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. 2023 Jun 13;52(5):1969–2010. doi: 10.1007/s10508-023-02633-3

Table 2.

Summary of included studies

Authors (year) Country Participants Sociodemographics Focus Design Outcomes assessed Time period of data collection
Aantjes et al. (2023) Mozambique 38 sex workers, 10 outreach workers, 7 informants with key positions in national COVID coordination bodies, Ministry of health and civil society organizations

Sex workers: 100% female

Mean age not reported; range 18–24

Others: Not reported

The impacts of national COVID-19 restrictions on young adult sex workers in Mozambique and actions taken (at individual, governmental and civil society levels) to mitigate these Qualitative interviews

Sex workers: Impact of COVID-19 on income, security, health and well-being; coping and support; health services utilization; COVID prevention and vaccine acceptability

Key informants and outreach staff: National and institutional responses to the pandemic, insights into sex workers’ needs, mitigation strategies

Sex workers and outreach staff: February–April 2021

Key informants: June–October 2021

Al-Rawi and Zemenchik (2022) Not reported (presumed global) 1458 (re)tweets from 22 sex worker Twitter accounts 68.2% cisgender women; 22.7% sexual and gender minorities (1/5 was transgender); 9.1% cisgender men How public social media is used as a tool of professional and personal expression by sex workers during the pandemic Qualitative content analysis of tweets Content analysis of all tweets referring terms relating to the pandemic December 2019–July 2021
Avwioro et al. (2021) Nigeria 604 female commercial sex workers

100% female

Age range 15–35; age-group with largest representation was 26–30 (33.1%)

COVID-19 knowledge, awareness and prevention practices Cross-sectional survey COVID-19 knowledge (e.g., of symptoms and prevention), awareness (e.g., exposure to COVID media) and preventive practices (e.g., use of face mask during sex); potential associated factors (marital status, age, alcohol/cigarette/drug use, average number of clients per day, years of sex work experience, support for government prohibition of commercial sex work) May–July 2020
Azam et al. (2021) Netherlands and Belgium Not reported

Gender not reported

Age-group most represented was 25–30 pre-lockdown, 20–25 during lockdown

Impact of the pandemic on prostitution markets Analysis of Web sites with user-generated content about prostitution markets Price, duration and type of services provided; sociodemographic characteristics of sex workers; textual comments and reviews April 2019–April 2020
Benoit and Unsworth (2022) Canada 10 staff members of sex worker organizations providing support, advocacy and education by, for and with sex workers Not reported Stigma and marginalization experienced during the pandemic Qualitative interviews Impact of the pandemic on sex workers; whether some groups of sex workers have been more affected than others; whether services have been offered; whether organization has introduced new services or modes of delivery November 2020
Brouwers and Herrmann (2020) UK

45 adult service Web sites (9 responded to questions);

7 sex worker-led organizations

N/A The response of adult service Web sites to the pandemic Mixed-methods

Public sections of Web sites were searched for pop-ups posts, banners, etc., about COVID-19

Web sites were asked 5 questions relating to whether services or features had been adjusted; whether advice had been provided regarding in-person services; whether contact with sex worker support organizations had been made; and any other actions taken in response to the pandemic

Organizations were asked whether they had been contacted by or received donations from the Web sites; whether they knew of any further Web site responses to the pandemic; and the responses they would have liked to see

Web sites contacted 6 weeks after UK introduced lockdown measures; organizations contacted a further 4 weeks after that
Burgos and Del Pino (2021) Spain 11 women involved in prostitution

100% female

Mean age 32 (range 23–63)

The impact of confinement on the lives of sex workers Qualitative interviews Impact of confinement on their lives; fear of catching COVID-19; emotions and feelings; relationship with surroundings April 2020
Cabras and Ingrasci (2022) Italy

Interviews: 10 key informers including social workers, police officers, lawyers

Observation: 6 outreach activities, including social workers, volunteers and sex workers

Not reported The pandemic experiences of female migrant sex workers Mixed-methods (interviews, participant observation) Interview schedules not described. Observation included listening to and joining conversations between sex workers and social workers/volunteers January 2020–January 2021
Callander et al. (2020a)

