International Journal of Community Medicine and Public Health | April 2017 | Vol 4 | Issue 4 Page 886
International Journal of Community Medicine and Public Health
Paul R et al. Int J Community Med Public Health. 2017 Apr;4(4):886-890
http://www.ijcmph.com
pISSN 2394-6032 | eISSN 2394-6040
Review Article
Factors influencing health-care access of female commercial sex
workers in India: an in-depth review
Rudrajit Paul
1
*, Meera Suresh
2
, Jayati Mondal
3
INTRODUCTION
Commercial sex workers (CSW) comprise a marginalized
and vulnerable section of any society. As a group, CSW
includes male, female, children and transgenders. In this
in-depth review, we will concentrate on only adult female
CSWs belonging to the reproductive age group (15-49
years) in India. We have decided to focus on this
demographic group as it is the largest section among
CSWs in India.
The exact number of female CSWs in any region is
difficult to estimate because of the covert nature of this
profession. One estimate in India, done by mapping and
census, puts the number of CSWs at 0.2 to 0.5% of the
adult female population of any region.
1
In another study,
it was estimated that up to 1% of the adult female
population of reproductive age may be engaged in
commercial sex in certain parts of India.
2
However, while
brothel based CSWs are easier to reach, non-brothel
based CSWs are often untraceable. This latter
unorganised group is also likely to be more vulnerable in
terms of age and unmet healthcare needs. In one study
from Andhra Pradesh, India it was found that nearly 50%
of home based female CSWs were less than 24 years of
age.
3
CSWs have diverse health problems. Prevalence of
various diseases like sexually transmitted diseases
(STDs) is very high among CSWs. A study from Surat,
India showed 43% prevalence of HIV and 23%
prevalence of Syphilis in female CSWs.
4
Another study
from south India found that female CSWs had very high
levels of alcohol and tobacco abuse and up to 78% of
them had psychiatric co-morbidity.
5
In summary, female CSWs in India comprise a large and
vulnerable population with high prevalence of various
health problems. In this review, we aim to review (based
on available literature) some of the problems in accessing
health-care faced by this vulnerable population.
ABSTRACT
Commercial sex workers (CSW) are a vulnerable section of the society with diverse health problems. However,
different surveys have consistently shown limited healthcare access by this group. There are a lot of factors, related
both to the health care facility and the potential users, which influence this access. In this review, we have analysed
some of the factors affecting healthcare access of female CSWs in India. The analysis has been done according to a
standard conceptual framework. Certain remedial measures have also been proposed at the end.
Keywords: Commercial sex worker, Healthcare access, Barrier, Policy
1
Dept. of Medicine, Medical College Kolkata. West Bengal, India
2
Program & Quality Control Manager, KDPP-KSM, Sree Chitra Tirunal Institute for Medical Sciences & Technology
Trivandrum, Kerala, India
3
RMO, Chittaranjan Seva Sadan, Kolkata, West Bengal, India
Received: 20 February 2017
Accepted: 14 March 2017
*Correspondence:
Dr. Rudrajit Paul,
E-mail: r.paul.medicalcollege@gmail.com
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
DOI: http://dx.doi.org/10.18203/2394-6040.ijcmph20171302