calculating an hourly wage rate, the respondents were compensated just over twice the U.S. national hourly minimum wage. Overall, 614 respondents started the survey and between 609 and 611 respondents completed all the questions utilized in the multiple regression analysis.

Scholars have found that MTurk is an inexpensive tool for conducting survey research without jeopardizing the quality of the data. Buhrmester et al. (2011) find that MTurk samples are demographically more diverse than typical online samples and surveys of college students. Related, Thomas and Clifford (2017) uncover that MTurk online participants are as attentive as are offline participants who are recruited for research. The authors demonstrate that online participants do not produce unreliable or invalid data, and that online participants are equally likely to be impacted by intricacies in survey research. Likewise, Levay et al. (2016) show that MTurk respondents do not differ from the popular national population-based surveys in unmeasurable ways. Landers and Behrend (2015) point out that all samples, even organizational samples, are convenience samples. The authors highlight how reviewers engage in counterproductive behavior when assessing samples as good or bad based on the ease of data collection, rather than assessing the sample itself or the methodological approach. Overall, researchers can advance research using MTurk if they acknowledge the ways their sample might differ from the population and how those differences could impact the results.

Our sample is quite similar to the population when exploring sociodemographic and attitudinal variables, with two exceptions. The sample has a slightly higher proportion of male respondents when compared to women. Additionally, after coding partisan leaners as partisans, the sample has a noticeably higher proportion of Democratic identifiers. Thus, since we find gender and partisan differences in associations, we must recognize that overall levels of associations could be impacted by these two variables. In the “Appendix D”, descriptive statistics are displayed for the associations based on weighted survey data accounting for these sampling patterns. Further, output is presented where models were estimated with weighted survey data that we calculated using U.S. Census and aggregate polling data. The results are substantively similar.

Dependent Variables

There are six dependent variables for exploration in the analysis representing associations of the causes and consequences with exchanging sexual services for payment. In formulating the survey questions, we aimed for a conceptualization allowing the results to be applied or compared to the existing literature, while describing the practice of interest explicitly. Each survey respondent was asked, “How closely do you associate the exchange of sexual services for payment with the following?” Then, six concepts were provided representing three positive and three negative associations: sexual freedom, companionship, women’s empowerment, poverty, women’s exploitation, and human trafficking.Footnote 1 The concepts were provided in a random order for each participant and they were asked to place their level of associations with the concepts on a 0–10 continuous scale from “0—not at all” to “10—to a great degree”. Since the dependent variable is a 10-point Likert-scale measure, we employ OLS linear multiple regression to estimate predictors of acceptability.

Table 1 presents the mean level of associations in the survey sample for the six concepts. First, when exploring positive associations, the results indicate that respondents lean slightly towards association with the three concepts, since a value of 5 indicates a neutral position on associations. There is no statistically significant difference between associations of sexual freedom and companionship or sexual freedom and women’s empowerment. However, there is a statistically significant difference in the mean level of association between companionship and women’s empowerment. Respondents were more likely to associate the exchange of sexual services for payment with women’s empowerment, which indicates that respondents are potentially more likely to reflect on the seller when asked about such exchanges. Figure 1 displays the density (percentage that selected each category) of responses to the associations questions. In the graph on the left, responses to the three positive associations are shown. The modal response to the companionship and women’s empowerment question was a 7, and for sexual freedom question it was a 6. Generally, the distribution of levels of association were quite similar for the positive concepts.

Table 1 Association with the exchange of sexual services—descriptive statistics
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Fig. 1
figure 1

Density of respondents for positive and negative associations

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A similar trend exists when exploring association responses to the negative causes and consequences with exchanging sexual services for payment. Figure 1 demonstrates that the distribution of levels of association were very similar for the three negative concepts. The modal response for women’s exploitation and poverty was an 8, and for human trafficking it was a 7. The levels of associations with the negative concepts were slightly higher when compared to the positive association. That being said, the mean levels of associations for the negative concepts were on average around only one-third of a point higher on the 0–10 scale. The mean level of associations for all three negative concepts was just over 6, indicating that a majority of respondents lean towards associating the concept with the exchange of sexual services for payment. Overall, there is considerable variance in responses to the associations questions that is worth exploring.

Independent Variables

There are several sociodemographic and attitudinal measures utilized in the models as predictor variables. In terms of sociodemographic variables, age, gender, race, education, and income are included in the models. Studies have generally been mixed regarding the impact of age on attitudes. Therefore, there exists no clear expectations regarding the impact of age. There is a similar lack of expectations for the impact of race or income on positive and negative associations. On the other hand, since women are commonly thought of as negatively impacted by the sex industry, the expectation is that women will be more likely than men to have a higher level of negative associations with exchanging sexual services for payment. In contrast, the prediction is that education will lead to a higher level of association with the positive concepts.