Global

(North America 49.8%, Europe 23.8%, Asia 16.6%, Oceania 4.2%, South America 3.1%, Africa 1.6%)

19,388 online profiles of male sex workers (78,399 data points)

100% male

Mean age 27.5 (range 18–80)

Effects of COVID-19 on male sex work Longitudinal study of ecological digital data Study assessed changes over time in online activity and qualitatively analyzed free-text sections of sex work profiles for any references to COVID-19 September 2019–May 2020
Callander et al. (2020b)* Not reported—presumed to be global N/A Not reported Longitudinal analysis of online sex work activity and content analysis of safer sex work guidelines Longitudinal study of ecological digital data Number of active, inactive and newly created profiles on a sex work Web site; number of profile views May–August 2020
Callander et al. (2022) USA 15 sex workers, 4 delivering services to sex workers, and 2 who were both

47% cisgender women, 29.4% cisgender men, 17.6% non-binary, 5.9% transgender women

Median age 34 (range 23–54)

COVID-19 effects on the health and safety of sex workers in the USA Qualitative interviews

Sex workers: How COVID-19 has affected sex work practices; service access; social/financial support; knowledge and awareness of COVID-19; self-reported mental health

Support services: How COVID-19 has affected sex work; support and advocacy work; policy, social and financial support provided

May–August 2020
Chakrapani et al. (2022) India

Survey: 132 men who have sex with men, including 57 (43%) engaged in sex work

Interviews: 10 men who have sex with men, including 3 (30%) engaged in sex work

100% male

Age for the subgroup of sex workers not reported

Economic well-being and healthcare access among men who have sex with men Mixed-methods: Survey and interviews Sexual stigma; internalized homonegativity; economic stress; stress due to social/physical distancing; depressive symptoms since lockdown; anxiety symptoms since lockdown; access to HIV and sexual and mental health services; COVID protective behaviors April–June 2020
Chiang et al. (2022) Brazil 219 women engaged in prostitution

100% female (78.8% cisgender, 21.1% transgender)

Mean age 41.3 (range 19–73)

The exposure of prostitutes working in São Paulo to COVID-19 Cross-sectional survey Work and behavior during pandemic; prevention and exposure factors to SARS-Cov-2; comorbidities; medication; close contact with individuals with COVID-19; symptoms or positive tests for COVID-19; hospitalization; post-COVID complications; vaccination status May 2021
Couto et al. (2022) Brazil 30 sex workers

100% female

Mean age not reported; most (78.26%) aged between 18 and 35

Mental health, stressors and coping strategies of female sex workers during COVID-19 Qualitative interviews Questions relating to how the pandemic has affected day-to-day life, mental health during the pandemic, and which care options had been taken as a result September–October 2020
Cubides Kovacsics et al. (2023) Netherlands 4 sex workers, 1 member of the support organization Spot 46 Not reported (In)security of sex workers during COVID-19 Qualitative interviews Questions relating to COVID-19 June–August 2020
Dziuban et al. (2021) Poland 3 members of a sex worker-led activist and advocacy collective—academics, activists and/or sex workers Not reported The struggle of the sex workers’ community during the pandemic Collaborative auto ethnography N/A December 2020
Fedorkó et al. (2022) Austria, UK (England and Scotland), France, Germany, Greece, Ireland, Italy, Norway, Poland, Portugal, Spain and Switzerland Members of 19 different organizations working with and providing support to sex workers, of which 14 were sex worker-led Not reported How the pandemic affected the socioeconomic, health and safety conditions of sex workers and how they responded to the first waves Cross-sectional survey Composition of the organizations and their sites; impact of COVID-19 on sex workers; type of response deployed by the organizations; collaboration with other organizations; key demands for improving conditions for sex workers during the pandemic October 2020–February 2021
Folayan et al. (2022) Nigeria 2076 total sample size of which 1056 (50.87%) engaged in transactional sex (i.e., entered into a sexual relationship with a man to get needed or important things such as food and clothing) and 921 (44.36%) who sell sex

