Reviewing the Perspectives on the Relationship between Religious Beliefs and Sex Work: A Qualitative Systematic Review

: The intersection of religious beliefs and sex work has long been a subject of debate, with varying perspectives on the moral, social, and legal implications. This qualitative systematic review aimed to review the nuanced relationship between religious beliefs and sex work by synthesizing the existing literature and providing insights into the diverse perspectives and experiences. The rationale for this research is to understand how religious beliefs influence societal attitudes, policies, and the experiences of sex workers in order to inform more effective and culturally sensitive interventions and support mechanisms. This review focused on articles pertaining to female-identified sex workers, as the gendered discussion happens heavily in religious interpretations and in current anti-trafficking legislation, which now genders men as customers and not as sex workers. Five stages of systematic review were followed in this review. The following peer-reviewed electronic databases from 2000 to 2023 were utilized: Google Scholar, Scopus database, Science Direct, and PubMed. The search strategy focused on identifying studies that investigated the impact of religious beliefs on various aspects of sex work, including attitudes towards sex work within religious communities and the influence of religious teachings on the behavior and practices of sex workers. Inclusion criteria were defined based on population, exposure, study design, and outcomes, while exclusion criteria were established to ensure the relevance and rigor of the included studies. Only 25 relevant studies resulted from this research. Four themes emerged from this study: (1) religious attitudes towards sex work; (2) experiences of sex workers, including stigmatization and marginalization within religious contexts; (3) social control; and (4) empowerment and advocacy. The relationship between religious beliefs and sex work is complex and multifaceted, influenced by cultural, social, and historical factors. Recognizing and understanding these perspectives is essential for developing more inclusive and effective interventions and policies that address the needs and rights of sex workers within the context of their religious beliefs and communities.


