Table 1. Studies and mental health outcomes.
| Author and year | Country/income classification | Sample demographics | Sampling procedure | Outcome(s) of interest | Method of assessing outcome(s) | Events | Sample size | Prevalence (%) | Research quality |
|---|---|---|---|---|---|---|---|---|---|
| AFRICA | |||||||||
| Abelson (2019) | Cameroon, lower-middle income | FSWs Sex work location: Brothel, lodge, bar, other entertainment establishment: 100% Median age: 30.1 y (range: 23–36) Education: Primary/less: 30.9% Secondary/higher: 69.0% Martial status: Never married: 77.3% Currently married/in relationship: 10.7% Divorced/separated/ widowed: 12.0% |
Respondent driven sampling | Depression | PHQ-9 with cut-off > 5 |
1,067 | 2,165 | Any level depression: 49.8% | Strong (7) |
| Akinnawo (1995) | Nigeria, lower-middle income | FSWs Sex work location: Brothel, lodge, bar, other entertainment establishment: 100% Age: 30.5 y (range: not reported) Education: not reported Married status: Never married: 41.6% Currently married/in relationship: 44.0% Divorced/separated/ widowed: 14.4% |
Purposive | Affection/mood disorder | Awaritefe Psychological Index |
36 | 125 | 28.8% | Moderate (5) |
| Neuroticism | Eysenck Personality Inventory | 25 | 20.0% | ||||||
| Barnhart (2019) | Tanzania, low income |
Female bar workers Demographics not reported for FSWs |
Random sampling | Depression | PHQ-9 measuring moderate to severe using cut-off > 10 | 3 | 23 | 13.0% | Moderate (6) |
| PTSD | Primary care PTSD screening tool using cut-off >3 | 3 | 13.0% | ||||||
| Berger (2018) | Swaziland, lower-middle income | FSWs Sex work location: Brothel, lodge, bar, other entertainment establishment: 27.0% Street/public place: 8.7% Home: 57.8% Mean age: 26 y (range: 16–49) Education: Primary/less: 32.4%, Secondary/higher: 67.9% Martial status: Never married: 89.1%, Currently married/in relationship: 4.1% Divorced/separated/widowed: 6.9% |
Respondent driven sampling | Ever suicide ideation | “Have you ever felt like you wanted to end your life?” | 188 | 325 | 58.6% | Moderate (5) |
| Bitty-Anderson (2019)**, Tchankoni (2020)** | Togo, low income | FSWs Sex work location: Brothel, lodge, bar, other entertainment establishment: 100% Median age: 25 y, IQR 21–32 y Education: Primary/less: 44.9% Secondary/higher: 55.1% Marital status: Never married: 86.1% currently married/in relationship: 13.9% Divorced/separated/widowed: 0% |
Respondent driven sampling | Psychological distress | Kessler Psychological Distress Scale (K10) with cut-off scores: Mild: 20–24 Moderate: 25–29 Severe: >30 |
Mild: 223 Severe/moderate: 181 |
952 | Mild: 23.4% Severe/moderate: 19% |
Moderate (6) |
| Cange (2019) | Burkina Faso, low income | FSWs Sex work location: not reported Mean age: 26 y (range: 18–59) Education: Primary/less: 53.8% Secondary/higher: 0.7% Martial status: Never married: 53.6% Currently married/in relationship: 10.9% Divorced/separated/widowed: 35.5% |
Respondent driven sampling | Ever depression | “Ever felt sad or depressed for more than 2 weeks at a time” | 290 | 695 | 41.8% | Moderate (5) |
| Ever suicide ideation | Ever wanting to end their life at least once | 149 | 21.4% | ||||||
| Coetzee (2018) | South Africa, upper-middle income | FSWs Sex work location: not reported Median age: 31 y (IQR: 25–37) Education: Primary/less: 75.6% Secondary/higher: 12.4% Relationship status: not reported |
Respondent driven sampling | Depression | CES-D 20 using cut-off >21 | 349 | 508 | 68.7% | Strong (7) |
