Global changes in migration, health, employment, and public policy are having a major impact on the sex industry. As editors of this themed issue on sex work have put together papers to document some of these changes, revisit the epidemiological and social understanding of the role of sex work in relation to sexually transmitted infections, and assess interventions that can reduce the burden of disease and of stigma on participants in the industry.

Major drivers of change in the sex industry are economic, demographic, ideological, and technological. Globalisation is the umbrella term used to express many of these changes, which include increased economic interdependence of different countries through trade, the extension of the world market to areas of the world previously isolated, increased movement of people and of capital, and the rapid spread of new technologies and media across wide sections of the globe.

Each of these aspects has had an impact on the sex industry.¹ For example, countries of the former Soviet Union have seen a massive economic transition with an increase in unemployment and radical restructuring of employment.^2,3 More people are seeking paid work and many cannot find it in the formal sector and look to alternatives, one of which is the sex industry.⁴ Some people move to urban centres, others to different countries in the hope of finding a better living. Some individuals, mainly women, are coerced into migrating for sex work or other forms of informal or unregulated labour. It is difficult to quantify the actual numbers of people selling sex but there are many reports of a widespread increase in numbers of sex workers.^5,6

This greater potential supply of sex workers seems to be matched by increased demand in many parts …