Introduction
Sex workers refer to individuals who engage in consensual sexual activities in exchange for money or goods [1].Some religious traditions encourage compassion, empathy, and support for sex workers, but most denounce the practice as unethical and sinful [1].Social conflict is both encouraged and reinforced by religion, claims conflict theory [2].It fosters hatred and violence caused by religious differences and aids in persuading the impoverished to accept their position in life [2].It is interesting to note that religious convictions may, in the context of sex work, support discrimination against sex workers on the basis of moral grounds and contribute to their stigmatization and marginalization, increasing social inequality.
Sexes 2024, 5 172 Nonetheless, a number of scholars of religion contend that the significance placed on sexuality, particularly the sexuality of women, by many religious individuals demonstrates societal prejudice against women that is not justified by religious teachings [3,4].In the Bible (Deuteronomy 23:19-20, Matthew 21:12-13) and the Qur'an (2:275-280), lending money with interest and other "financial sins" are denounced at least as strongly as sexual sins.However, these verses are frequently disregarded or interpreted differently because banking and credit are now viewed as socially acceptable activities and regulated with the law [5].Additionally, Jesus is said to have rejected stigma and punishment for women who are perceived as sexual sinners in a number of biblical accounts, such as Luke 7:36-50 and John 8:1-114 [5].Every religion has a long history of offering consolation and assistance to the downtrodden and impoverished.This has been referred to as a "preferential option for the poor" in the Christian faith [6].Sex workers should be particularly included in this "preferential option" since they are some of the most disadvantaged and oppressed groups in society [7].The Catholic Bishop of Rustenburg, Kevin Dowling, has distributed free condoms to a large number of individuals, including sex workers, on the grounds that he feels protecting health and life is more vital than upholding Catholic teachings regarding contraception and sexual morality [8].
But the majority of religious organizations are adamant that sex work should remain illegal in South Africa and other countries [9,10].Because of these organizations' influence, the US government has implemented an "anti-prostitution pledge" that prevents funding from going to organizations that "advocate the decriminalization or practice of prostitution", even in cases where those organizations are giving sex workers essential health or other services [11][12][13].It is interesting to note that research has demonstrated how clearly sin and human dignity are distinguished in Judaism [14].Under Judaism, God did not take away the Israelites' human dignity or impose moral judgments on them; rather, he simply told them not to sin.On the other hand, the Torah makes it apparent that sex workers deserve respect and self-worth even though they are sinners by refusing to place moral judgments on Tamar and Ishter [14].Tamar, for instance, was not condemned but was ultimately seen as righteous for her actions to secure her place in her family lineage (Genesis 38).This implies that Judaism recognizes the inherent dignity of individuals regardless of their actions and refrains from casting moral aspersions on them.
Christianity also maintains that sinning does not deprive a person of their human dignity.This belief stems from the idea that all humans are created in the image of God (Genesis 1:27) and are worthy of respect and love.While sex work is viewed as sinful within Christian doctrine, as seen in the teachings of the New Testament, this sinfulness does not negotiate the person's inherent dignity.The New Testament recounts Jesus's interactions with sinners, including sex workers, whom He treated with compassion and respect, urging them to repent and sin no more (John 8:1-11).This perspective suggests that Christian societies should treat sex workers with dignity and compassion despite their involvement in activities deemed sinful.In Islam, the Quaran and Hadiths provide guidance on the treatment of individuals and the concept of sin.Like Judaism and Christianity, Islam teaches that human dignity is inherent and not contingent upon one's actions.The Quaran emphasizes the importance of treating all people with respect and kindness (Quaran 49:13).While sex work is considered sinful in Islam, the religion also advocates for the protection and fair treatment of all individuals, including sex workers.The principle of human dignity is paramount, and Muslims are encouraged to help those in sin find their way back to a righteous path without demeaning them [14].
On the other hand, sex work and the topics of human trafficking and sex trafficking touch on the fundamental ideas of gender, justice, morality, sexuality, and human rights [15].Christians have been an outspoken group on all three of these issues, which are widely perceived as intimately entwined, wicked, and repugnant [15].Therefore, it is expected that Christian activists will oppose sex work and think that women who are trafficked are being trafficked for the purpose of sexual enslavement; this is an incorrect perception that sex trafficking is the primary type of modern-day slavery [15].Interestingly, the late Rev. Dr. Margaret Fowler was a social worker by training and a United Church minister who was a leading proponent of LGBTQ rights and a prominent voice against human trafficking in Jamaica [16].As the organization's creator, Rev. Fowler assisted a great number of people who were forced into prostitution or sexually exploited.Notably, in order to combat human trafficking, Fowler argued that the church should adopt a handsoff stance [16].Interestingly, the authors noted that it is very important to highlight the distinctions among abuse, human trafficking, and prostitution.Abuse refers to the infliction of physical, emotional, or psychological harm on individuals, often without consent, while human trafficking involves the coercion, abduction, or deception of individuals for the purpose of exploitation [17].In contrast, prostitution involves the consensual exchange of sexual services for remuneration [17].This clarity helps address religious beliefs and their impacts on sex work.
Nonetheless, the question of what role religion plays in assisting sex workers in balancing sexuality and morality arises, given that spirituality and religion are seen as significant aspects of what it means to be human [18].Therefore, the authors did point out that studies on the subject of the connection between sex work and religion are scarce.With regard to the connection between religious beliefs and sex work, the goal of this study was to assess the body of evidence, pinpoint knowledge gaps, and provide guidance for policy and practice within the context of the relationship between religious beliefs and sex work.

Literature Review Methodology
A literature review is a critical analysis and assessment of prior studies and written works related to a specific topic or issue [19].It contributes to establishing the significance of the research being done, gives a summary of the present state of knowledge, and points out any gaps or contradictions in the literature [19].In order to thoroughly collect, assess, and summarize the current viewpoints on the connection between sex work and religious views, the authors employed a systematic review technique [20].In order to find and evaluate all pertinent research on a subject, a systematic review employs an organized methodology that reduces bias and produces a thorough overview of the available data [20].Using this method, researchers can methodically evaluate the consistency and quality of the literature, leading to more dependable conclusions and the identification of areas in need of additional study or intervention [19].The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) declaration served as the framework for a methodical evaluation of the scientific literature and official documents [19].The review has not been registered because it does not comply with certain requirements for registration with the International Prospective Register of Systematic Reviews (PROSPERO).The review was conducted using the five stages of systematic review, namely, the research question formulation, the literature search, data evaluation, data extraction and analysis, and the presentation of results.

Problem Identification
The research problem in this study was in understanding the complex interplay between religious beliefs and sex work, which involved navigating sensitive cultural, moral, and legal terrain.This intersection raised questions about the influence of religious teachings on societal perceptions, policymaking, and individual experiences within the context of sex work.In this stage, the researchers were guided by the research question to identify the research problem.The following research questions guided this review: How do various religious beliefs influence societal perceptions and attitudes towards sex work?What role do religious institutions and leaders play in shaping policies and interventions related to sex work?How do individuals engaged in sex work navigate their religious beliefs within their profession, and how does this impact their experiences?

Literature Search
The search for the literature was started by the authors in January 2024.The databases Scopus, Science Direct, PubMed, and Google Scholar were used in the literature search.Three steps were involved in implementing the search strategy: (1) a first search that only looked through databases; (2) a second search that looked through all the keywords and terms indexed in all the databases that were included; and (3) a search of the reference lists of the articles that were obtained but were not previously retrieved in the databases' literature search.It is very important to note that the authors reviewed English-language studies published from 2000 to 2023 because they noted that there are limited studies focusing on the relationship between sex work and religious beliefs.The full search strategy for each database is detailed in Appendix A. The authors managed to retrieve 25 relevant studies, and only 8 studies were not retrieved.The reasons for not retrieving those studies are access restrictions, database limitations, publication bias, and language limitations.However, the selection process for the studies is shown in Figure 1.
What role do religious institutions and leaders play in shaping policies and interventions related to sex work?How do individuals engaged in sex work navigate their religious beliefs within their profession, and how does this impact their experiences?

Literature Search
The search for the literature was started by the authors in January 2024.The databases Scopus, Science Direct, PubMed, and Google Scholar were used in the literature search.Three steps were involved in implementing the search strategy: (1) a first search that only looked through databases; (2) a second search that looked through all the keywords and terms indexed in all the databases that were included; and (3) a search of the reference lists of the articles that were obtained but were not previously retrieved in the databases' literature search.It is very important to note that the authors reviewed English-language studies published from 2000 to 2023 because they noted that there are limited studies focusing on the relationship between sex work and religious beliefs.The full search strategy for each database is detailed in Appendix A. The authors managed to retrieve 25 relevant studies, and only 8 studies were not retrieved.The reasons for not retrieving those studies are access restrictions, database limitations, publication bias, and language limitations.However, the selection process for the studies is shown in Figure 1.

Eligibility Criteria
The population, exposure, and outcome (PEO) model was utilized by Maily to help the authors formulate eligibility criteria [18].The same inclusion and exclusion criteria listed in Table 1 below was applied for choosing which papers were eligible for this evaluation.

Data Evaluation and Quality Appraisal
The 10-item Critical Appraisal Skills Program (CASP) Qualitative Studies Checklist was used to analyze and assess this study in order to reduce the possibility of bias and preserve rigor, appropriateness, and overall value [21].In addition, the authors used a modified checklist with 13 issues on a Likert scale of 0 to 2, in an effort to further enhance the quality of this study.Afterwards, 1 (ambiguous/partially reported), 2 (sufficiently reported), and 0 (not reported/not specified) were identified as scores [22].A score of 0 meant that the study contained no information about the topic at hand, while a score of 1 meant that the researchers touched on the issue briefly and insufficiently.A score of 2 indicated that the researchers had a full discussion of the subject and provided a clear and intelligible explanation of the approach.The quality assessment of the studies that were part of this evaluation is displayed in Table 2 below.

Data Extraction and Analysis
The data extraction process involved several systematic steps to ensure a thorough and consistent analysis.Initially, titles and abstracts were screened to identify potentially relevant studies, with irrelevant ones excluded based on the predefined criteria.This was followed by a full-text review of the remaining studies to confirm their relevance.During this stage, the methodological quality of each study, including the design, sample size, and data collection methods, was assessed.Using a piloted, modified form, the authors asked two reviewers to extract the study data on their own.Study parameters (e.g., study design, inclusion/exclusion criteria, participant characteristics, and age) were among the extracted data.The two reviewers discussed and compared the findings in order to resolve differences over data extraction.Subsequently, the two writers (Leshata Winter and Gsakani Olivia.)employed Creswell's Tesch technique for data analysis.The development of the codes aided the writers in developing the research's themes.To further ensure the reliability of the findings, studies were evaluated for bias, validity, and reliability.Any discrepancies in data extraction were resolved through discussion with the two reviewers.By following this criterion, the review maintained a rigorous approach to reading and analyzing the literature on the relationship between religious beliefs and sex work.

Presentation of Results
This review was made of female sex workers as dominant participants in the literature.This study included only 25 relevant studies.The majority of the studies were of good quality, which made this research more reliable.Four themes emerged from this study: (1) religious attitudes towards sex work; (2) experiences of sex workers, including stigmatization and marginalization within religious contexts; (3) social control; and (4) empowerment and advocacy.

Theme 1: Religious Attitudes towards Sex Work
According to the dissertation by Johnston, Matthew 1:1-17 presents Tamar and Rahab, both women said to be in the sex industry according to the Bible yet described without moral judgement [1].Even Jesus himself says very little about sex work except to tell the Pharisees that tax collectors and harlots will enter the kingdom of God before they will [23].The scriptural basis for classifying sexual behaviors outside of heterosexual marriage as "deviant" seems to stem from multiple passages penned by those regarded as having access to the Bible [1].Certain passages in the Old and New Testaments, such as Leviticus 19:29, which warn against forcing your daughter into prostitution or making her a harlot, can provoke anxiety and promote stigmatization.The passages express the worry that these actions could lead to widespread wickedness and harlotry throughout the nation.Sexual contact between two unmarried individuals is known as fornication, and by definition, this includes relationships between sex workers and their clients [24].
The New Testament's Abrahamic morality on sexuality seems to have its roots in Paul's epistolary letters to the churches following Jesus's crucifixion [1].Paul commanded that "the followers of Christ must always be exceptionally chaste: They do not or should not visit brothels (Rom 6:15-20) [25]", according to Knust in her book Abandoned to Lust: Sexual Slander and Ancient Christianity.They do not and should not put up with sexual immorality or fornication among themselves [25].These verses portray sex work as immoral, with the result that a sex worker would face rejection and estrangement from their family and community.They further warn that being immoral puts one at risk of divine retribution [26].While the Bible stigmatized harlotry more than conventions that still existed outside of Israel, Israelite culture nonetheless considered harlots degradingly; therefore, this framing of sexual "deviance" was consistent with the sexual mores of the time [27].
According to a study by McGrow, "many Christian ministries approach sex work from the perspective that the problem is a woman trapped and the solution is liberation via Christian ministry [26]".Rescue, renew, and restore ideology and language are common themes among Christian ministry outreach groups.The biblical verses mentioned above support the idea that sex employment is "immoral".It is evident that the way Christian communities frequently treat sex workers is largely justified by fears of salvation syndrome, isolation from the community, and not being accepted in paradise.Savior syndrome, also known as the white knight complex, is a phenomenon that is intrinsically connected to Christian hegemony and colonization.It is characterized by individuals who, while feeling morally superior, nevertheless feel burdened by caring for others, undermining the autonomy and dignity that those in need of services deserve.In order to purge or save everyone around them from what they see as evil, these saviors engage in violent or oppressive deeds [28].Nevertheless, McGrow contends that looking at sex workers through this prism is harmful to those who work in the field because it is based on the underlying presumptions that women have no other option, are severely harmed by prostitution, and are therefore defenseless victims in need of valiant intervention [26].
Studies conducted outside of Western Christianity in developing nations like China, Brazil, Indonesia, Thailand, and Ecuador concentrate on the religious views of sex workers and how these beliefs support them in their profession [29].Despite the fact that religious views in various regions do differ.The attachment style to God is different from that of Westernized religions, and as a result, the views on sex work also vary.For instance, sex labor for financial gain is viewed as an opportunity rather than something to be embarrassed of in Thailand, where God is revered as a protector and provider [18].According to Sorajjakool and Benitez's research, participants' attachment style to God was brought about by their family members' rejection and desertion, which led them to turn to God in order to satisfy their needs [18].In order to properly analyze the relationship between religious beliefs and familial dynamics, Sorajjakool and Benitez's study offers pertinent background information that was relevant to our research [18], implying that study participants felt alienated from their families because of their careers.
Conversely, some religious traditions take a more nuanced or compassionate approach to sex work.Within certain branches of Buddhism, for instance, there is an emphasis on nonjudgement and understanding towards individuals engaged in sex work, recognizing their humanity and inherent worth [30][31][32].Hinduism, with its diverse array of beliefs and practices, also contains teachings that advocate for empathy and support for marginalized communities, including sex workers [33].Some Hindu texts emphasize the importance of treating all beings with kindness and respect, regardless of their occupation [33].Additionally, there are religious groups and organizations that actively work to support and uplift individuals involved in sex work, regardless of their faith background.For example, some Christian ministries provide outreach and assistance to sex workers, offering resources for education, healthcare, and alternative employment opportunities [1].It is important to note that even if some Christian ministries provide outreach to sex workers, the tenet of ministering for conversion is still very often present, which is not necessarily the case with the other Abrahamic faiths.Similarly, certain Islamic charities and community initiatives aim to address the root causes of sex work, such as poverty and a lack of social support, while providing practical assistance to those in need [34].

Theme 2: Experiences of Sex Workers Including Stigmatization and Marginalization within Religious Contexts
When working in religious environments, sex workers frequently have to negotiate a difficult web of stigma, moral judgment, and occasionally even condemnation [35].Spiritual and religious identities might clash with other aspects of a person's identity.The issue of coexisting identities has been discussed in relation to monitoring by religion.Theorists like Harvey, who contend that religion functions as a site of surveillance where people are accountable for making sure they are in accordance with religious standards, have examined the concept of surveillance within religion.These standards could relate to conduct, attire, and sexuality [36].Disapproval of having sex before marriage, opposition to abortion, support of heteronormativity, and ingrained patriarchy in various religious engagements, for instance, are all factors that shape an individual's identity and conduct [37].Religion, therefore, regulates the formation and performance of identities and has an impact on the daily lives of spiritual and religious sex workers [38].As such, religious and spiritual prostitutes encounter stigma from the religious authorities concerning their status as prostitutes as well as secularism concerning their religious and spiritual identities [39].
Notably, research has shown that there is a connection between religious and spiritual sex workers and believing without belonging.The belief in a God is involved in believing without belonging, but the believer is not directly involved in the structured aspect of religion [39].Research on believing without belonging with religious sex workers in Thailand was conducted by Sorajjakool and Benitez [18].Four respondents said they did not often go to places of religion but that they possessed shrines or other places of devotion in their houses [18].The remaining eight participants discovered that religion was a big part of their daily lives and that they frequently interacted with religious locations [18].As a result, individuals adapted religion to fit their daily lives and interacted with it in diverse ways [40].Given that people can adapt their religion to fit in with other identities for harmony, this emphasizes how personal religious and spiritual pursuits can be.According to Fones, depictions of sex workers are mainly negative throughout the Hebrew and New Testaments [41].Religious sex workers may therefore have to compromise between their religious views, professional demands, and social norms [42].In support of this, Johnston suggests that rather than practicing organized religion, the sex workers in his research practiced personalized religion [1].
In societies deeply influenced by religious beliefs, sex work can be viewed as morally reprehensible, contradicting the teachings of many faiths regarding sexuality, fidelity, and purity [43].This stigma can lead to ostracization from religious communities and discrimination in accessing support services, healthcare, and legal protection [44].However, the experiences of sex workers within religious contexts are not monolithic.Some religious institutions and communities advocate for compassion, understanding, and support for marginalized individuals, including sex workers [45].They may offer outreach programs and counseling aimed at addressing the systemic issues that contribute to the vulnerability of sex workers, such as poverty, lack of education, and exploitation [44].However, the tension between religious teachings and the realities of sex work remains a challenge.Sex workers who are religious may experience internal conflicts, grappling with their faith's teachings and their chosen profession.