There are three attitudinal variables included in the models as predictor variables. First, due to the ever-increasing importance of political partisanship in predicting a range of attitudes and evaluations in the U.S., a measure of partisanship is included as a predictor variable. Generally, it is expected that Republican partisans will be less likely to associate exchanging sexual services for payment with the positive concepts. Second, a measure of political ideology is utilized in the models. Since liberals are more likely overall to engage with debates on the topic, we expect liberals to have a higher association with both positive and negative concepts than do their conservative counterparts.Footnote 2 Finally, a measure of the acceptability exchanging sexual services for payment is utilized as a predictor variable. In particular, the respondents’ views on the acceptability of selling such services is included in the models.Footnote 3 The expectation is that increased acceptability will be related to a greater association with the positive concepts. It is important to note that several independent variables were explored in previous analyses that did not produce statistically significant results, such as inclusion of a measure of religiosity and the importance of sexual privacy. We provide the coding scheme and descriptive statistics in “Appendix A and B” for these additional variables. However, these variables were ultimately excluded from the final analysis since they did not contribute to our knowledge on the topic.

Results

Model output for the six multiple regression models predicting associations with of exchanging sexual services for payment for the three positive and three negative concepts are presented in Table 2. The first aspect of the output to highlight is that the constant value is statistically significant across all models. In addition, the constant/intercept values are statistically smaller for the positive concepts when compared to the negative concepts. In other words, when all the independent variables are held at zero, the level of associations for the positive associations is statistically significantly lower than for the negative associations. A second aspect of the output to highlight is that the measures of fit scores (\({R}^{2}\) and adjusted \({R}^{2}\)) indicate that the model specification performs substantially better in explaining variance in the associations of the positive concepts when compared to the negative concepts. Thus, the result indicates that the predictor variables are less able to explain variance in the associations with the negative concepts most likely because the negative causes and consequences are more salient in public debates.

Table 2 Models predicting associations with the exchange of sexual services for payment
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Third, model output in Table 2 confirms our expectations regarding the impact of sociodemographic variables. Age, race, and income have no statistically significant relationship with the level of association for positive or negative concepts, with one exception. A higher income is statistically related to a lower association with companionship and the exchange of sexual services for payment. That being said, when plotting the predictions for the effect of income on the association with companionship, while holding all other independent variables at their survey weighted median value, the results indicate that income does not have substantive impact.

On the other hand, gender and education do have a statistically significant and substantively important relationship with predicting associations for many of the concepts. Output indicates that there is a statistically significant gender gap in associating the negative concepts with exchanging sexual services for payment. On average, women are just over a half a point more likely to associate poverty, women’s exploitation, and human trafficking with these exchanges when compared to men. Since women are more often thought of as facing negative implications related to sex work, it makes sense that women would be more likely to recognize the negative associations. The result provides support for \({H}_{1}\). In comparison, there is no gender gap in associating the positive concepts. Women and men have an equal level of acknowledgement of the positive aspects of exchanging sexual services for payment.

Model output also lends partial support for \({H}_{2}\). Educational level is associated with a statistically greater association with two of three of the positive concepts. A higher education level is related to a greater association between companionship and women’s empowerment. In comparison, education level has no statistically significant relationship with the negative concepts. It is reasonable to expect that individuals with higher levels of education would exhibit greater awareness of the positive concepts than those who are only exposed to public debates on the topic, where the negative aspects of exchanging sexual services for payment mainly surface. The output in Table 2 shows that there are several attitudinal variables that predict associations with the causes and consequences of exchanging sexual services for payment. Partially aligned with \({H}_{3}\), Republican partisan are less likely to associate exchanging sexual services for payment with two of the three positive concepts. Specifically, Republican partisans are less likely to associate such exchanges with companionship and women’s empowerment. As discussed, the Republican party’s traditional stance towards the family and sexual behavior in general would lead us to expect that Republican partisans would be less inclined to associate positive concepts with exchanging sexual services for payment.

Similarly, the output in Table 2 provides mixed support for \({H}_{4}\), which indicates that a liberal ideology is related to a greater association between the exchange of sexual services for payment and both positive and negative concepts. A respondent indicating a liberal ideology is more likely to associate four of the six concepts with these exchanges. Liberal individuals are more likely to associate the positive concepts of companionship and women’s empowerment with the activity. However, liberal respondents are also more likely to associate it with women’s exploitation and human trafficking. On average, when comparing a very conservative and a very liberal respondent, the very liberal respondent is one point more likely to associate the exchange of sexual services for payment with these concepts. The result is intuitive since liberals are much more likely to engage in debates on the subject, which would give them are more thorough understanding of both sides of the issue.

Finally, model output indicates that the acceptability of selling sexual services translates into statistically greater associations between such exchanges and sexual freedom, companionship, and women’s empowerment. While statistically related to the negative association of poverty, the relationship between the acceptability of selling sexual services is not substantively notable when calculating predictions for the relationship’s effect. In Fig. 2, predictions with 95% confidence intervals are displayed for the effect of views on the acceptability of selling sexual services and the six concepts, while holding all other independent variables at their survey-weighted median values. The substantive effect of the variable is large when exploring the positive associations and nonexistent on predicting the negative associations. For example, when comparing a respondent that indicated that selling sexual services is “0—not at all acceptable” to a respondent that selected “10—to a great degree acceptable” there is an average increase in the association of sexual freedom with such exchanges of 3.17 points. In other words, when accounting for the 95% confidence bounds, almost one-third of the variance in the association of sexual freedom with the exchange of sexual services for payment is explained by views on the acceptability of selling sexual services.