| PTSD | PTSD-8 using cut-off >9 | 201 | 39.6% | ||||||
| Suicide ideation in past month and year | “In the past month has the thought of ending your life been in your mind?” “Within the past year have you felt suicidal because you are a sex worker?” |
15 | 2.9% | ||||||
| Suicide attempt in past year | “In past year have you attempted suicide?” | 5 | 1% | ||||||
| Grosso (2019) | Togo and Burkina Faso, low income | FSWs and MSM Sex work location: not reported Median age: not reported Education: primary/higher: 57.0% Martial status: not reported |
Respondent driven sampling | Ever suicide ideation | “Have you ever had suicidal thoughts?” | 284 | 1,383 | 20.5% | Moderate (5) |
| Kim (2018) | Burkina Faso, low income | FSWs and MSM Sex work location: not reported Age (categories): <20: 10.2% 21–29: 37.8% >30: 52% Education: not reported Martial status: Never married: 44.5% Currently married/in relationship: 4.3% Divorced/separated/widowed: 34.0% |
Respondent driven sampling | Ever suicide ideation | “Have you ever felt like you wanted to end your life?” | 80 | 350 | 22.9% | Moderate (5) |
| Lion (2017) | South Africa, upper-middle income | FSWs who use methamphetamines Sex work location: not reported Age: 29 y (range not reported) Education: primary or lower not reported Martial status: not reported |
Respondent driven sampling | Depression | PHQ-9 using cut-off >10 | NA | 53 | NA | Moderate (6) |
| PTSD | PTSD Breslau’s 7 items using cut-off >4 | 21 | 38.7% | ||||||
|
MacLean (2018) |
Malawi, low income | FSWs Sex work location: Not reported Median age: 24 y (IQR: 22–28) Education: Primary/less: 17.0% Secondary/higher: 2.0% Martial status: Never married: 14.0% Currently married/in relationship: 4.0 Divorced/separated/widowed: 81.0% |
Purposive | Depression | PHQ-9 using cut-off >10 | 16 | 200 | 8% | Strong (7) |
| PTSD | PCL using cut-off >38 and >44 | 16 | 8% | ||||||
| Suicide ideation past 2 weeks | Used PHQ-9 item: “Have you had thoughts you would be better off dead” (passive ideation) and “of hurting yourself in some way” (active ideation) | 6 | 3% | ||||||
| Ortblad (2020) | Uganda, low income | FSWs Sex work location: Not reported Median age: 28 y (IQR: 24–32) Education: Primary/less: 55.7% Secondary/higher: 43.1% Marital status: Not reported |
Random sampling | Depression | PHQ-9 using cut-off > 10 | Uganda: 416 | 960 | 43.2% | Strong (10) |
| Suicide ideation past 2 weeks | Used PHQ-9 item: “Have you had thoughts you would be better off dead or of hurting yourself in some way” | 302 | 31.5% | ||||||
| Zambia, lower-middle income | Depression | Zambia: 441 | 965 | 45.7% | |||||
| Suicide ideation past 2 weeks | 540 | 56.7% | |||||||
| Peitzmier (2014)* Sherwood (2015)* |
The Gambia, low income | FSWs Sex work location: Not reported Mean age: 31 y (Range: 17–51) Education: Primary/less: 60.4% Secondary/higher: 39.6% Martial status: ever married: 23.0% Currently married/in relationship: 2.0% Divorced/separated/widowed: 69.8% |
Purposive | Depression | Sad or depressed mood for 2 or more weeks at a time in the past 3 years | 154 | 246 | 62.6% | Moderate (6) |
| Poliah (2017) | South Africa, upper-middle income |
FSWs Sex work location: Not reported Mean age: not reported Education: Primary/less: 65.2% Secondary/higher: 34.8% Martial status: Never married: 94.8% Currently married/in relationship: 2.6% Divorced/separated/widowed: 1.9% |