100% women or girls (transgender or cisgender)

Age of subgroups involved in sex work or transactional sex not reported

Factors associated with poor access to HIV, tuberculosis, and sexual and reproductive health services among women and girls with HIV Cross-sectional survey Impacts of COVID-19 on HIV, tuberculosis and sexual and reproductive health services access; economic and social situation; health and well-being June–October 2021
Gbagbo (2020) Ghana 35 commercial sex workers

85.7% female, 14.3% male

Mean age not reported; age-group most represented was 29–39 (60%)

Experiences of sex workers during COVID-19 restrictions Qualitative interviews Perceptions and experiences since the imposition of restrictions on movement April–May 2020
Gichuna et al. (2020) Kenya 117 sex workers; 15 healthcare providers

Sex workers: 100% female

Mean age not reported (range 16–46; more than half were under 33)

Healthcare workers: Not reported

Access to health care during the pandemic Qualitative interviews Immediate experiences of coping under COVID-19 and lockdown including income; housing; health; service provision; food security; working conditions; doing sex work; police; gender-based violence April–May 2020
Gonzalez and Garrido (2022) Spain 2 activist migrant sex workers, 2 members of civil society entities with roles in pro-rights activism

Sex workers: 100% female

Age not reported

Civil society entities: Not reported

The usefulness of the concept of ‘deservingness’ of social benefits Mixed-methods: Analysis of secondary sources, political discourse on social networks, and qualitative interviews Not reported

Political discourse tracked from March–September 2020

Interviews March–September 2021

Hassan et al. (2023) Kenya 117 sex workers; 15 healthcare practitioners

Sex workers: 100% female, age not reported

Practitioners: Not reported

Challenges faced by sex workers living in urban informal settlements in Nairobi during the pandemic Qualitative interviews

Sex workers: Experiences of working during the pandemic; challenges faced by sex workers

Practitioners: Access to healthcare and practical solutions to the crisis for this population

May–June 2020
Jepson et al. (2022) Australia 50 street-based sex workers (compared to 53 people with disability or their carers; 53 aged care workers; 54 refugee and asylum seekers; 61 deaf/hard of hearing; 50 Aboriginal and Torres Strait Islander people; 1121 general community)

Sex workers only:

90% female, 8% prefer not to say, 2% reported their gender was not listed

Mean age not reported; most common age-group was 40–49 (42%)

How vulnerable communities seek and respond to COVID-19 public health information Cross-sectional survey Sources of exposure to COVID-19; opinions regarding trust in people/groups such as politicians and general practitioners; COVID-safe behaviors; and ease of finding COVID-19 information May–July 2021
Jones et al. (2022) Ethiopia 20 young people involved in commercial sex work

100% female

Mean age not reported; 50% aged between 15 and 19, 50% aged between 20 and 24

Sexual and reproductive health in vulnerable youth Qualitative interviews Questions regarding experiences since the start of the pandemic, knowledge of COVID-19, experiences of the public health response impact on sexual and reproductive health and right to bodily integrity June 2020
Judge and Jackson (2023) USA 172 male sex workers providing services to men

100% male

Mean age 32.14 for White men, 28.09 for Black men, 28.29 for men of other races (Latin, Mixed, Mediterranean, Arab, Asian, Native American or other)

Factors associated with advertising sex work services online during the pandemic Longitudinal Availability of men to carry out sex work, based on advertisements on a popular sex work Web site; age; race Number of advertisements in March 2019, April 2020, January 2021 and February 2021
Kahambing (2021)* Philippines Massage therapists who welcome the possibility of sex work within their practice (‘n’ not reported) (It should be noted that they opted to be referred to as massage therapists, ‘sex worker’ was not their preferred identification

100% female

Age not reported

Mental health of massage therapists who practice sex work during the pandemic Not reported Not reported December 2020–June 2021
Kavanagh et al. (2021) Kenya 1,725 women in rural Kenya (including 266 people engaged in sex work as a primary source of income and 904 people engaged in sex work as a secondary source of income)

