Open research questions in Sex work and related issues

What the literature leaves open

• Lalita Devi1, Muskan Bhatia2 1PhD. Research Scholar, Department of Laws, Guru Nanak Dev University, Amritsar 2Assistant Professor, Law and Legal Studies, DAV University, Jalandhar ABSTRACT Human trafficking is one of the most pervasive forms of transnational organised crime in the world. It constitutes grave violation of fundamental human rights. If we analyse historically, the trafficking conversation has centered on women and children, while male victims have received very less consideration. This paper discusses some of the recent trends emerging around the trafficking of men, which is a marked but underrepresented development in victim profiles, especially within the realm of labour and sexual exploitation. Following a doctrinal and analytical research methodology, the study looked at international as well as domestic legal frameworks such as the Protocol to Prevent, Suppress and Punish Trafficking in Persons, especially Women and Children) and various provisions under BNS. This paper examines that despite the formal gender neutrality, these frameworks respond inadequately to men. It fails to adequately identify and address the specific vulnerabilities of male victims. It studies the various socio-cultural barriers such as the traditional complex concept of masculinity and underreporting reports of male victims. These factors contributes to the invisibility of male survivors in the criminal justice system. The institutional barriers, lack of gender inclusive policies and inadequate rehabilitation mechanism further exacerbate the marginalization of trafficked males. This study recommends targeted reforms in male victim identification, to promote support services and strict legal enforcement of legal framework so that equitable justice can be provided to all the victims without any prejudice of their gender.

  Male Victimization in Human Trafficking: Legal Frameworks, Challenges and Policy Recommendations · 2026 · DOI

• Despite the strengths of this research study, several limitations must be noted. Namely, the sampling strategy, small sample size, and southwestern geographical focus limit the generalizability of the study findings. Additionally, this study relied exclusively on service provider perspectives. While service providers offer critical insights into harm reduction, the absence of survivor-centered perspectives limits our understanding of how these approaches are experienced by survivors themselves. Moreover, study participants tended to work in agencies focused on lower-income, often unhoused populations, limiting our understanding of other types of survivors. Findings may also be influenced by social desirability bias, particularly given participants’ professional roles and commitments to harm reduction principles. Finally, our study examined substance use and harm reduction for survivors of sex trafficking specifically, without attention paid to survivors of labor trafficking. Even though substance use is less commonly documented among survivors of labor trafficking, SUD rates among labor trafficking survivors remain high (Dell et al., 2025), and future research is needed to examine how harm reduction strategies and outreach can be effectively tailored to address substance use among labor trafficking survivors. In future qualitative studies, including survivor-centered perspectives and 24 ARTICLE IN PRESS ARTICLE IN PRESS ACCEPTED MANUSCRIPT expanding the geographic focus would deepen understanding of harm reduction attitudes, implementation, and impact across diverse settings and populations.

  “People are going to do drugs:” harm reduction as a strategy for survivors of sex trafficking who use substances · 2026 · DOI

• To our knowledge, this is the first study to explore the role of potentially supportive family members of STSC participants using family-report data. Focusing on the perceptions and characteristics of these family members illuminates possible avenues through which family members may be able to offer support and promote women’s success within specialty court programs. Some limitations should be acknowledged. All participants were recruited from one STSC program. Familial relationships between family members and specialty court participants may vary across regional contexts. All family members were located within a 90-minute radius, it is unclear how familial support and other relational dynamics may vary among family members in farther proximities. Additionally, women who are arrested and thus have the possibility of entering such a program are likely to have different experiences and potentially different family environments compared to other members of this population who are participating in other types of substance use treatment. J Hum Traffick. Author manuscript; available in PMC 2026 June 09. A u t h o r M a n u s c r i p t A u t h o r M a n u s c r i p t A u t h o r M a n u s c r i p t A u t h o r M a n u s c r i p t Murnan et al. Page 17 Notably, all women who reached out and were screened were eligible and, as such, had a family member willing and able to participate. Women without family who perceived themselves as supportive were likely to have elected not to reach out to the study team. Conclusions about the prevalence of supportive family members are limited as we did not screen all STSC participants for supportive family members. Findings illuminated from the current sample of family members cannot be generalized to all family members as they were hand-selected by court participants as supportive of their treatment success. STSC participants may have family members, who directly threaten their safety and recovery either via abusive behaviors or seeking to exploit, interfere with their recovery, or coerce them back into the sex trade industry. Any effort seeking to engage family supports into treatment programming for this population need to be consciously aware and attentive to the potential presence of such harmful family members.

  Characteristics, Experiences, and Perceptions of Family Members of Sex Trafficking Specialty Court Participants: An Exploratory Qualitative Inquiry · 2026 · DOI

• Drawing from Longwe’s framework and the study findings, the following social work and policy recommendations are proposed: ● Integrate female scrap collectors into local development planning through the formal recognition of their labour, provision of PPE, and designated safe workspaces. ● Facilitate collective organisation, such as cooperatives or support networks, to enable participation, advocacy, and peer-led change. These could be facilitated by practitioners at the Department of Small Business Development and Department of Cooperative Governance and Traditional Affairs. ● Promote rights-based and feminist conscientisation initiatives facilitated by social workers and community development practitioners to build awareness of gendered oppression and labour rights. ● Ensure access to essential services, including mobile health units, psychosocial counselling, legal support, childcare facilities and access to safety nets such as social protection. ● Advocate for gender-sensitive policy reforms that include informal workers in health and safety regulations and provide protection against gender-based violence.

  “He left us in the dark forest and unloaded us off the truck”: Work and health related vulnerabilities of female scrap collectors in rural Eastern Cape and the implications for women’s rights · 2026 · DOI

• Given limited evidence regarding sex workers’ use of overdose prevention tools, including take-home naloxone (THN), we examined period prevalence, time trends, and structural factors longitudinally associated with THN ownership among sex workers over 7 years.

  Take-home naloxone (THN) ownership among a community-based cohort of sex workers who use drugs in metro vancouver: longitudinal trends and structural determinants (2017–2024) · 2026 · DOI

• Examination of this understudied group of MSS may serve to inform criminal justice professionals in the effort to decrease the demand of illegal sex solicitation.

  The Other Side of the Sex Work Equation: A Scoping Review of What We Know About Men Who Solicit Sex in the United States · 2026 · DOI

• The current study offers new perspectives on the evolving characteristics of those involved in CSEM offences, yet its contributions are bound by certain limitations. We used demographic information from the B.C. Corrections administrative data pull, along with items from the STABLE-2007 and ACUTE-2007 scales as indicators of offending characteristics, both of which have substantial research supporting their validity (e.g., Babchishin et al., 2023; Brankley et al., 2021; Nitsche et al., 2022). Although these items were scored based on participant interviews, it is important to acknowledge that only a single item was used per construct, which is suboptimal for ensuring reliability (Diamantopoulos et al., 2012). Ideally, multiple items would have been included to ach­ ieve a more robust measurement of each construct. Participants were scored multiple times on STABLE-2007 and ACUTE-2007 measures, and we only used their first assess­ ment for their analyses. Additionally, the definition of the items in the current study Sexual Offending: Theory, Research, and Prevention 2026, Vol. 21, Article e16273 https://doi.org/10.5964/sotrap.16273 Cumulative Meta-Analysis: CSEM-Exclusive Versus Mixed 14 also does not exactly match the definition of the items in Babchishin et al.’s (2015) meta-analysis (see Table S1, Supplementary Materials, for the definition of the items in the current study in comparison to Babchishin et al.’s [2015] study). An additional limitation is the unequal sample size between the offending groups (238 CSEM-exclusive versus 94 mixed), which may influence effect size estimates and reduce statistical power. Another limitation of the current study is the data collection period. Data collection ranged from January 2005 and June 2013 (Mdn = 2009). Although this period is dated, it remains more recent than the data collection periods reported in Babchishin et al.’s (2015) meta-analysis. Among the six studies we used for the current cumulative metaanalysis (i.e., Finkelhor et al., 2009, 2012; Long et al., 2013; Neutze et al., 2011, 2012; Smid et al., 2015) that reported the data collection period, the dates ranged from June 2000 to August 2011 (Mdn = 2006). While our data are more recent than those in Babchishin et al. (2015), they were still collected between 2005 and 2013 (Mdn year = 2009) and thus may not reflect the most recent trends. Recent research suggests that the profile of individuals involved in CSEM offences may be evolving, with evidence indicating that individuals with CSEM offences are younger and that some offences may involve peer-to-peer dynamics, particularly in digital environments (Steel et al., 2024; van Wijk & Esseveldt, 2021). These trends suggest a possible shift in offender motivation, social context, and developmental background, potentially reflecting greater accessibility to exploitative material and the normalization of coercive behaviours in online spaces.

