CLIENT-PERPETRATED VIOLENCE AND PSYCHOLOGICAL WELL-BEING AMONG FEMALE SEX WORKERS IN PAKISTAN

Abstract

Sex work in Pakistan exists within a nexus of legal prohibition, social stigma, and endemic violence, rendering sex workers among the most psychologically vulnerable populations in the country. Client-perpetrated violence encompassing physical assault, sexual coercion, verbal abuse, and psychological intimidation constitutes a pervasive occupational hazard that profoundly undermines the mental health of those engaged in sex work (Shannon et al., 2015). This study investigates the nature, frequency, and psychological consequences of client violence experienced by sex workers in Pakistan, with particular focus on its associations with depression, post-traumatic stress disorder (PTSD), anxiety, self-esteem deterioration, and suicidal ideation. Drawing on a quantitative framework, data were collected from 200 sex workers across urban and semi-urban settings, using structured interviews and validated psychometric instruments including the Harvard Trauma Questionnaire (HTQ) for PTSD, and the DASS-21 for depression, anxiety, and stress (Lovibond & Lovibond, 1995; Mollica et al., 1992). Findings reveal that an overwhelming majority of participants reported experiencing at least one form of client violence, with physical and sexual violence being the most frequently cited. Regression analyses demonstrated that sexual and physical violence emerged as the strongest independent predictors of trauma and stress. Structural factors including criminalization, police harassment, social marginalization, and absence of legal recourse were identified as compounding barriers that exacerbate psychological harm and prevent access to mental health services.