Purposive | Depression | PHQ-9 using cut-off score >5 | 121 | 150 | 80.9% | Moderate (5) |
| Depression and anxiety | SRQ-20 using cut-off score >7 | 120 | 78.4% | ||||||
| Rhead (2018) | Zimbabwe, lower-middle income | FSWs Sex work location: Not reported Age range: 19–58 y Education: Primary/less: 42.5% Secondary/higher: 57.5% Marital status: Never married: 4.6% Currently married/in relationship: 50.0% Divorced/separated /widowed: 44.8% |
Random sampling of venues followed by respondent driven sampling | Psychological distress | Shona Symptom Questionnaire Cut-off not reported |
43 | 174 | 24.7% | Moderate (6) |
| Roberts (2018) | Kenya, lower-middle income | HIV-negative FSWs Sex work location: Brothel, lodge, bar, other entertainment establishment: 88.0% Street/public place: 0% Home: 12.1% Median age: 33.5 y (IQR: 27.2–40.6) Education: 3.1 y (IQR: 1.2–9.8) Marital status: not reported |
Purposive | Depression | PHQ-9 using cut-off score >10 | 30 | 283 | 10.6% | Moderate (6) |
| PTSD | PCL-C using cut-off score >30 | 63 | 22.1% | ||||||
| EASTERN MEDITERRANEAN | |||||||||
| Lari (2014) | Iran, upper-middle income | FSWs with history of drug use who are engaged with harm reduction centres Sex work location: not reported Mean age: 32.5 y (range: 16–51) Education status: only reported for secondary: 39.2% Marital status: only reported for divorced: >50.0% |
Nonprobability sample | Psychological distress | Symptom Checklist-90 Cut-off not reported |
NA | 125 | NA | Weak (4) |
| Ranjbar (2019) | Iran, upper-middle income | FSWs Sex work location: not reported Age: 30.9 y (range: 18–45) Education and relationship status: not reported |
Purposive | Mental health disorders | GHQ-28 using cut-off score >23 | 30 | 48 | 62.5% | Weak (4) |
| Structured Clinical Interview for DSM-IV mood disorders | 16 | 53.5% | |||||||
| Structured Clinical Interview for DSM-IV anxiety disorders | 11 | 36.7% | |||||||
| EUROPE | |||||||||
| Lang (2011) | Armenia, lower-middle income | FSWs Sex work location: Street/public place: 100% Median age: 33.8 y (range: 20–52) Education and relationship status: not reported |
Purposive | Depressive symptoms | CES-D-8 item using cut-off >7 | 53 | 117 | 45% | Moderate (5) |
| SOUTH EAST ASIA | |||||||||
| Ghose (2015) | India, lower-middle income | HIV-positive FSWs attending an HIV clinic Sex work location: Brothel, lodge, bar, other entertainment establishment: 92% Street/public Place: 8% Mean age: 23 y Education and relationship status: not reported |
Purposive | Depression | Hospital Anxiety Depression Scheme Cut-off not reported |
30 | 100 | 30% | Moderate (5) |
| Anxiety | 44 | 44% | |||||||
| Hengartner (2015) | Bangladesh, lower-middle income | FSWs Sex work location: Brothel, lodge, bar, other entertainment establishment: 71.8% Home: 61.8% Mean age: 23.2 y (range 11–48) Education: Yes: 23.0%; No: 77.0% Marital status: Currently married/in relationship: 23.2% |
Response driven sampling | Major depressive disorder | WHO Mental Health Composite International Diagnostic Interview Cut-off not reported |
11 | 259 | 4.2% | Moderate (6) |
| Generalised anxiety disorder | 54 | 20.8% | |||||||
| PTSD | 8 | 3.1% | |||||||
| Iaisuklang (2017) | India, lower-middle income | FSWs enrolled in an HIV programme Sex work location: not reported Mean age: 29.5 y Educational status: Primary/less: 24.0% Secondary/higher: 45.0% Martial status: Never married: 9.0% Currently married/in relationship: 34.0% Divorced/separated/widowed: 57.0% |