Theme 3: Social Control
Religious institutions have historically wielded significant influence over sexuality, often using doctrine to regulate or suppress behaviors they deem inappropriate or sinful [46,47].One example is the Catholic Church's stance on contraception and premarital sex.Through teachings rooted in religious doctrine, the church has sought to control sexual behavior by prohibiting the use of contraceptives and promoting abstinence until marriage [48].This doctrine not only influences individual behavior but also impacts public policy and healthcare access in many countries with large Catholic populations [49].Similarly, in conservative Islamic societies, religious teachings and institutions play a crucial role in regulating sexuality [39].
Moreover, certain religious beliefs demonize sex work, viewing it as morally corrupt and sinful [30].For example, in some interpretations of Christianity, sex work is condemned as a form of exploitation and degradation of the human body, which is considered a sacred vessel.This condemnation often leads to stigmatization and discrimination against sex workers, making it difficult for them to access basic rights and protections [1].In Hinduism, the caste system has historically played a role in regulating sexuality and professions, including sex work [33].While not explicitly condoned by religious texts, the lower castes often faced limited economic opportunities, pushing some individuals into sex work as a means of survival [33].However, societal attitudes influenced by religious teachings perpetuated discrimination against sex workers, further marginalizing them within society.

Theme 4: Empowerment and Advocacy
The relationship between some religions and support for sex work is a complicated one that varies widely based on theological, historical, and cultural circumstances.In a little piece titled "We Must Not Keep Silent" that was published in 2012 on Ecclesio.com[16], the Rev. Dr. Fowler argued vehemently that Jamaican churches should speak out against human trafficking [16].Fowler, whose Christian religion is her foundation, urged prayer and information sharing among other faith communities and organizations [16].Fowler resolutely pushed against human trafficking, citing the neglect of the experiences of sex workers in general and Jamaican sex workers in particular in the debate around sex trafficking and human trafficking [16].The emphasis was always on the postcolonial Jamaican environment, which is greatly influenced by Christian perspectives [50].There was also consideration of the ambiguities surrounding the sex tourism industry as a neocolonial venture, something that Fowler did not support [50].Fowler's reasoning rested on what George et al. called the "Neo-Abolitionist View", which saw prostitution and sex trafficking as equivalent and rendered consent a moot point.It is interesting to note that many Christians were among the Neo-abolitionists who said that the sex business should be abolished since it objectified and mistreated women [45].Sex trafficking and sex work were perceived as components of a system that profits from violence against women and girls; predators received financial and sexual rewards for exploiting women [45].
Coerced or uncoerced, sex work was viewed as harmful and ought to end [15].Scholars like Campbell and Zimmerman, for whom the question of consent was crucial, provided a counterbalance to this viewpoint [51].Campbell and Zimmerman dismissed attempts to depict commercial sexual exploitation as the most prevalent type of human exploitation, emphasizing that human trafficking was an abomination [51].As a result, they disapproved of the broad denunciation of sex work as a prerequisite for combating trafficking, which inevitably followed [51].However, Scheper-Hughes documented the existence of these distinctions even in the Roman Catholic debates on human trafficking, where there was "dispute" between defining prostitution as inherently coercive and demeaning to human dignity and arguing that not all forms of sex work were coerced or connected to human trafficking [52].Interestingly, Pope Francis made a distinction among forced marriage, forced prostitution, human trafficking, and slave labor in his speech on 8 February 2022, the International Day of Prayer and Awareness Against Human Trafficking and the Feast Day [53].However, O'Connor's work was taken seriously when she warned that the concepts of choice, agency, and consent were best understood as being on a continuum, based on the lived experiences of women who had been trafficked and others who had chosen to engage in the sexual industry [54].
On the other hand, some religious perspectives, particularly within certain branches of Buddhism and Hinduism, have historically accommodated or even embraced forms of sacred prostitution or erotic ritual practices [55].In these traditions, sexuality is often viewed as a natural and integral aspect of human existence and the expression of sexual energy is sometimes seen as a means of connecting with the divine [56].For example, in certain Hindu traditions, the concept of the devadasi, meaning a woman dedicated to serving a particular deity through dance and sexual rituals, has existed for centuries.While the devadasi system has undergone significant changes and criticisms over time, it illustrates a cultural acceptance of the intersection between religion and sex work in some contexts [57].Similarly, in some forms of Tibetan Buddhism, tantric practices involve the use of sexuality as a path to enlightenment, with practitioners engaging in sexual rituals under the guidance of a qualified teacher.These practices are often highly ritualized and involve strict ethical guidelines, emphasizing the transformation of desire into spiritual realization [58].In modern times, the relationship between religion and sex work is often more contentious [59].Many mainstream religious traditions, including Christianity, Islam, and Judaism, generally condemn or prohibit sex work due to ethical and moral concerns surrounding issues such as exploitation, objectification, and the commodification of human bodies [1].These perspectives are often rooted in religious teachings that prioritize concepts such as purity, modesty, and the sanctity of marriage.Despite these positions, there are individuals and groups within religious communities who advocate for the rights and dignity of sex workers, often from a perspective of social justice and human rights [60].They argue that criminalizing or stigmatizing sex work only exacerbates the vulnerability of sex workers to violence, exploitation, and discrimination [60].

