Sex workers' professional agency, quality of life, and problematic substance use in Finland

Introduction: Sex workers suffer considerable marginalization that limits their choices and exposes them to various types of harm. Hence, it is important to examine sex workers' professional agency and its association with quality of life. In the current study, we investigated professional agency, quality of life, and problematic substance use among sex workers in Finland. Methods: Using an online survey, we collected data from 136 sex workers contacted through Finnish sex work organizations and social media platforms. We conducted correlational analyses between the study variables and linear regression analyses with professional agency as the independent variable and quality of life and problematic alcohol and drug use as dependent variables. Results: As expected, in the regression analyses, professional agency was strongly positively associated with quality of life (β = 0.86, p < 0.001) and negatively associated with problematic alcohol (β = −0.38, p = 0.002) and drug (β = −0.69, p < 0.001) use. Professional agency explained as much as 73% of the variance in quality of life. Most sex workers rated their quality of life as either good or very good. Conclusion: Our results underscore the importance of professional agency to sex workers' well-being, explaining a substantial proportion of the variance in quality of life. Promoting agency should therefore be at the heart of sex work policymaking. However, as most of the respondents were Finnish-born cis women, our results might not generalize to foreign-born, male, and gender diverse sex workers. Future studies should prioritize reaching these populations to ensure broader representativeness.