Purposive | Major depressive disorder | MINI International Psychiatric Interview cut-off not reported | 9 | 100 | 9% | Weak (4) |
| Generalised anxiety disorder | 8 | 8% | |||||||
| PTSD | 21 | 21% | |||||||
| Pandiyan (2012) | India, lower-middle income | FSWs who use alcohol or drugs, attending psychiatric outpatient department Demographics not reported |
Purposive | Depression | GHQ items not specified Cut-off not reported Clinical interview to confirm diagnosis |
142 | 200 | 71% | Weak (3) |
| Anxiety | 84 | 42% | |||||||
| Patel (2016) | India, lower-middle income | FSWs Sex work location: Brothel, lodge, bar, other entertainment establishment: 27.6%, street/public place: 4.5%, Home: 13.9%, Mobile phones: 54% Mean age: 31.0 y Education: Yes: 43.8%, No: 56.2% Marital status: Never married: 5.0% Currently married/in relationship: 66.5% Divorced/separated/widowed: 28.5% |
Random sampling | Depression | PHQ-2 using cut-off >3 | 696 | 2,400 | 29% | Strong (9) |
| Patel (2015) | India, lower-middle income | FSWs Sex work location: Brothel, lodge, bar, other entertainment establishment: 7.7% Street/public place: 63.8%, Home: 28.5% Age, education, and relationship status: not reported |
Random sampling | Depression | PHQ-2 using cut-off >3 | 778 | 1,986 | 39.2% | Strong (9) |
| Shahmanesh (2009) | India, lower-middle income | FSWs Sex work location: Brothel, lodge, bar, other entertainment establishment: 57.6% Street/public place: 22.8% Home: 28.1% Mean age: not reported Education: Yes: 32.7%, No: 67.3% Martial status: Never married: 28.4% Currently married/in relationship: 31.3% Divorced/separated/widowed: 40.3% |
Respondent driven sampling | Depression and anxiety | Kessler-10 Cut-off not reported |
NA | 326 | NA | Strong (7) |
| Suicide ideation past 3 months | Suicide items not described | 114 | 34.9% | ||||||
| Suicide attempts past 3 months | 61 | 18.7% | |||||||
| Suresh (2009) | India, lower-middle income | FSWs Sex work location: Street/public place: 100% Mean age: 34 y (range: 20–27) Educational: Secondary: 51% Marital status: not reported |
Purposive | Depression | CES-D cut-off not reported | 49 | 57 | 86% | Weak (4) |
| PTSD | PCL-C using cut-off >45 | 31 | 56% | ||||||
| Ever suicide ideation | Ever having thoughts of suicide at the level of forming a plan | 17 | 30% | ||||||
| WESTERN PACIFIC | |||||||||
| Brody (2016) | Cambodia, low income | Female entertainment workers Sex work location: Brothel, lodge, bar, other entertainment establishment: 100.0% Mean age: 25.6 y Education: Formal education: 6.4 y (mean) Marital status: Never married: 44.1% Currently married/in relationship: 28.6% Divorced/separated/widowed: 27.2% |
Two-stage cluster sampling method | Psychological distress | GHQ-12: mean score for whole sample used as cut-off | 284 | 657 | 43.2% | Strong (8) |
| Suicide ideation past 3 months | Suicide items not described | 128 | 19.5% | ||||||
| Suicide attempts past 3 months | 48 | 7.3% | |||||||
| Carlson (2017) | Mongolia, lower-middle income | FSWs with harmful level of alcohol use Demographics not reported |
Purposive | Depression | BSI depression subscales using cut-off >63 | 134 | 222 | 60.4% | Moderate (5) |
| Chen (2017) | China, upper-middle income | FSWs working in commercial sex venues Sex work location: Brothel, lodge, bar, other entertainment establishment: 100% Mean age: 25.2 y (range: 18–42) Education: Secondary/less: 7.4% Secondary/higher: 25.5% Marital status: Never married: 30.2% Currently married/in relationship: 63.2% Divorced/separated/widowed: 6.0% |