100% female

Mean age 29.3 (of whole sample; mean age for subgroup engaged in sex work not reported)

Economic security, food security, health and sexual behavior of women at high risk of HIV infection during COVID-19 Longitudinal surveys Self-reported income, employment hours, number of sexual partners and transactional sex partners, food security, expected economic status in next 6 months, general health, health concerns, COVID-19 symptoms and prevention behaviors, access to health care May–June 2020 (compared with data collected September 2019–March 2020)
Lahav-Raz et al. (2021) Israel 33 workers of aid organizations working with individuals in the sex trade Not reported Challenges facing aid organizations working with sex workers during the pandemic Qualitative interviews Aid organization’s work during the pandemic; pandemic’s impact on clientele; challenges faced by the assisted population and aid workers May–July 2020
Laikram and Pathak (2021) Thailand

Interviews: 24 sex workers

Case studies: 3 sex workers

Focus group: 4 participants working for NGOs, 3 from local government agencies, 7 sex workers

Interviews: 8 female, 8 male, 8 third gender

Age range for females 17–42; males 19–28; other gender 16–55

Case studies: 1 male, 1 female, 1 third gender

Focus group: Not reported

Legal implications regarding the rights of sex workers during the pandemic Mixed-methods: Qualitative interviews, focus group and case studies, as well as secondary data from government and NGO reports Not reported Not reported
Lamontagne et al. (2022) Nigeria 4,556 females with or at risk of HIV including 1,733 (38.31%) who were sex workers and 1,994 (44.06%) who engaged in transactional sex

100% female

Age of subgroup who were sex workers not reported

Effect of COVID-19 on food insecurity, financial vulnerability and housing insecurity among women and girls living with or at risk of HIV Cross-sectional survey Food insecurity; financial vulnerability; housing insecurity May–September 2021
Leyva-Moral et al. (2023) Spain 29 individuals who engaged in sex work 20 (69%) transgender women, 6 (20.7%) cisgender men, 2 (6.9%) who identified their gender as ‘queer’ and 1 (3.4%) non-binary Impact of COVID-19 on sex workers in accessing health and social services Qualitative interviews Questions assessed knowledge and perception of COVID-19; experiences of sex work during lockdown; specific health and social needs; knowledge of available help resources; access to medical care; resources search strategies; barriers to accessing care; sex work experiences; discrimination in social/health services; experiences of violence November 2020–February 2021
Machingura et al. (2021)* Zimbabwe Female sex workers attending HIV prevention and treatment services (‘n’ not reported)

100% female

Age not reported

Risk of contracting HIV during COVID-19 Comparison of lockdown data with 2017 data Client numbers; income; work conditions; condomless sex (compared to data from 2017) April–October 2020
Magnani et al. (2022) Indonesia Female sex workers; ‘n’ not reported

100% female

Age not reported

Impact of COVID-19 on HIV and AIDS control efforts among female sex workers Analysis of data from local implementing units of a national HIV/AIDS program for sex workers Number of sex workers continuing to work; number of entertainment areas open for business; number of clients; number of health facilities and mobile clinics continuing to offer HIV testing; monthly numbers of sex workers contacted via community outreach mechanisms; condoms distributed; HIV tests; 3-month retention rates for sex workers that had initiated ART 4 sources of monthly data between January–July 2020
Mantell et al. (2021) Kenya 193 sex workers

100% female

Median age 22; age range 18–24

Awareness and precautions relating to COVID-19 compared to HIV Surveys (with participants of an ongoing randomized controlled trial beginning pre-COVID) Questions relating to COVID-19 awareness and precautions, access to health services, sex work during Kenya’s state of emergency, impact of the pandemic (on income, access to food, clients, and violence from a client or main partner) Initial study October 2019–February 2020; follow-ups between April–July 2020
Matambanadzo et al. (2021) Zimbabwe 19,407 HIV-negative sex workers screened for PrEP

