Literature Review: Risk Factors of Sexually Transmitted Infections among Commercial Sex Workers

Abstrak

Sexually transmitted infections (STIs) remain a major public health concern, particularly among commercial sex workers who experience repeated sexual exposure, multiple sexual partners, and unequal power in negotiating safe sex practices. This literature review aimed to identify risk factors associated with STI incidence among commercial sex workers, with a specific focus on condom use, duration of sex work, and number of clients. This study used a literature review method by collecting, identifying, and evaluating previous research articles. Articles were searched through electronic databases, including Google Scholar, PubMed, ScienceDirect, and ProQuest. The search was limited to studies published between 2021 and 2025 using the keywords “risk factors,” “commercial sex workers,” and “sexually transmitted infections.” Ten research articles that met the inclusion criteria were reviewed and analyzed. The findings showed that condom use was the most consistent factor associated with STI incidence. Most studies reported a significant relationship between inconsistent or unsafe condom use and higher STI risk, although one study found no significant association with chlamydia infection. Duration of sex work was also frequently associated with STI incidence, suggesting that longer involvement in sex work may increase cumulative exposure to sexual risks, condom failure, and reinfection. However, this factor showed more varied findings across studies, indicating that its effect may depend on other conditions such as access to screening, condom negotiation ability, and working environment. The number of clients was another important risk indicator, as higher client volume increased the frequency of sexual exposure and the possibility of contact with untreated infections. Overall, this review indicates that STI incidence among commercial sex workers is influenced by interconnected behavioral and occupational factors rather than a single determinant. Condom use and number of clients appeared to be the most consistent risk indicators, while duration of sex work showed more inconsistent results. STI prevention programs should therefore prioritize consistent condom use, free condom access, routine STI screening, targeted outreach for workers with high client volume, and supportive health services that reduce stigma and improve early treatment.