Participatory Research Project on sex workers and health

  • Study title: Sexual health and HIV/STI-Prevention strategies and needs of sex workers
  • Research objectives: 1) Differentiated description of sex workers' prevention strategies and of the changes brought about by the “Prostituiertenschutzgesetz” (Prostitutes’ Protection Law) and the Covid pandemic; 2) Identification of conducive and obstructive factors in prevention, testing and treatment services for sex workers; 3) Characterization of the potential of the HIV pre-exposure prophylaxis (PrEP) as a safer sex method for sex workers and description of the barriers to fully unfolding it.
  • Method: Focus groups with sex workers
  • Target group: sex workers working in Germany from different living and working contexts
  • Project duration: 01.04.2022 - 31.03.2024
  • Project Manager: Eléonore Willems; +30690087-73;

Background and questions

Globally, sex workers have an increased risk of acquiring HIV[1]. Among the reasons for this are the persistent (often multiple) stigmatization and discrimination, criminalization and experiences of violence. At the same time, many people in sex work have inadequate or no access to health services, for example if they are not health insured. So far, there is little scientifically knowledge about the situation in Germany.

With the qualitative study "Sexual Health and HIV/STI Prevention Strategies and Needs of Sex Workers”, Deutsche Aidshilfe wants to answer some questions about the situation of sex workers in Germany. For this purpose, sex workers with different (e.g. biographical, socio-economic or socio-cultural) backgrounds, with different gender identities and from different living and working contexts are to be questioned within focus groups on the following topics:

  1. Which health risks (especially with regard to HIV and sexually transmitted infections/STIs) do sex workers perceive and what strategies do they use to protect their own health? How do or did sex workers deal with the structural changes brought about by the ProstituiertenSchutzGesetz, which came into force in July 2017 and, among other things, introduced mandatory health counseling as a condition for legally engaging in sex work, as well as with the changes brought about by the Covid pandemic (specifically occupational bans and the reduction of prevention services)?
  2. Which prevention, testing and care services do sex workers use and how do they use them? What are barriers to accessing these services? Which needs are not (sufficiently) covered by the existing services?
  3. What are the needs and barriers among different groups of sex workers regarding the use of HIV pre-exposure prophylaxis (PrEP) as a safer sex method?

The study should incorporate the experiences of a high diversity of people in sex work in order to capture different needs and requirements of sex workers.

Goals and benefits of the project

The results as well as recommendations for action from the project are to be published in scientific articles and in a brochure as well as online. The research findings should have a positive impact on several levels:

  1. Sex workers can learn more about the different needs of their communities and will be able to articulate and substantiate their demands better.
  2.  Prevention services for sex workers can be improved according to the identified needs of the different target groups. In addition, the development of new services can be supported by the project results.
  3.  Evidence-based recommendations to policy makers should contribute to the development of structures that improve the health as well as living and working conditions of sex workers. At the same time, the results can provide an important contribution to the evaluation of the Prostituiertenschutzgesetz.

Research Methods and Participation

The study follows a purely qualitative research design. People currently engaged in sex work in Germany will be interviewed in the context of several different focus groups. Focus groups are small groups, which are stimulated to discuss a specific topic by an information input and an open moderation. Up to seven groups with a maximum of 10 participants are planned, who for each group have certain factors in common (e.g. sex work on the street or identification as trans*).

The group discussions are expected to take place at different locations in Germany starting in October 2022. In order to fully incorporate the diverse experiences of migrant sex workers into the project, the focus groups will be conducted in different languages. Peer researchers, i.e. members of the sex worker community, will moderate the focus groups. For this purpose, they will receive a training and an allowance of 100€.

The conversations will be recorded acoustically, transcribed and the transcripts will be translated into German. The evaluation of the data will be presented in such a way that the anonymity of the individuals is preserved. Participants in the focus groups will receive an expense allowance of 100€.

Based on the results, recommendations for action will be developed in a participatory process with members of the sex worker community and further research needs will be formulated.

A project advisory board with representatives from communities, research and professional practice will be formed soon to accompany and advise the project throughout its entire duration.


The project is funded by the German Federal Ministry of Health.

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You have questions about the project? You want to make a suggestion? You are a sex worker in Germany and are interested in participating in a focus group? Please get in touch with Eléonore Willems:
Deutsche Aidshilfe
Wilhelmstr. 138
10963 Berlin
Eléonore Willems, M.A. Political Science, has among other things accompanied the participatory research project positive stimmen 2.0 and was herself in sex work for a while.

[1] See for instance UNAIDS, HIV and Sexwork, Human Rights Fact Sheet Series, 2021 (Short link: oder Beyrer, C. et al., An action agenda for HIV and sex workers, The Lancet, 2015, 385 (9964): 287–301 (Short link: