Health and prostitution in Germany: requirements for prevention based on a systematic literature review

Background. The health of sex workers in Germany is closely associated to their profession. Due to the precarious living conditions, prostitutes suffer in general from a worse health status compared to the general population. Objectives. The aim of this paper is to present the current state of research regarding the health situation of sex workers in Germany. Which factors are the cause of challenges concerning health care and which target groups are predominantly vulnerable are also determined. Materials and methods. Through a systematic review, 13 publications were identified which discuss health-related issues related to sex workers in Germany. The research was conducted in February 2018 in PubMed and includes all studies published since 2002. Results. Overall, the health status of sex workers is worse than the health status of the general population. However, this cannot be generalized for all health-related aspects. Previous studies investigated in particular the prevalence of sexually transmitted infections (STI). Sex workers with a migrant background and male prostitutes were identified as vulnerable groups which suffer from a restricted access to health care. Conclusions. The results indicate a special need for prevention among prostitutes. Underlying causes are the generally poorer state of health of sex workers, the challenges associated with the work as a prostitute as well as legal aspects. So far mainly the occurrence of STI has been investigated; therefore, experiences of violence as well as associated health impairments should be addressed in the future.