Discussion
The study findings provide valuable insights into four key aspects of the relationship between religious beliefs and sex work.Firstly, they uncover a diverse range of attitudes towards sex work within religious communities.These attitudes span from condemnation to acceptance, reflecting the complex interplay between religious teachings and individual beliefs.Such diversity suggests that religious attitudes towards sex work are not monolithic but shaped by various factors, including the interpretation of religious texts, cultural norms, and personal experiences [1].Secondly, the research highlights the experiences of sex workers within religious contexts, revealing pervasive stigmatization and marginalization.Participants reported feeling ostracized and judged by their religious communities, often facing discrimination and social exclusion [27,28].This finding underscores the impact of religious teachings on societal attitudes towards sex work and the challenges faced by sex workers in navigating religious norms and expectations.
Thirdly, the study elucidates the role of religion in exerting social control over sex workers.Participants described mechanisms such as moral policing, shaming, and ostracization used by religious communities to regulate and enforce behavioral norms [26,31].These control mechanisms reflect the influence of religious institutions in shaping societal perceptions of morality and sexuality, often exacerbating the stigmatization and marginalization experienced by sex workers [26,31,32].Finally, the research identifies instances of empowerment and advocacy among sex workers in religious contexts.Despite facing stigmatization and social control, some participants described finding support and solidarity within their religious communities or engaging in advocacy efforts to challenge stigma and discrimination [36][37][38].Interestingly, Pope Francis has strongly condemned sex work (prostitution), viewing it as a violation of human dignity and a form of modern slavery, consistent with Catholic teachings on human dignity and social justice [53,61].He emphasized compassion and support for individuals trapped in the sex trade, while condemning systemic exploitation and those who facilitate or purchase sexual services.His stance advocates for comprehensive societal changes to address the root causes of sex work, such as poverty and a lack of education, aligning with the Church's mission of social justice [43].
The relationship between religious beliefs and sex work is complex and often marked by strong condemnation.Interestingly, religious texts that denounce financial sins such as lending money with interest (usury) are often equally forceful in their language [5].However, while modern society has largely disregarded or interpreted these financial prohibitions due to the widespread acceptance and regulation of banking and credit, sexual sins, particularly sex work, remain heavily stigmatized.This disparity highlights how cultural and economic factors can influence the interpretation and enforcement of religious doctrines.While some religions condemn all forms of sex work, including consensual sex work, others distinguish between consensual transactions and coercive or exploitative situations like trafficking and slavery [15,17,62].For example, some religious teachings emphasize compassion and support for individuals engaged in consensual sex work while vehemently opposing trafficking and slavery due to their inherent exploitation and violation of human dignity [15,17,62].These distinctions are not only theological but also have practical implications for how religious communities and societies address issues related to sex work and its associated ethical, legal, and social dimensions.In addition, the topic of sexual assistants for handicapped people, particularly in the context of sex work, is not extensively addressed in religious doctrines or texts.Religions often have moral teachings regarding sexuality and relationships, but discussions specifically about sexual assistance for handicapped individuals in the form of sex work are not commonly found.This lack of explicit discussion in religious texts on this specific topic reflects a significant bias in addressing the diverse needs and realities of individuals with disabilities within religious frameworks.Therefore, there is a notable lack of empirical data that delve into the specific lived experiences of sex workers across diverse religious backgrounds, often resulting in a homogenized perspective.Additionally, there is insufficient intersectional analysis, which overlooks how race, gender, socio-economic status, and geographic location intersect with religious stigma.
Notably, when comparing the quality of life and sexual wellbeing of sex workers in religious versus atheist environments, religious settings often foster stigma and discrimination against sex work, potentially leading to lower overall wellbeing for sex workers.In contrast, more secular environments may offer greater support services, possibly contributing to better quality-of-life outcomes.It is clear that religious beliefs influence societal attitudes towards sex work and impact the experiences of individuals involved in sex work.Therefore, the Social Constructionist Theory (SCT) provides a robust framework to strengthen this study, offering insights into how religious beliefs surrounding sexuality and morality are socially contracted and reinforced within religious communities [63].This theory would guide the study by examining how religious ideologies shape societal attitudes towards sex work, construct moral boundaries, and influence individual behaviors and identities [63].It would prompt researchers to explore ways in which religious teachings are interpreted, disseminated, and contested within communities, shedding light on the dynamic and contested nature of religious beliefs surrounding sexuality.By analyzing the social construction of religious attitudes towards sex work, the study can elucidate how these beliefs intersect with broader societal structures to shape perceptions, behaviors, and power dynamics within religious contexts, thus providing a deeper understanding of the complexities surrounding religion and sexuality [63].Therefore, the current literature offers mixed perspectives on the role of religions in the lives of sex workers.While some religious communities provide valuable support networks, advocacy efforts, and rehabilitation programs that can enhance the overall and subjective quality of life for sex workers, others may contribute to the stigma and marginalization through moral condemnation and judgmental attitudes.

