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The Impact of the COVID-19 Pandemic and Lockdowns on Sex Workers in West Bengal, India.

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Title: The Impact of the COVID-19 Pandemic and Lockdowns on Sex Workers in West Bengal, India.
Authors: Lewis, Katherine A.1, Ray, Protim2, Janibekyan, Emma3, Kaushik, Niharika4, Anigol, Darshna5, Tieu, Denise3, Luo, Zhenyi3, Hernandez, Leonel3, Sen, Asim2, Kumar, Suchith6, Fehrenbacher, Anne E.1, Swendeman, Dallas7 DSwendeman@mednet.ucla.edu
Source: Journal of Community Health. Aug2025, Vol. 50 Issue 4, p668-681. 14p.
Subject Terms: *Sexually transmitted diseases, *Qualitative research, *Anxiety, *COVID-19 pandemic, *Mental depression, Sex work, Mental health, Health status indicators, HIV, Research funding, Interviewing, Food security, Stay-at-home orders, Thematic analysis, Financial stress, Intersectionality, Cisgender people, Trans women, Social support, Social isolation, Sexual health
Geographic Terms: India
Abstract: India's COVID-19 lockdowns were among the strictest globally, and sex workers were uniquely impacted. Extremely limited literature has examined pandemic consequences on sex workers. We use a qualitative approach to examine the impact of the COVID-19 pandemic and lockdowns on the lives and livelihoods of sex workers in urban West Bengal, India. Cisgender female and male, and transgender female sex workers (N = 40) participated in individual in-depth interviews. Interviews were coded using inductive thematic coding. Nine themes arose from the data: (1) COVID-19 pandemic and lockdowns, (2) Social isolation, (3) Lack of customers, (4) Financial stress, (5) Decreased negotiating power, (6) Food insecurity, (7) Receiving support, (8) Providing support, and (9) Mental health. We propose a Gendered Stress Proliferation Model incorporating Pearlin et al.'s 1997 conceptualization of stress proliferation and Swendeman, Fehrenbacher et al.'s 2018 gendered stress process model. In this model, primary stressors of COVID-19 pandemic and lockdowns proliferated into secondary stressors across multiple domains (social isolation, lack of customers, financial stress, food insecurity, reliance on support, decreased negotiating power). All of these pathways were shaped by pre-existing vulnerabilities and systems of intersectional marginalization. These stressors had significant mental health impacts including feelings of depression and anxiety. Food insecurity has implications for physical health outcomes, and financial stress coupled with decreased negotiating power has implications for sexual health, potentially placing sex workers at increased risk of sexually transmitted infections and HIV. Gendered Stress Proliferation may be a useful framework to examine how marginalized populations uniquely experience population-level crises. [ABSTRACT FROM AUTHOR]
Copyright of Journal of Community Health is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: The Impact of the COVID-19 Pandemic and Lockdowns on Sex Workers in West Bengal, India.
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  Data: <searchLink fieldCode="AR" term="%22Lewis%2C+Katherine+A%2E%22">Lewis, Katherine A.</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Ray%2C+Protim%22">Ray, Protim</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Janibekyan%2C+Emma%22">Janibekyan, Emma</searchLink><relatesTo>3</relatesTo><br /><searchLink fieldCode="AR" term="%22Kaushik%2C+Niharika%22">Kaushik, Niharika</searchLink><relatesTo>4</relatesTo><br /><searchLink fieldCode="AR" term="%22Anigol%2C+Darshna%22">Anigol, Darshna</searchLink><relatesTo>5</relatesTo><br /><searchLink fieldCode="AR" term="%22Tieu%2C+Denise%22">Tieu, Denise</searchLink><relatesTo>3</relatesTo><br /><searchLink fieldCode="AR" term="%22Luo%2C+Zhenyi%22">Luo, Zhenyi</searchLink><relatesTo>3</relatesTo><br /><searchLink fieldCode="AR" term="%22Hernandez%2C+Leonel%22">Hernandez, Leonel</searchLink><relatesTo>3</relatesTo><br /><searchLink fieldCode="AR" term="%22Sen%2C+Asim%22">Sen, Asim</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Kumar%2C+Suchith%22">Kumar, Suchith</searchLink><relatesTo>6</relatesTo><br /><searchLink fieldCode="AR" term="%22Fehrenbacher%2C+Anne+E%2E%22">Fehrenbacher, Anne E.</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Swendeman%2C+Dallas%22">Swendeman, Dallas</searchLink><relatesTo>7</relatesTo><i> DSwendeman@mednet.ucla.edu</i>
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  Data: <searchLink fieldCode="JN" term="%22Journal+of+Community+Health%22">Journal of Community Health</searchLink>. Aug2025, Vol. 50 Issue 4, p668-681. 14p.
