Intended for healthcare professionals

Letters Better health for sex workers

Prostitution is a symptom of structural inequalities

BMJ 2018; 362 doi: (Published 19 September 2018) Cite this as: BMJ 2018;362:k3631
  1. Fabienne El-Khoury Lesueur, postdoctoral researcher
  1. Sorbonne université IPLESP, Equipe de recherche en épidémiologie sociale (ERES), Faculté de médecine Pierre et Marie Curie, pôle Saint-Antoine, 27 rue de Chaligny, Paris 75012, France
  1. fabienne.khoury{at}

Behaviours do not exist in a vacuum. Structural inequalities influence many health determinants and behaviours, with social gradients affecting factors ranging from self esteem to smoking, bad diet, and cancer.123 Examining any outcome while disregarding the structure of the society that shapes it is nonsensical.

Prostitution is at the intersection of many structural inequalities …

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