Fig. 2
figure 2

The effect of the acceptability of selling sex on positive and negative associations

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The relationship between views on the acceptability of selling sexual services and the association of companionship and women’s empowerment with these exchanges are also quite strong. When comparing a respondent that indicated that selling sexual services is “0—not at all acceptable” to a respondent that selected “10—to a great degree acceptable” there is an average increase in the association of companionship with such exchanges of 2.19 points. Similarly, when making the same comparison there is an average increase of 2.37 points in the association of women’s empowerment with the exchange of sexual services for payment. Again, these estimates account for the 95% confidence bounds. The results highlight that around a quarter of the variance in these associations can be explained by views on the acceptability of selling sexual services. The results provide support for \({H}_{5}\), and indicate that less stigmatized views of exchanging sexual services for payment translate into a greater recognition of the positive aspects of the activity.

As previously stated, the surprising finding displayed in Fig. 2 is that views on the acceptability of exchanging sexual services for payment have no substantive impact on levels of association with the negative concepts. In fact, someone who indicates that the exchange of sexual services for payment is “not at all” acceptable has statistically the same level of predicted association for the negative concepts as a respondent who answered “to a great degree” acceptable. In other words, individuals with a favorable view of exchanging sexual services for payment are equally likely to acknowledge the potential negative aspects as are individuals with an unfavorable view. The result suggests that all respondents might be similarly familiar with the negative causes and consequences of exchanging sexual services for payment, while only respondents with a favorable view of the activity would be cognizant of the positive aspects.

Discussion

In this study, we sought to fill a gap in the literature by investigating positive and negative associations with the causes and consequences of exchanging sexual services for payment. While prior research would posit arguments for why particular individual-level associations might exist, hypotheses remained unspecified and the assertions have gone untested. Besides this existing gap in literature, more research is needed on the subject because studies find that negativity towards exchanging sexual services for payment has adverse effects on sex workers’ lives. Therefore, in this research agenda we were focused on two research questions: (1) What level of associations do respondents have between exchanging sexual services for payment and concepts representing positive and negative causes and consequences of the activity? (2) What variables predict the level of associations with exchanging sexual services for payment and these concepts? Overall, we uncover several relationships.

First, we find that women have a greater recognition of the negative causes and consequences of exchanging sexual services for payment. Since women are much more likely to be affected by the negative aspects of exchanging sexual services for payment, the finding is intuitive. Second, the greater the education level of an individual, the more likely they are to recognize the positive aspects. Third, Republican partisans are less likely to recognize the positive concepts as being associated with exchanging sexual services for payment. Fourth, we find that liberals are more likely to associate both positive and negative concepts with exchanging sexual services for payment. Finally, a view that the act of selling sex is acceptable translates into a greater recognition of the positive causes and consequences of exchanging sexual services for payment. The effect of views on the acceptability of selling sex on the level of association with the positive concepts was substantively strong. On the other hand, we find that respondents had a similar level of association with the negative concepts regardless of their general attitudes towards these exchanges. Again, this result indicates that everyone might be equally familiar with the negative causes and consequences of exchanging sexual services for payment. Sex workers' rights advocates could leverage this knowledge as they tailor their messages and strategies.

Based on our findings, we provide some humble suggestions for sex workers’ rights advocates who are already knowledgeably and actively engaged in the ongoing struggle against repressive policies that adversely affect sex workers. Firstly, we encourage advocates to remain sensitive to their diverse audiences and tailor their messaging accordingly. For instance, when addressing women's groups, it is essential to acknowledge women's greater associations with the negative causes and consequences of exchanging sexual services for payment. In such contexts, advocates may counterbalance this negativity by providing information on the harm caused by repressive policies, emphasizing the importance of safeguarding the well-being of all individuals involved. When engaging with Republican politicians or partisans, it is worth recognizing that they may be less inclined to acknowledge the positive aspects of sex work. In these interactions, advocates can stress the principles of freedom and personal choice, highlighting how these values align with the decriminalization and empowerment of sex workers.

The results show that a belief that selling sex is acceptable is correlated with a greater level of positive associations with the causes and consequences of exchanging sexual services for payment. Consequently, a broader societal acceptance of sex work can lead to a greater number of individuals recognizing its positive aspects. Organizations dedicated to supporting sex workers should actively play a role in promoting a more favorable public perception of sex work. This suggestion aligns with the study's results, which underscore the strong connection between increased acceptance of the exchange of sexual services for payment and more positive societal attitudes. One way for sex workers’ rights advocates to accomplish this goal would be to emphasize narratives that humanize sex industry participants. Providing the public with individual testimonials could help in reducing the stigma attached to sex work. Future research should continue to explore individual-level associations with exchanging sexual services for payment to provide further knowledge and additional strategies to guide the success of sex workers’ rights advocates.