Random sampling venues and purposive selection of FSWs | Depression | CES-D 20 using cut-off score >16 | 189 | 457 | 41.3% | Moderate (5) |
| Gu (2010a) | China, upper-middle income | FSWs who inject drugs Sex work location: Brothel, lodge, bar, other entertainment establishment: 100% Mean age: not reported Education: Secondary/below: 75.5% Secondary/higher: 24.5% Marital status not reported |
Snowball sampling | Depression | Depression subscale of Chinese Depression Anxiety Stress Scale Cut-off not reported |
NA | 234 | NA | Moderate (6) |
| Hopelessness | Chinese Hopelessness Scale Cut-off not reported |
NA | NA | ||||||
| Gu (2010b) | China, upper-middle income | FSWs who inject drugs Sex work location: not reported Mean age: 28.1 y Education: Primary/less: 17.6% Secondary/higher: 82.4% Marital status: Never married: 53.7% Currently married/in relationship: 19.0% Divorced/separated/widowed: 26.4% |
Convenience | Psychological Distress | "You hate yourself very much" | 155 | 216 | 71.8% | Moderate (5) |
| "You feel very depressed" | 167 | 77.3% | |||||||
| "You are suffering from severe insomnia" | 142 | 65.7% | |||||||
| Gu (2014) | China, upper-middle income | FSWs who inject drugs Sex work location: Brothel, lodge, bar, other entertainment establishment: 100% Mean age: 33.9 y Education: Primary/less: 13.6% Secondary/higher: 86.4% Marital status: Never married: 36.0% Currently married/in relationship: 46.5% Divorced/separated/widowed: 17.5% |
Snowball sampling | Depression | Depression subscale of Chinese Depression Anxiety Stress Scale using cut-off >21 | 78 | 200 | 39.0% | Moderate (6) |
| Suicide ideation past 6 months | "Have you thought of committing suicide in the past 6 months?" | 89 | 44.7% | ||||||
| Suicide attempt past 6 months | “Have you attempted to commit suicide in the past 6 months?” | 54 | 26.8% | ||||||
| Hong (2010) | China, upper-middle income | FSWs Sex work location: Brothel, lodge, bar, other entertainment establishment: 100% Median age: 22.5 y (range: 16–42) Education: <6 y: 33.6%, 7–9 y: 48.1% >9 y: 29.6% Marital status: Not married: 85.5%, Currently married/in relationship: 14.5% |
Purposive | Depression | CESD-10 using cut-off score of >16 | 94 | 310 | 30.3% | Moderate (6) |
| Suicide ideation past 6 months | “In the past 6 months, have you thought of committing suicide?” | 55 | 17.8% | ||||||
| Suicide attempt past 6 months | “In the past 6 months, have you attempted to commit suicide?” | 28 | 9.0% | ||||||
| Hong (2007a)***, Fang (2007)***, Wang (2007)*** | China, upper-middle income | FSWs Sex work location: Brothel, lodge, bar, other entertainment establishment: 100.0% Mean age: 23.5 y Education (y): 5.8 y Marital status: Never married: 60.0% Currently married/in relationship: 35.2% Divorced/separated/widowed: 4.9% |
Random sampling venues and purposive selection of FWSs | Suicide ideation past 6 months | “In the past 6 months, have you thought of committing suicide?” | 40 | 454 | 14.2% | Strong (7) |
| Suicide attempt past 6 months | “In the past 6 months, have you attempted to commit suicide?” | 23 | 8.4% | ||||||
| Hong (2007b) | China, upper-middle income | FSWs Sex work location: Street/public place: 100% Mean age: 23.5 y Education (y): 5.84 y (mean) Martial status: Never married: 57.5% Currently married/in relationship: 35.2% Divorced/separated/widowed: 6.9% |