Policy Implication
The study's policy implications may include guiding efforts to enhance the rights and welfare of sex workers, such as promoting laws that acknowledge and respect their diversity of religious views.Furthermore, given the impact of religious beliefs on people's decisions and experiences in this setting, the results may point to the necessity of inclusive and culturally sensitive methods in sex work legislation.

Study Limitations
The study focused only on the relationship between sex work and religious beliefs.Our work drew on multiple qualitative studies.However, the data were not presented in a way to fully understand the complexity and issues surrounding the relationship between sex workers and religious beliefs, and studies within this field are very few and limited.This study only included English-published studies from 2000 to 2023.It is possible that our search strategy might have missed relevant studies.

Conclusions and Recommendations
In conclusion, this systematic review sheds light on the complex interplay between religious beliefs and sex work.Through an in-depth exploration of diverse perspectives, it has become evident that religious beliefs can significantly shape the experiences, attitudes, and behaviors of individuals engaged in sex work.The findings underscore the importance of recognizing and respecting the diverse religious beliefs of sex workers, as well as the need for culturally sensitive approaches in policies and interventions aimed at supporting this population.Moving forward, addressing the intersection of religion and sex work will require multifaceted strategies that promote understanding, inclusivity, and the protection of human rights for all individuals involved.Furthermore, this research recommends more comprehensive empirical research that explores the lived experiences of sex workers across diverse religious backgrounds with an intersectional approach.

Figure 1 .
Figure 1.A flow chart diagram representing the search strategy [19].

Table 1 .
Summary of eligibility criteria.
➢ Studies focusing solely on outcomes unrelated to the interaction between religious beliefs and sex work.