  Understanding variations among individuals with child sexual exploitation material offences: A cumulative meta-analysis · 2026 · DOI

• Our study has several important limitations. Our samples comprise only internet-using children; inferences are therefore limited to this subgroup. In high-connectivity countries (such as Malaysia and Thailand) this covers the majority of children, but substantial popu- lations remain excluded in low-connectivity settings (such as Ethiopia). Cross-sectional data preclude causal inference; we cannot determine whether knowing where to seek help facilitated disclosure, or whether Nature | www.nature.com | 9 disclosed experiences increased awareness of support channels. Binary measurement (for example, help seeking, premarital sex) of key con- structs provides only preliminary estimates. As such, all findings should be interpreted as identifying plausible associations that warrant future testing77 through ethically appropriate and feasible methodological approaches. The eight demographic and sociocultural factors we investigated are not exhaustive40 and other important influences may exist. It is also likely that quantitative measurements alone cannot capture sociocultural influences at a sufficiently granular level to fully shed light on disclosure. Furthermore, our theoretical operationalization of technology-facilitated CSEA may blur the distinction between potential versus actual forms of CSEA (such as, sending and receiving sexual images)18. Data were collected in 2020–2021 before the widespread emergence of generative artificial intelligence tools. Our measures therefore do not capture artificial-intelligence-facilitated forms of CSEA. Disclosure is also a multifaceted and continuous process, which our measurement may risk oversimplifying by treating as a sin- gular event32. As questions about barriers were administered only to non-disclosers, findings may under-represent barriers overcome by those who eventually disclosed. Finally, we acknowledge the position- ality of our authorship team. None of the authors are originally from eastern and southern Africa or Southeast Asia. While the Disrupting Harm project was designed by teams with local representation and implemented in partnership with local stakeholders, future work would be strengthened by increasing equitable representation and diversify- ing authorship78.

  Technology mediation in child sexual exploitation and abuse in Africa and Asia · 2026 · DOI

• Several limitations should be considered when inter- preting the findings of this study. First, recruitment through SWING introduced a sampling bias toward SWs already connected to peer support; thus, the perspectives of non-networked, undocumented, or rural workers may be underrepresented, affecting broader transferability. Second, preferences for LAI-PrEP remain largely hypothetical. As many participants (particularly FSWs) were first introduced to PrEP during this study, stated interest reflects anticipated acceptability rather than observed clinical uptake or long- term adherence. Third, the use of FGDs in a stigmatized context may have introduced social desirability bias, poten- tially influencing disclosures regarding sensitive behaviors. Logistical challenges, such as workplace-related late arriv- als and environmental noise, also impacted data collection sessions. Finally, while the HBM provides a structured framework, its individualistic focus may overlook broader systemic factors. We mitigated this by integrating structural issues such as criminalization and socio-economic precarity as prompts in the FGD sessions.

  Barriers and Enabling Factors for Taking PrEP: The Lived Perspectives of Female, Male and Transgender Sex Workers in Thailand · 2026 · DOI

• DISCUSSION AND CONCLUSION: Our findings contribute to the literature by offering new insights regarding previously underexplored challenges to social reintegration, highlighting significant gender differences in social stigmatization and systematic barriers like the scarcity of essential support services.