Purposive | Depression | CES-D 10 using cut-off score ≥16 | 174 | 278 | 62.6% | Moderate (6) |
| Hong (2013)†, Su (2014)†, Zhang (2014a)†, Zhang (2014b)†, Zhang (2017)† | China, upper-middle income | FSWs Sex work location: Brothel, lodge, bar, other entertainment establishment: 91.2%, Mini hotels and streets: 8.7% Mean Age: 24.8 y Education status: Primary/less: 63.4% Secondary/higher: 36.6% Marital status: Never in relationship: 71.5% Ever in relationship: 28.5% |
Random sampling venues and purposive selection of FSWs | Depression | CES-D 10 using cut-off score ≥16 | 502 | 1,022 | 49.1% | Strong (8) |
| Severe suicide ideation or suicide attempt | Ever “seriously considered killing yourself” or ever “tried to kill yourself” | 97 | 9.5% | ||||||
| Ever suicide ideation | Ever “seriously considered killing yourself | 83 | 8.0% | ||||||
| Ever suicide attempt | Ever “tried to kill yourself” | 49 | 4.8% | ||||||
|
Huang (2014)§, Zaller (2014)§, Yang (2018)§ |
China, upper-middle income | FSWs Sex work location: Brothel, lodge, bar, other entertainment establishment: 100.0% Median age: 23.5 y (IQR 20.9–26.4 y) Education: Secondary/less: 56.7% Secondary/higher: 43.5% Marital status: Currently married/in relationship: 44.5%, Single/divorced/widowed: 54.4% |
Random sampling venues and purposive selection of FSWs | Depression | CES-D using cut-off >20 | 34 | 154 | 22.1% | Strong (7) |
| Anxiety | Social anxiety scale using cut-off >60 | 6 | 3.9% | ||||||
| Suicide ideation past year | Suicide ideation item not described | 15 | 9.7% | ||||||
| Suicide attempt past year | Suicide attempt item not described (authors noted having plan as indicating an attempt) | 9 | 5.8% | ||||||
| Suicidal behaviour past year | Suicide behavior not described | 8 | 5.2% | ||||||
| Jackson (2013) | China, upper-middle income | FSWs Sex work location: Brothel, lodge, bar, other entertainment establishment and street/public place: 100% Mean age: 26.7 y Education: Primary/less: 13.9% Secondary/higher: 86.9% Marital status: Currently married/in relationship: 64.4% |
Purposive | Depression | CES-D cut-off not reported | NA | 395 | NA | Weak (4) |
| Muth (2017) | Cambodia, lower-middle income | HIV positive FSWs Sex work location: Brothel, lodge, bar, other entertainment establishment: 100.0% Median age: 32 y (IQR: 28–35) Education: Primary/less: 85.0% Secondary/higher: 15.0% Martial status: not reported |
Purposive | Psychological distress | Kessler-10 cut-off not reported | 27 | 88 | 31% | Moderate (6) |
| Offringa (2017) | Mongolia, lower-middle income | FSWs Sex work location: Brothel, lodge, bar, other entertainment establishment and street/public place: 100% Mean age: 35.2 y Education: Primary/less: 7.8% Secondary/higher: 92.2% Martial status: Divorced/separated/widowed: 52.3% |
Random sampling | Depression | BSI depression subscale Cut-off not reported |
NA | 204 | NA | Strong (7) |
| Sagtani (2013) | Nepal, low income | FSWs Demographics not reported |
Snowball sampling | Depression | CES-D 20 using cut-off >16 | 173 | 210 | 82.4% | Strong (8) |
| Shen (2016) | China, upper-middle income | FSWs working in commercial sex venues Sex work location: Brothel, lodge, bar, other entertainment establishment and street/public place: 100% Mean age: not reported Education: Primary/less: 23.4% Secondary/higher: 76.5% Marital status: Not married: 42.3% Currently married: 43.6% |
Convenience sampling | Depression | GHQ-12 Chinese version using sample mean score as cut-off | 342 | 653 | 52.4% | Moderate (6) |
