The Unanticipated Benefits of Behavioral Assessments and Interviews on Anxiety, Self-Esteem and Depression Among Women Engaging in Transactional Sex

Abstract

Women engaging in transactional sex have disproportional mental health co-morbidity and face substantial barriers to accessing social services. We hypothesized that participation in a longitudinal research study, with no overt intervention, would lead to short-term mental health improvements. For 4-weeks, 24 women disclosed information about their lives via twice daily cell-phone diaries and weekly interviews. We used t tests to compare self-esteem, anxiety, and depression at baseline and exit. Tests were repeated for hypothesized effect modifiers (e.g., substance abuse severity; age of sex work debut). For particularly vulnerable women (e.g., less educated, histories of abuse, younger initiation of sex work) participation in research conferred unanticipated mental health benefits. Positive interactions with researchers, as well as discussing lived experiences, may explain these effects. Additional studies are needed to confirm findings and identify mechanisms of change. This work contributes to the growing body of literature documenting that study participation improves mental health.

Keywords: Anxiety; Cell phones; Depression; Self-esteem; Sex worker.