Reasons for Entering into Sex Work in Iran: A Comparison Between Women Who Initiated Sex Work as Minors and Those as Adults

This study explored reasons for women’s entry into sex work using data from the national bio-behavioral survey of female sex workers (FSWs) in Iran. We also compared FSWs’ reasons for those who entered sex work as a minor (< 18) versus those as an adult (≥ 18). We recruited 1347 FSWs who reported having sex in exchange for money, goods, services, or drugs with at least two clients in the previous year in 13 large cities. Participants were asked about their main reason for entering into sex work. Overall, economic hardship was the main reason for entry into sex work (56.2%), followed by personal choice (20.2%), environmental forces (16.6%), and drug use (7.0%). While economic hardship was the main reason in all birth cohorts, it decreased from 68.3% among FSWs born before 1970 to 39.6% among those born in 1990 or later. Compared to women who began sex work as adults, women who entered sex work as minors were more likely to report environmental forces (31.5% vs. 15.2%, P < 0.001) and less likely to report economic hardship as reasons for beginning sex work (36.2% vs. 58.7%, P = 0.003). Our data suggest that the engagement of women in sex work in Iran is multi-factorial. The main factor is dependence on sex work for income which highlights the need for economic empowerment programs. Programs should also target environmental forces and provide access to social support services for those who have entered sex work as minors.