| Shrestha (2017) | Nepal, low income | FSWs (and MSM/trans) Sex work location: Brothel, lodge, bar, other entertainment establishment and street/public place: 100% Mean age: not reported Education by literacy status: Yes: 67.8% No: 32.1% Marital status: Currently married/in relationship: 59.0% |
Random sampling | Depression | CES-D using cut-off >22 | 112 | 610 | 18.3% | Strong (7) |
| Ever suicide ideation | Suicide item not described | 210 | 4.4% | ||||||
| Urada (2013) | Philippines, lower-middle income | FSWs Sex work location: Brothel, lodge, bar, other entertainment establishment: 100.0% Median age: 22 y (IQR: 20–25) Education: 10 y (IQR 9–10) Martial status: Currently married/in relationship: 29.0% Living alone/separated/widowed: 71% |
Purposive | Depression | CES-D 24 using cut-off >23 | 83 | 143 | 58% | Moderate (6) |
| Witte (2010) | Mongolia, lower-middle income | FSWs who had recent unprotected sex with client, enrolled in National AIDs Foundation Program Sex work location: not reported Mean age: 28 y (range 18–40) Education: Secondary/higher: 100% Marital status: Never married: 67.0% |
Purposive | Depression | BSI-depression subscale Cut-off score not reported |
19 | 48 | 38% | Weak (4) |
| Yang (2005) |
China, upper-middle income | Female migrants engaged in sex work Sex work location: Brothel, lodge, bar, other entertainment establishments: 100.0% Mean age: 23.9 y (mean) Education: Secondary/less: 92.3% Marital status: Never married: 76.9% |
Random sampling of venues and convenience sample of FSWs | Depression | CES-D 20 using cut-off >16 | 20 | 40 | 50% | Moderate (6) |
| AMERICAS | |||||||||
| Devóglio (2017) | Brazil, upper-middle income | FSWs Sex work location: not reported Mean age: 26.8 y Education: Secondary/less: 30.1% Higher than secondary: 92.6% Relationship status: Never married: 94.0% Currently married/in relationship: 6.0% Divorced/separated/widowed: 4.8% |
Purposive | Depression | Hospital Anxiety and Depression scale Cut-off not reported |
11 | 83 | 13.2% | Moderate (5) |
| Anxiety | 33 | 39.7% | |||||||
| González-Forteza (2014) | Mexico, upper-middle income | FSWs Sex work location: Brothel, lodge, bar, other entertainment establishment: 48% Street/public place: 16% Median age: 28.8 y Education: Primary/less: 31.4% Secondary/higher: 60.8% Marital status: Never married: 49.0% Currently married/in relationship: 28.0% Divorced/separated/widowed: 22.3% |
Purposive | Depression | MINI International Psychiatric Interview, including suicide risk | 41 | 103 | 39.8% | Weak (3) |
| Ever suicide risk | MINI International Psychiatric Interview, including suicide risk: “Do you ever feel like life is not worth living?” “Have you ever thought about killing yourself. If so, how would you do it?” | 40 | 38.8% | ||||||
| Jain (2019) | Mexico, upper-middle income | FSWs Sex work location: not reported Median age: 38 y (IQR: 20–46) Education: Secondary: 44.1% Marital status: not reported |
Purposive | Depression | Beck Depression Inventory using cut-off score >20 | 106 | 295 | 35.9% | Moderate (5) |
| Logie (2018) | Jamaica, upper-middle income | FSWs who are lesbian and bisexual women Sex work location: not reported Mean age: 27.2 y (range: 19–43) Education: not reported Marital status: Never married: 8.9% Currently married/in relationship: 71.1% |
Purposive | Depression | PHQ-2 using cut-off >3 | 42 | 45 | 93.33% | Moderate (6) |