  Key Challenges Experienced by Bangladeshi Human Trafficking Survivors During Social Reintegration: Insights from Survivors, Experts, and Social Workers · 2025 · DOI

• A 2013 service-provider survey regarding the sexual exploitation of males by ECPAT-USA found that male survivors are vastly under reported, are at danger of significant health risks, receive fewer services, and the number of gay and transgender survivors has been overestimated in estimates of the total number of male survivors.

  A Look at Services for Male Victims of Sex Trafficking: 10 Years After the Report from ECPAT-USA · 2025 · DOI

• The Prevalence Reduction Innovation Forum (PRIF) project sought to bridge this gap in research by testing the various sampling methods in prevalence estimation in selected economic sectors in Brazil, Costa Rica, Morocco, Pakistan, Tanzania, and Tunisia.

  Human Trafficking Prevalence Research: Lessons and Practical Guidance from the Prevalence Research Innovation Forum (PRIF) · 2025 · DOI

• In Romania, the National Strategy Against Trafficking in Persons for the period 2024 - 2028 reveals that in the field of combating trafficking in human beings, the specialized human resources are insufficient, and the need to train the main categories of specialists who can come into contact with the alleged victims of trafficking in persons persists.

  UNSEEN FACES OF HUMAN TRAFFICKING · 2025 · DOI

• This article examines four critical gaps in the evidence-policy relationship on human trafficking and modern slavery (HTMS) in the UK: prioritization, epistemology, synchronization and trust.

  Mind the Gap(s)? Evidence and UK Policymaking on Human Trafficking and Modern Slavery · 2024 · DOI

• I identify seven issues in this research area: overstated objectives, a lack of evidence concerning the accuracy of human annotators and trafficking indicators, subjective interpretation of these indicators, an assumption of the veracity of ads as true representations of sex workers, a tendency to conflate human trafficking with sex work, and an oversimplified understanding of the experiences of human trafficking victims.

  Why We Cannot Identify Human Trafficking from Online Advertisements · 2024 · DOI

• The exploratory findings illustrate the importance of intelligence in risk assessment and decision-making processes during police operations, but also the need to conduct yet further research on risk assessment within the context of human trafficking investigations to inform policy and decision-making policing practices.

  Investigating organised human trafficking crimes: case studies of police investigations in England · 2024 · DOI

• Despite increases in online child sexual exploitation (OCSE) internationally, no study has examined risk factors for re-offending among females who perpetrate OCSE, resulting in limited knowledge regarding the idiosyncratic needs of this cohort.

  An Exploration of Risk Factors for Further Police Contact Among Females Known for Online Child Sexual Exploitation Offenses · 2024 · DOI

• Though many programs aim to serve youth who are (potential) victims of CSEC, it remains unclear what strategies and techniques are most helpful in engaging this population in treatment.

  “Flexibility and Consistency”: Qualitative Insights on Valuable Skills for Providers Working with Survivors of Child Sex Trafficking · 2023 · DOI

• Early career mental health professionals (professionals who have paraprofessional and pre-licensed status including graduate students and independently licensed mental health professional status who had been in practice five or fewer years) are likely to encounter survivors of sex trafficking in community agencies and private practices, yet little is known about how best to prepare professionals to provide counseling services to survivors of sex trafficking.

  Early-Career Mental Health Professionals’ Preparedness to Counsel Survivors of Sex Trafficking · 2023 · DOI

• Research limitations/implications As is usual in qualitative research, rather than obtain generalizable results, the main objective was to delve deeper into under-researched or complex issues (Polit and Beck, 2010).

  Impact of the COVID-19 pandemic on the health of survivors of trafficking for sexual exploitation: a qualitative study in Spain · 2023 · DOI

• Black and Brown youth, lesbian, gay, bisexual, transgender, and queer (LGBTQ) youth, youth with previous experiences of child and sexual abuse, youth in the foster care system, and those who have run away and/or are experiencing homelessness are disproportionately affected by CSEC, thus warranting special attention.

  Perspectives of Stakeholders Working to End the Commercial Sexual Exploitation of Children in Atlanta, Georgia · 2022 · DOI

• The objectives of this study were (1) to assess the knowledge and perceptions of human trafficking (HT) among leaders and staff from 11 community-based organizations (CBOs) and faith-based organizations (FBOs) in South Los Angeles, and (2) to identify gaps in knowledge of HT and inform community organizations regarding possible best practices in health promotion for addressing this emerging public health problem.