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  Data: *<searchLink fieldCode="DE" term="%22Sexually+transmitted+diseases%22">Sexually transmitted diseases</searchLink><br />*<searchLink fieldCode="DE" term="%22Qualitative+research%22">Qualitative research</searchLink><br />*<searchLink fieldCode="DE" term="%22Anxiety%22">Anxiety</searchLink><br />*<searchLink fieldCode="DE" term="%22COVID-19+pandemic%22">COVID-19 pandemic</searchLink><br />*<searchLink fieldCode="DE" term="%22Mental+depression%22">Mental depression</searchLink><br /><searchLink fieldCode="DE" term="%22Sex+work%22">Sex work</searchLink><br /><searchLink fieldCode="DE" term="%22Mental+health%22">Mental health</searchLink><br /><searchLink fieldCode="DE" term="%22Health+status+indicators%22">Health status indicators</searchLink><br /><searchLink fieldCode="DE" term="%22HIV%22">HIV</searchLink><br /><searchLink fieldCode="DE" term="%22Research+funding%22">Research funding</searchLink><br /><searchLink fieldCode="DE" term="%22Interviewing%22">Interviewing</searchLink><br /><searchLink fieldCode="DE" term="%22Food+security%22">Food security</searchLink><br /><searchLink fieldCode="DE" term="%22Stay-at-home+orders%22">Stay-at-home orders</searchLink><br /><searchLink fieldCode="DE" term="%22Thematic+analysis%22">Thematic analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Financial+stress%22">Financial stress</searchLink><br /><searchLink fieldCode="DE" term="%22Intersectionality%22">Intersectionality</searchLink><br /><searchLink fieldCode="DE" term="%22Cisgender+people%22">Cisgender people</searchLink><br /><searchLink fieldCode="DE" term="%22Trans+women%22">Trans women</searchLink><br /><searchLink fieldCode="DE" term="%22Social+support%22">Social support</searchLink><br /><searchLink fieldCode="DE" term="%22Social+isolation%22">Social isolation</searchLink><br /><searchLink fieldCode="DE" term="%22Sexual+health%22">Sexual health</searchLink>
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  Label: Geographic Terms
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  Data: <searchLink fieldCode="DE" term="%22India%22">India</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: India's COVID-19 lockdowns were among the strictest globally, and sex workers were uniquely impacted. Extremely limited literature has examined pandemic consequences on sex workers. We use a qualitative approach to examine the impact of the COVID-19 pandemic and lockdowns on the lives and livelihoods of sex workers in urban West Bengal, India. Cisgender female and male, and transgender female sex workers (N = 40) participated in individual in-depth interviews. Interviews were coded using inductive thematic coding. Nine themes arose from the data: (1) COVID-19 pandemic and lockdowns, (2) Social isolation, (3) Lack of customers, (4) Financial stress, (5) Decreased negotiating power, (6) Food insecurity, (7) Receiving support, (8) Providing support, and (9) Mental health. We propose a Gendered Stress Proliferation Model incorporating Pearlin et al.'s 1997 conceptualization of stress proliferation and Swendeman, Fehrenbacher et al.'s 2018 gendered stress process model. In this model, primary stressors of COVID-19 pandemic and lockdowns proliferated into secondary stressors across multiple domains (social isolation, lack of customers, financial stress, food insecurity, reliance on support, decreased negotiating power). All of these pathways were shaped by pre-existing vulnerabilities and systems of intersectional marginalization. These stressors had significant mental health impacts including feelings of depression and anxiety. Food insecurity has implications for physical health outcomes, and financial stress coupled with decreased negotiating power has implications for sexual health, potentially placing sex workers at increased risk of sexually transmitted infections and HIV. Gendered Stress Proliferation may be a useful framework to examine how marginalized populations uniquely experience population-level crises. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
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  Data: <i>Copyright of Journal of Community Health is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1007/s10900-025-01452-y
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 14
        StartPage: 668
    Subjects:
      – SubjectFull: Sexually transmitted diseases
        Type: general
      – SubjectFull: Qualitative research
        Type: general
      – SubjectFull: Anxiety
        Type: general
      – SubjectFull: COVID-19 pandemic
        Type: general
      – SubjectFull: Mental depression
        Type: general
      – SubjectFull: Sex work
        Type: general
      – SubjectFull: Mental health
        Type: general
      – SubjectFull: Health status indicators
        Type: general
      – SubjectFull: HIV
        Type: general
      – SubjectFull: Research funding
        Type: general
      – SubjectFull: Interviewing
        Type: general
      – SubjectFull: Food security
        Type: general
      – SubjectFull: Stay-at-home orders
        Type: general
      – SubjectFull: Thematic analysis
        Type: general
      – SubjectFull: Financial stress
        Type: general
      – SubjectFull: Intersectionality
        Type: general
      – SubjectFull: Cisgender people
        Type: general
      – SubjectFull: Trans women
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      – SubjectFull: Social support
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      – SubjectFull: Social isolation
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      – SubjectFull: Sexual health
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      – SubjectFull: India
        Type: general
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      – TitleFull: The Impact of the COVID-19 Pandemic and Lockdowns on Sex Workers in West Bengal, India.
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