| Rael (2017a)‡, Rael (2017b)‡ | Dominican Republic, upper-middle income | HIV-negative FSWs with dependent children Sex work location: Brothel, lodge, bar, other entertainment establishment: 70.1% Mean age: 27.5 y Education: 8.4 y (mean) Marital status: Currently married/in relationship: 32.4% |
Purposive sample | Depression | CES-D 10 using cut-off >10 | 245 | 349 | 70.20% | Moderate (6) |
| Semple (2019) | Mexico, upper-middle income | FSWs in street-based work and establishment-based indoor sex work Sex work location: Brothel, lodge, bar, other entertainment establishment: 39.0% Street/public place: 61.0% Mean age: 33.6 y (range: 18–56) Education: Primary/less: 41.8%, secondary/higher: 59.1% Marital status: Never married: 56.0% Currently married/in relationship: 28.8% Divorced/separated/widowed: 14.7% |
Time-location sampling | Depression | Beck Depression Inventory using cut-off score >20 | 155 | 426 | 36.4% | Moderate (6) |
| Ulibarri (2009)Ꝁ, Ulibarri (2014)Ꝁ | Mexico, upper-middle income | HIV-negative FSWs Sex work location: Brothel, lodge, bar, other entertainment establishment: 41.2% Street/public place: 54.8%, Other: 3.2% Mean age: 33.4 y (range 18–64) Education: 6.13 y (mean) Marital status: Never married: 46.0% Currently married/in relationship: 33.0% Divorced/separated/widowed: 26.0% |
Purposive | Psychological distress (depression and somatization) | Brief Symptom Inventory Subscales: depression and somatization (cut-off not reported) |
NA | 916 | NA | Moderate (5) |
| Ulibarri (2013) | Mexico, upper-middle income | FSWs who inject drugs Sex work location: not reported Mean age: 33.7 y Educational status: 7.1 y (mean) Martial status: Never married: 49.0% Currently married/in relationship: 38.0% Divorced/separated/widowed: 13.3% |
Purposive | Depression | CES-D 10 using cut-off >10 | 538 | 624 | 86.2% | Moderate (6) |
| Ulibarri (2015) | Mexico, upper-middle income | FSWs who use drugs and have a regular partner Sex work location: not reported Mean age: 37.3 y (mean) Education: 6.7 y (mean) Marital status: Currently married/in relationship: 98.0% |
Snowball sampling | Depression | CES-D 10 cut-off not reported | NA | 214 | NA | Moderate (5) |
*Papers report findings on same study but explore different associations with outcome of interest.
**Papers report findings on same study but explore different associations with outcome of interest.
***Papers report findings on same study but explore different associations with outcome of interest.
†Papers report findings on same study but explore different associations with outcome of interest.
§Papers report findings on same study but explore different associations with outcome of interest.
‡Papers report findings on same study but explore different associations with outcome of interest.
ꝀPapers report findings on same study but explore different associations with outcome of interest.
Abbreviations: BSI, Brief Symptom Inventory; CES-D, Centre for Epidemiological Studies Depression Scale; DSM-IV, Diagnostic and Statistical Manual of Mental Disorders, 4th edition; FSW, female sex worker; GHQ, General Health Questionnaire; HIV, human immunodeficiency virus; IQR, interquartile range; MINI, Mini-International Neuropsychiatric Interview; MSM, men who have sex with men; NA, not applicable; PCL, PTSD CheckList; PCL-C, PTSD CheckList – Civilian Version; PHQ, Patient Health Questionnaire; PTSD, post-traumatic stress disorder; SRQ, WHO Self-Reporting Questionnaire.