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PLoS Medicine
Public Library of Science
Publication Date
DOI: 10.1371/journal.pmed.0040300
  • Correspondence
  • Mental Health
  • Public Health And Epidemiology
  • Respiratory Medicine
  • Health Policy
  • Public Health
  • Smoking
  • Substance Use (Including Alcohol)
  • Economics
  • Medicine


10.1371_journal.pmed.0040300.pdf PLoS Medicine | 1702 Correspondence The US Anti-Prostitution Pledge: A Call for Cooperation Jay Silverman, Michele Decker Masenior and Beyrer’s article is an important contribution to the continuing debate as to the direction of public health efforts regarding commercial sex work [1]. The authors are correct in that the debate between those focused on the social and economic rights of prostituted women and girls as “workers” and those focused on preventing the trafficking of women and girls into prostitution has resulted in precious little dialogue on how to best proceed. Regrettably, as illustrated by the authors, the US anti- prostitution pledge may well have contributed to the polarization of these two groups. However, to make progress, multiple realities must be acknowledged and considered. The authors present the conflation of sex trafficking and prostitution as a barrier to effective action and policy that must be eliminated; however, compelling evidence exists to support such conflation. Specifically, approximately half of sex workers are prostituted as minors [2,3]. Studies including prostituted minors indicate that virtually all were trafficked into sex work [4], and studies of sex workers across multiple countries indicate that the majority would prefer to leave prostitution if it were safe and economically feasible to do so [2,5]. Thus, anti-trafficking advocates may reasonably contend that maintaining the institution of sex work through decriminalization and organization of health and social welfare programs will likely lead to continued trafficking of women and girls to maintain this highly profitable activity. On the other hand, as presented by Masenior and Beyrer, the many thousands of women and girls involved in commercial sex work need and deserve assistance based on the tremendous health risks they suffer (e.g., HIV infection). However, those focused on promoting the health of sex

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