The Mental Health of Female Sex Workers: A Systemic Review (Research Paper Sample)

The Mental Health of Female Sex Workers: A Systemic Review.
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DESCRIPTION OF THE EVIDENCE
An overwhelming majority of the rampant cases of female sex worker are attributed to high demand for job opportunities, poverty, domestic strife, and psychological wreckages. Female sex workers have had to contend with hard times characterized by anxiety and depression among other challenges that come with commercial sex. There is a wide spectrum of reasons that make women indulge in commercial sex. Studies have shown that 50% to 70% of the female sex workers are discriminated against in India. Consequently, they have had to suffer from poor mental health due to the stigmatization. 86% of the cases were reported to have suffered from depression while post traumatic stress disorder, suicidal ideation and attempts, drug use and deception, and violence in India and Australia registered 45%, 42%, 51% and 67% respectively. Laws regulating commercial sex and/or prostitution have to be implemented (Abel, 2011).
Looking at the evidence obtained from studies, it came out that the legislations in India, China and Australia had failed to recognize female sex workers through documentation licensing the sex workers. Laws are enforced to curb prostitution at all levels in the three countries. In India, prostitution is rated the same as gambling and drug sale and they are charged equally in courts of law. However, there are laws such as the Immoral Traffic (Suppression) Act (SITA) and Immoral Traffic Prevention Act (PITA) by the Indian government that tend to make commercial sex neither legal nor illegal. These laws require that sex workers may do their businesses indoors but public customer solicitation is an illegality (Jhumka, 2011). These laws also prohibit organized prostitution where one makes money by trading on prostitutes.
An Indian study has shown that most of the sex workers indulge in this act due to economic and/or financial needs. They are not coerced by any physical influences. According to this study, the commercial sex workers are reported to have experienced higher psychological effect, isolation, distress fear among them and loneliness (William, 2006). According to Virtanen (2007), stress is caused by poverty, sexual and physical abuse and substance. These factors are associated with mental degradation which leads to post traumatic stress disorder (PTSD).
China has the highest cases of suicidal ideation and attempts among women involved in the sex work locale. These women who trade on sex have high demands for fast financial dividends and returns to help make a living for their families which would be on the verge of starvation. Studies have pointed that a section of the female sex workers are unemployed and therefore, they indulge in prostitution as a survival tactic. The young population of female sex workers are said to have been forced to do sex for money while others opt for prostitution due to lack of confidence in relationships. Others do commercial sex as a life long profession. The hot spots for these businesses were found to be in entertainment facilities, dancing halls, night clubs and bars among others. Just like in India and elsewhere in the world, Chinese female sex workers are stigmatized and discriminated against. These women experience psychological distress, drug abuse and high depressive symptoms (Tucker, 2010).
As female sex workers are explored, the issue of HIV/AIDS is not left behind at all. Commercial sex workers who use drugs through injection provide a platform favourable for transmission of HIV/AIDS. Transmission of HIV/AIDS is facilitated by the fact once one has taken the drugs, they may not be in rightful and sane minds to avoid sharing the injection needles. Studies have it that, the Injection Drug Users Female Sex Workers (IDUFSWs) have chances to casual sex partners, high rate of commercial sex transactions, low rate of condom use during intercourse (Wang, 2009). These are preliminary predisposing factors for HIV/AIDS infection and contraction (Wang, 2011).
Posttraumatic stress disorder among female sex workers was found to be prevalent in Sydney, Australia. Female sex workers go through traumatizing moments toned up with recurring stress. The female sex workers have a high dependence on drugs such as cocaine (Tran, 2004).
KEY FINDINGS FROM THE EVIDENCES
According to the research carried out in Chennai, India, most women indulge in prostitution due to poverty, family problems and inadequate education. There are challenges that face commercial sex workers at their work locale. These women thus have had to experience depression and posttraumatic stress disorder. 30% of the female sex workers reported suicidal ideation and 86% had depression. These findings send a signal that among the female sex workers, there are those who have cultured feelings of committing suicide due to depression while some have not. Considering their mental fitness, it turns out that stigmatization and discrimination from family and friends has been a major ailing factor.
The research carried out in China indicated high cases of mental disorders among Injection Drug Users Female Workers (IDUFSWs). Akin to elsewhere in the world, depression and feelings of haplessness and hopelessness are prevalent among the female sex workers. Depression score was at 30%, suicidality in the past six months had 9% and suicidal ideation stood at 18% (Keilp et al., 2012). Most of female sex workers were noted to have between 75.3% to 92.4% rates of depression, 45% to 72% hopelessness, 26% to 37% pessimistic, 24% to 43% optimistic and 55% to 75% did not access the desired support from family and friends. Social stigmatization and segregation was found to be highly pronounced in China mainly because the act of prostitution is against the high venerated Chinese culture (Holroyd, 2008). From studies carried out and the findings thereof, depression rates were more prevalent in China and India relative to psychological disorders that are attributed to prostitution. In the research carried out in Australia reported 87% depression, 42% suicidal ideation, 93% traumatic events and multiple traumas. Besides, 47% were reported to have posttraumatic stress disorder.
The research was also carried out in Hong Kong where 77.5% of the female sex workers had spouses with children. According to Stoebenau (2009), the female sex workers indulge in prostitution due hard economic times. The research indicated that loss of employment, low income; burden debt and low salary were the major factors that make women indulge in commercial sex in Hong Kong. The respective percentages for the predisposing factors are 14.9%, 27.7%, 8.5% and 19%. Hussain (2012) notes that the female sex workers fear contracting HIV/AIDS and insults from the passers-by and the thorough checkups of their identity cards by the police. Most of these women opt for suicide upon contraction of HIV/AIDS.
Post-traumatic stress disorder and psychotic cases are prevalent in the United States of America. Suicidal ideation and attempts were noted to be high in the United States due to mental instability (Letourneau, 1996). The studies carried out point out that female sex workers undergo a lot of depression due to violent clients who end up mistreating the unsuspecting customers. This cuts across all the countries that were studied.
META-ANALYSIS
A meta-analysis of the data and/or research findings encompasses the methodology of data collection and the materials used. The characteristics of the population sample are also covered in this section with special attention on the statistical aspects.
Interview and questionnaires were employed to collect data from 57 female sex workers. The questions administered in questionnaires were well structured and they were distributed to the female sex workers in a random manner. Ethical considerations were the centre stage in carrying out the study. Women aged up to more than 20 years were selected randomly from the female sex workers population. This was meant to guarantee accuracy of the research and the data collected. Oral interviews were employed to take care of those who might not have been comfortable with the questionnaires for confidentiality reasons. Information collected included depression, post-traumatic stress disorders, family background, mental health status, suicidal ideation and attempts, demographics data and work related violence.
The interviewed population ranged between the age of 20 years and 47 years. 25% of the population had driving and tailoring jobs for their daily living while 75% were jobless. Looking at the education levels, 51% had secondary education. The religious orientations of the people were found to be as follows; 14% were Muslims, 77% were Hindus and 9% were Christians. On the part of residence, an overwhelming majority of 80% was noted to be living in the city while the remaining 20% resided in rural areas. The demographic profile of the female sex workers can be summarized as shown in the table below.
Characteristics Number percentage Mean SD
Age
20 to 25 yrs 4 7% 34.4 6
26 to 30 yrs 11 19
31 to 35 yrs 16 28
36 to 40 yrs 17 30 - -
41 to 45 yrs 8 14 - -
46 to 50 yrs 1 2 ...