100% female

Age not reported

Uptake of PrEP among sex workers during the pandemic Mapping of clinical data PrEP screening, initiation, follow-ups, refills and routine clinical follow-ups Pre-lockdown (January–March 2020); during severe restrictions (April–June 2020); subsequent easing (July–September 2020) and during drug stock-outs (October–December 2020)
Mavhandu-Mudzusi and Moyo (2022) Zimbabwe 10 sex workers

100% female

Mean age not reported; all aged between 31 and 45, age-group most commonly represented 31–35

Experiences of sex work in the context of the COVID-19 pandemic Qualitative interviews Work experiences during the pandemic December 2020–March 2021
Mlambo and Masuku (2022) South Africa 11 commercial sex workers

100% female

Age not reported

Social support for sex workers during the pandemic Qualitative interviews Interview schedule not reported; presumed to be questions about income and social support Not reported
Moura et al. (2022) Portugal 5 leaders of the support network created by the Movement of Sex Workers

Gender not reported

Mean age not reported; range 28–46

The work of the Portuguese national Movement of Sex Workers and their perceptions of the impact of COVID-19 Longitudinal / qualitative interviews The impact of COVID-19 on their work, sex work, and sex workers; what could improve response to these workers; second interview assessed continuity of work since the first interview May–August 2020; participants interviewed 3 times each during this time
Moyo et al. (2022) Zimbabwe 10 sex workers

100% female

Mean age not reported; range 31–45

Utilization of HIV services during the pandemic Qualitative interviews Experiences utilizing HIV services during lockdown December 2020–March 2021
Museva et al. (2021) Zimbabwe

Surveys: 200 sex workers

Interviews: Government officials, local private clinic manager, peer educators (‘n’ not reported)

Surveys: 88% female, 12% male

Mean age not reported; age-group most represented was under 30 (55%)

Interviews: Not reported

Impact of COVID-19 on sex workers’ livelihoods Mixed-methods: Cross-sectional survey; qualitative interviews

Surveys: Income before and after lockdown; sustainability of adaptation strategies

Interviews: challenges and opportunities encountered by sex workers due to COVID measures; coping and response strategies used by sex workers

April–June 2020
Nyabeze et al. (2022) Zimbabwe 10 sex workers

100% female

Age not reported

Resilience of female sex workers in the wake of COVID-19 Mixed-methods: Qualitative interviews, document analysis, naturalistic observation Not reported Not reported
Pearson et al. (2022) Canada 208 female sex workers

100% female (11.5% transgender women)

Median age 45 (range 36–52)

Barriers to accessing governmental income support for sex workers Cross-sectional survey nested within an ongoing prospective cohort study Pandemic impacts on housing and economic factors; work environment; safety, violence and policing; social outcomes; experience of intimate partner violence; social cohesion; access to COVID emergency income supports April 2020–April 2021
Pereira (2021) Portugal 13 sex workers

100% male

Mean age 32.5 (range 23–47)

Motives, safe sex practices and social vulnerabilities in male sex workers during the pandemic Cross-sectional survey Motives for sex work, safe sex practices, impact of COVID-19 on personal and professional lives January 2021
Pollard et al. (2021) India 16 sex workers (along with 13 men who have sex with men and 15 transgender women)

Sex workers: 100% female

25% aged 20–29; 57% aged 30–39; 19% aged 40–19

HIV service delivery during the pandemic for vulnerable groups Qualitative focus groups HIV service access; risk behaviors; economic security; feedback to ensure service continuity November–December 2020
Prior (2022) Israel & Vietnam 10 men who paid women for sex (9 in Israel, 1 who had been traveling in Vietnam)

100% male

Mean age 38.6 (range 22–53)

COVID-19 experiences of men who pay women for sex Qualitative interviews Considerations for paying for sex or abstaining from it; sex consumption patterns during the pandemic; online sex-for-pay; relationships with women who are paid for sex and men who pay for sex; perceptions of the impact of COVID on their experiences and the sex industry as a whole April–July 2020
Rao et al. (2022) South Africa 2776 sex workers newly initiating PrEP

