Pregnancy prevention and contraceptive preferences of online sex workers in the UK

Objectives: The internet has changed the organisation of sex work. The risk of sexually transmitted infections has frequently been a research focus, but less is known about sex workers’ use of contraception for pregnancy prevention. The aim of this research was to gain a better understanding of contraceptive preferences and provider interactions of online sex workers. Methods: Data were obtained from a multi-methods study of sex workers in the UK who advertise on the internet and have sexual contact with clients, particularly in the Birmingham and Solihull areas. The study comprised an online survey among 67 participants and eight qualitative interviews. Results: Reported high rates of condom use with clients led to sex workers considering pregnancy prevention to be a personal rather than an occupational issue. Disclosure of sex working to health professionals is often seen as unnecessary and/or undesirable due to concerns about stigma. A clear distinction between contraceptive needs for commercial and non-commercial partners was evident. Conclusion: Service providers need to take account of both personal and commercial needs during contraceptive consultations and avoid making assumptions based on homogeneous understandings of sex work. Encouraging disclosure of sex work to facilitate appropriate discussions may need new approaches to combat privacy and stigma concerns