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The effect of sex work regulation on health and well‐being of sex workers: Evidence from Senegal

Ito, S; Lépine, A; Treibich, C; (2018) The effect of sex work regulation on health and well‐being of sex workers: Evidence from Senegal. Health Economics , 27 (11) pp. 1627-1652. 10.1002/hec.3791. Green open access

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Abstract

Senegal is the only African country where sex work is legal and regulated by a health policy. Senegalese female sex workers (FSWs) are required to register with a health facility and to attend monthly routine health checks aimed at testing and treating sexually transmitted infections (STIs). Compliance to those routine visits is recorded on a registration card that must be carried by FSWs in order to avoid sanctions in case of police arrests. Although this policy was first introduced in 1969 to limit the spread of STIs, there is no evidence so far of its impact on FSWs' health and well‐being. The paper aims to fill this gap by exploiting a unique data set of registered and unregistered Senegalese FSWs. Using propensity score matching, we find that registration has a positive effect on FSWs' health. However, we find that registration reduces FSWs' subjective well‐being. This finding is explained by the fact that registered FSWs are found to engage in more sex acts, in riskier sex acts, have less social support from their peers, and are more likely to experience violence from clients and police officers. We prove that those results are robust to the violation of the conditional independence assumption, to misspecification of the propensity score model, and that covariate balance is achieved. The results suggest that more efforts should be deployed to reduce the stigma associated with registration and to address the poor well‐being of FSWs, which is counterproductive to HIV prevention efforts.

Type: Article
Title: The effect of sex work regulation on health and well‐being of sex workers: Evidence from Senegal
Open access status: An open access version is available from UCL Discovery
DOI: 10.1002/hec.3791
Publisher version: https://doi.org/10.1002/hec.3791
Language: English
Additional information: © 2018 The Authors. Health Economics Published by John Wiley & Sons, Ltd. This is an open access article under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/).
Keywords: HIV/AIDS, matching, Senegal, sex work, sexually transmitted infections
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
URI: https://discovery.ucl.ac.uk/id/eprint/10067489
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