Reviewer’ s report
Title: Factors influencing women’ s sex work in a Lebanese sample Results of a case-control study
Version: 0Date: 05 Nov 2019
Reviewer: Susan Dewey
Reviewer's report:
I was initially very excited to read a paper based on research in Lebanon, which is understudied in
an otherwise quite crowded field of studies on women in sex work. Unfortunately, review of theabstract considerably dampened my enthusiasm after I saw the study's framing of women in sexwork as mentally ill addicts whose previous experiences with abuse in various forms led to theircurrent predicament. This is already well-trodden terrain, as is the recruitment of women fromsettings where they are most likely to have had terrible life experiences (i.e. prison), and simplyoffering a repetition of findings from a Lebanese case study is insufficient to warrant publicationwithout revisions.
Here is what I suggest in terms of revisions, because I strongly believe that this work with
incarcerated women should be published:
1. Include consideration of whether factors currently experienced by sex worker study participants
are potentially the product of the pervasive stigma that universally accompanies prostitution, ratherthan prostitution itself. The authors need to do at least some work in the introduction and theliterature review to emphasize why they chose the factors that they did—trauma, child abuse, depression, anxiety, and stress— since a boatload of studies have already
explored these issues among women in sex work.
2. Specify in the title and throughout the paper that the sample was selected from a women's
prison, so that readers will know that the women included are more likely than their peers who arenot incarcerated to have had negative experiences in lower paid forms of prostitution where theyare more likely to be assaulted and otherwise harmed. In some ways, conducting a study ofprostitution in a women's prison is like conducting a study of marriage in a shelter for victim-survivors of intimate partner violence—the researchers are nearly determined to find that womenhave had negative experiences.
3. Emphasis how the case control provides new and unique contributions, as most studies of
women in prostitution do not include this benefit. To this end, it will be important for the authorsto emphasize the experiences of incarcerated women who did not admit to being involved inprostitution. What, in the authors' view, might have informed women's decisions to disclose beinginvolved (or not) in prostitution? Case files are insufficient to determine a woman's involvement inprostitution, as this information is self-reported. What implications does this have for studyresults?
4. The literature review needs a major revision to emphasis key debates about sex work (sex
worker rights, neo-abolitionism, harm reduction, public health, etc.), the dearth of literature fromthe Middle East, and engage with the literature on women in prison to emphasize the uniquenessof this population.
5. The paper needs a thorough edit to ensure it complies with formatting standards and standard
English.
6. At present the paper reads like a long list of statistical results that would likely be easier to
process as a table, graph, or chart. A careful revision will emphasize analysis of the work by
evaluating the significance of these findings more thoughtfully, rather than just reporting them.
I realize that implementing these revisions will require quite a bit of work but I think that it will be
worth the effort, as just by virtue of producing research from Lebanon the authors are likely toreceive a high number of citations.
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
YesDoes the work include the necessary controls?
If not, please specify which controls are required in your comments to the authors.
Yes
Are the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
NoAre you able to assess any statistics in the manuscript or would you recommend an
additional statistical review?If an additional statistical review is recommended, please specify what aspects require furtherassessment in your comments to the editors.
I am able to assess the statisticsQuality of written English
Please indicate the quality of language in the manuscript:
Not suitable for publication unless extensively editedDeclaration of competing interests
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