Legal Framework and Sexual and Reproductive Health Challenges Faced by Female Sex Workers in Sri Lanka: A Narrative Literature Review

Introduction: The term “sex work” refers to adults providing consensual sexual services for money or goods. This study aims to investigate the Sexual and Reproductive Health (SRH) challenges encountered by female sex workers (FSWs) in Sri Lanka, emphasising the interplay between legal frameworks, SRH issues, access to health services and violence.

Methods: A structured narrative review was conducted using academic databases and grey literature. An initial pool of 257 documents was identified of which 52 were selected for in-depth analysis. Data from the selected documents were manually extracted, charted, and analysed using thematic analysis. Key themes were categorised under (i) theoretical perspectives, (ii) legal and policy frameworks (national and global), (iii) SRH challenges, (iv) access to SRH services, and (v) experiences of violence and stigma.

Results: The study illuminates the complex challenges faced by FSWs, highlighting the inherent vulnerability resulting from early initiation into sex work (6% before 18 years), a high number of sexual partners (25 per month), and limited access to contraception and SRH healthcare. FSWs are at increased risk of Sexually Transmitted Infections, with high risk for unintended pregnancies and unsafe abortions. They also endure violence across various life stages, perpetuated by social stigma and discrimination. The current legal framework, which doesn’t explicitly criminalise sex work but penalises solicitation and brothel-keeping, remains inadequate to protect FSWs’ safely. Debate continues regarding potential legal reforms, with some advocating for legislation to safeguard FSWs’ human rights.

Conclusion: Addressing SRH challenges faced by FSWs in Sri Lanka requires urgent, evidence-based legal reforms and integrated health and social support systems to uphold their overall well-being.