Understanding the Impact of EU Prostitution Policies on Sex Workers: A Mixed Study Systematic Review

Abstract Introduction There is a growing interest in legislation and policies regarding sex work in the European Union and a debate between two opposite perspectives: prostitution is a form of gender violence or a work lacking legal and social recognition. This review aims to develop an integrative synthesis of literature regarding the impact of prostitution policies on sex workers’ health, safety, and living and working conditions across EU member states. Methods A search conducted at the end of 2020 in bibliographic databases for quantitative, qualitative, and mixed methods peer-reviewed research, and grey literature published between 2000 and 2020 resulted in 1195 initial references eligible for inclusion. After applying the selection criteria, 30 records were included in the review. A basic convergent qualitative meta-integration approach to synthesis and integration was used. The systematic review is registered through PROSPERO (CRD42021236624). Results Research shows multiple impacts on the health, safety, and living and working conditions of sex workers across the EU. Conclusions Evidence demonstrates that criminalisation and regulation of any form of sex work had negative consequences on sex workers who live in the EU in terms of healthcare, prevalence and risk of contracting HIV and STIs, stigmatisation and discrimination, physical and sexual victimisation, and marginalisation due to marked social inequalities, for both nationals and migrants from outside the EU. Policy Implications The evidence available makes a strong case for removing any criminal laws and other forms of sanctioning sex workers, clients, and third parties, which are prevalent in the EU, and for decriminalisation. There is a need for structural changes in policing and legislation that focus on labour and legal rights, social and financial inequities, human rights, and stigma and discrimination to protect cis and transgender sex workers and ethnical minorities in greater commitment to reduce sex workers’ social inequalities, exclusion, and lack of institutional support. These measures could also positively impact reducing and monitoring human trafficking and exploitation.