  Knowledge and perceptions of human trafficking among community-based and faith-based organization members in South Los Angeles · 2021 · DOI

• While numerous stakeholders have raised concerns regarding the potential effects of the Covid-19 pandemic on trafficked persons, very limited research exists documenting the effects of Covid-19 upon survivors.

  Impact of the COVID-19 pandemic on survivors of human trafficking in the Philippines · 2021 · DOI

• The proposed study is in line with the Sustainable Development Goals (SDGs) agenda; to date, limited research exists on the health consequences of human trafficking, and to our knowledge, no surveys have been conducted on the health needs of victims of trafficking for various forms of labor in the Republic of Moldova.

  The Health Impacts on Victims of Human Trafficking in the Republic of Moldova · 2021 · DOI

• This article addresses the present gap in research by exploring the rehabilitation and reintegration challenges faced by Albanian victims of sex trafficking and forced begging upon their return to Albania, as reflected by 15 professionals providing direct assistance to the victims.

  The Aftermath of Human Trafficking: Exploring the Albanian Victims’ Return, Rehabilitation, and Reintegration Challenges · 2021 · DOI

Most-cited papers in Sex work and related issues

• Violence and Legalized Brothel Prostitution in Nevada · Journal of Interpersonal Violence · 2005 · 151 citations
• Understanding Human Trafficking in the United States · Trauma Violence & Abuse · 2008 · 140 citations
• The mental health of female sex workers · Acta Psychiatrica Scandinavica · 2010 · 134 citations
• Antecedents to Prostitution · Journal of Interpersonal Violence · 1998 · 121 citations
• "Nobody gives a damn if I live or die": Violence, drugs, and street-level prostitution in inner-city Hartford, Connecticut · Medical Anthropology · 2003 · 119 citations
• Health Outcomes Among Women Trafficked for Sex in the United States · Journal of Interpersonal Violence · 2013 · 102 citations
• Sex Trafficking Into The United States: A Literature Review · Criminal Justice Review · 2006 · 94 citations
• The Prevalence of Sex Trafficking of Children and Adolescents in the United States: A Scoping Review · Trauma Violence & Abuse · 2020 · 85 citations
• Doors Wide Shut: Barriers to the Successful Delivery of Victim Services for Domestically Trafficked Minors in a Southern U.S. Metropolitan Area · Women & Criminal Justice · 2010 · 82 citations
• Strategies for engaging the private sector in sexual and reproductive health: how effective are they? · Health Policy and Planning · 2004 · 75 citations

Most recent work

• Crafting vulneramentality: Vulnerability (and resistance) among migrants with experiences of sex work in Malta · European Journal of Criminology · 2026
• Technology mediation in child sexual exploitation and abuse in Africa and Asia · Nature · 2026
• Experiences of Young Offenders of Child Sexual Exploitation Material Who Contact the Dutch Stop It Now Helpline: A Qualitative Study · Victims & Offenders · 2026
• ‘We are the cavalry, on the way to the rescue’: mobility-masculinity nexus among Chinese urban delivery workers during early Covid-19 lockdowns · Mobilities · 2026
• Barriers and Enabling Factors for Taking PrEP: The Lived Perspectives of Female, Male and Transgender Sex Workers in Thailand · AIDS and Behavior · 2026
• Prostitution, Sex Work, and Public Health: Scoping Review with ☸️SAIMSARA · SAIMSARA Journal · 2026
• Clothed, blurred, exposed: Visual privacy and Filipino male sexual labour on X (Twitter) · Sexualities · 2026
• Forced Labour and Human Trafficking: Definitions, Prevalence, and Legal Frameworks: International Norms, Local Realities · Zenodo (CERN European Organization for Nuclear Research) · 2026
• Addressing human trafficking in health care settings · Nursing · 2026
• HIV/AIDS risk factors among young single mothers working in alcohol-serving establishments in Rwanda · Discover Public Health · 2026

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