Effect of the registration policy for female sex workers in Senegal
Effect of the registration policy for female sex workers in Senegal on physical and mental health
Abstract: Senegal is the only sub-Saharan country where prostitution is legal and regulated by a health policy. To solicit clients in public places, female sex workers need to register with authorities and attend monthly routine health checks aiming to test and treat sexually transmitted infections.
The paper aims to evaluate the effect of this policy on physical and mental health. Based on a theoretical model, we show that registration can affect physical health in two opposite directions since registration leads to a greater number of sex acts, which has a detrimental effect on physical through greater infection risk, but at the same time, registration is associated with greater investment in health capital. The theoretical model also highlights that registration is expected to negatively affect mental health through increased stigma.
Using a unique data set from Senegalese sex workers, we test those results empirically. Given the voluntary nature of registration, we use propensity score matching in order to construct a balanced sample of registered and non-registered sex workers. Our results show that registration has a positive effect on physical health and confirm that it has a detrimental effect on mental health. Empirical analysis also sheds light on two unintended consequences of the policy that accentuate its negative effect on mental health: firstly, registered sex workers engage in riskier and more degrading sex acts and secondly, they have less social support from their co-workers.
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Diana Quirmbach