100% cisgender females

Mean age not reported; approximately 60% aged 25 or older

Persistence on oral PrEP among sex workers Longitudinal Use of PrEP—date of initiation; outcomes of subsequent monthly visits, including whether or not individuals stopped and restarted PrEP September 2016–December 2020
Richtermain et al. (2022)* Kenya 2090 women at risk for HIV enrolled; 1725 at first survey, 1731 at second survey during pandemic

100% female

Median age 27

Trends in transactional sex during the first year of the pandemic Longitudinal

Weekly income; employment hours; total number of sex partners and transactional sex partners in the past month; prices associated with transactional sex

Early and later pandemic outcomes compared with those from 6 months pre-pandemic

Surveys every 6 months; participants enrolled between 2017 and 2018 and trial ended March 2020

Telephone surveys conducted between May and June 2020 and between November 2020 and February 2021

Rogers et al. (2021) USA 46 street-based sex workers

50% cisgender male, 30.4% cisgender female, 13% transgender woman, 2.2% transgender man, 4.4% non-binary

Mean age not reported; age-group most represented was 25–34 (51.1%)

Impact of the pandemic on health behaviors and social circumstances Cross-sectional survey Frequency of substance use and sexual behaviors in past 30 days and whether there were changes due to the pandemic; use of PPE; impact of COVID-19 on life including access to services/jobs or housing/food/other needs, changes in relationships, changes in mood or thinking April–May 2020
Santos et al. (2021) Global 2,732 men who have sex with men (including 274 (11%) who had ever engaged in sex work)

100% male

Age of sex worker subgroup not reported

Effect of COVID-19 on economic situation, mental health, HIV prevention and HIV treatment in men who have sex with men Cross-sectional survey Impact of COVID on economic vulnerability; mental health; HIV prevention; testing and treatment and care impacts April–May 2020
Santos et al. (2022) Global—participants from over 150 countries 21,795 sexual and gender minority individuals, of whom 1456 (6.7%) had ever engaged in sex work Sociodemographic characteristics of subgroup involved in sex work not reported Disparities in COVID-19 impacts on HIV prevention and care among sexual and gender minorities Cross-sectional Impact of COVID on economic vulnerability; mental health status; HIV prevention, testing and treatment and care impacts October–November 2020
Shankar et al. (2022) India 2352 sex workers

2221 cisgender female; 63 transgender; 68 transgender male

Age not reported

Stereotypes concerning the immobility of sex workers within informal labor markets, their indebtedness and bondage to informal creditors Cross-sectional survey Labor history, income and expenditure; access to state assistance; accommodation and rents; savings and credit histories including how finances were managed pre- and post-COVID August–November 2020
Shekhar (2023) India 174 (120 commercial sex workers, 31 ‘informers, pimps, madams or brothel-keepers,’ 8 social workers, 11 researchers, 4 child welfare committee or shelter home superintendents

Gender not reported

Mean age not reported but the majority belonged to the 26–35 age-group

Economic condition and related risks faced by commercial sex workers in India Rapid interview assessments Economic status; change in customers during lockdown; financial exploitation April–May 2020
Silva and dos Santos Câmara (2020) Portugal & Brazil

2 transvestites involved in sex work;

Reflections from 2 researchers

Sex workers: Described as ‘transvestites,’ referred to with female pronouns. Mean age 41 (range 40–42) Challenges of anthropological research with sex workers during the pandemic Qualitative interviews with participants; reflections from researchers How participants are facing the pandemic; how the researchers can carry out anthropological research in times of social distancing Not reported
Singer et al. (2020)* Not reported; authors in the USA 21 people engaged in sex work

52% cisgender women; 33% transgender or gender fluid; 10% cisgender men; 14% declined to answer

Age not reported

Preventing COVID-19 in sex workers Qualitative interviews Barriers to accessing health care Date not reported; interviews took place during Illinois’ first ‘shelter-in-place’ phase
Singer et al. (2022) USA 16 Black sex workers

31.25% cisgender women; 25% cisgender men; 6.25% genderqueer or non-binary; 31.25% transgender women; 6.5% intersex female

Mean age 30.8 (range 23–42)

Health-related needs and experiences of Black sex workers in greater Chicago Qualitative interviews Physical, sexual and emotional health needs; conceptualization and experiences of safety; impact of COVID-19 December 2020–April 2021
Stevens et al. (2021) UK (England) 3 individuals representing sex workers—either sex workers themselves or ‘topic experts’ who provided support services to this group Not reported To identify the needs of various socially vulnerable groups during the first COVID-19 wave Qualitative interviews How the pandemic affected health, well-being and life circumstances April–May 2020
Su and Valiquette (2022) Brazil 12 transgender Venezuelan asylum seekers and undocumented migrants, 6 key informants who were sex workers, trans-activists or humanitarian/NGO staff (unclear how many were sex workers) Not reported Experiences of migration, informal labor and sex work in LGBTQI + people Mixed-methods: surveys and interviews How COVID-19 affected livelihood Not reported; dates of those interviews quoted in the text appear to be September–November 2021
Tan et al. (2021aª) Singapore

Interviews: 24 stakeholders from the sex work industry;

Surveys: 171 sex workers

Interviews: Not reported

Surveys: 62% cisgender female, 35.1% transgender female, 2.9% cisgender male

Mean age 41

The impact of the pandemic on sex workers’ health and social needs Mixed-methods (interviews and surveys)

Interviews: How COVID-19 impacted sex workers

Survey: Extent to which sex workers experienced hardships (income, food security, sexual compromise, access to medical care, housing insecurity)

April–October 2020
Tan et al. (2021b) Singapore

Interviews: 24 stakeholders from the sex work industry;

Surveys: 171 sex workers

Cyber ethnography: 8 Web sites

Interviews: Not reported

Surveys: 62% cisgender female, 35.1% transgender female, 2.9% cisgender male

Mean age 41

Cyber ethnography: N/A

Reorganization of sex markets as a result of COVID-19 Mixed-methods (interviews, surveys, and cyber ethnography)

Interviews: Organizational change; impact of the pandemic on the sex work industry and its stakeholders; recommendations for policymakers

Survey: Days of work per week; average number of clients; venues used; proportion of clients as regulars; type of clients before COVID-19; food and housing insecurity; sexual compromise; access to health care; income before and after COVID-19

Cyber ethnography: Client characteristics; ways of advertising; marketing and placement strategies; Web site design; quantity and quality of posts from sex workers or clients; impact of COVID-19 on interactions; how Web sites mediated interactions between sex workers and clients

April–October 2020
Tran et al. (2022) Vietnam 8 female sex workers with HIV

100% female

Mean age 40.5

Impact of the pandemic on people with HIV who are members of vulnerable groups Qualitative interviews Questions on knowledge of COVID and perceived risk of COVID, effect of COVID on income, effect of COVID on mental health, effect of COVID on antiretroviral treatment July 2020
Tümpel and Cardone (2022) Germany 1 sex worker who also works as a sexual assistant

Female participant

Specific age not reported; born in early 1980s

Reactions of self-employed people from various sectors to the constraints and requirements during the pandemic Case study (compared to multiple case studies from other sectors) involving interviews, participant observation, shadowing Reflections on the pandemic and doing business under the pandemic circumstances 18 months starting spring 2019
Wang et al. (2022) Dominican Republic 187 female sex workers living with HIV

100% female

Mean age 42.5

Impact of the pandemic on HIV care and treatment outcomes in sex workers Cross-sectional survey Impact of COVID-19 on financial situation, mental health, substance use, partner abuse, HIV care and treatment, and receipt of government benefits August–December 2020
Wirawan et al. (2022) Indonesia 951 sex workers

100% female

Median age 26

Impact of the pandemic and changes taking place in the Indonesian female sex worker community, and predictors of these changes Cross-sectional survey Questions on impact of behavioral changes on client frequency; shift to online sex services; adoption of COVID preventive practices; changes to condom use; fear of COVID-19 September–October 2020

*Published as a research letter; may not be peer-reviewed