The shifting sex industry and the need for better screening for sex workers

Health screening programmes developed decades ago should be updated to keep up with shifts in our demographics and industries.

- Rayner Tan

One public health challenge is how to extend public health engagement beyond regulated brothels. Expanding access, the writer says, is an effort to strengthen public health monitoring in our communities.

(PHOTO: PIXABAY)

"Prostitution is not an offence in Singapore... Forcing it underground will lead to the greater likelihood of involvement by triads and organised crime, the trafficking of women, and public health risks.

These remarks by then-Senior Minister of State for Home Affairs Ho Peng Kee in Parliament in 2009, underscore a recurring principle in Singapore's policymaking: on complex issues, moral discomfort cannot outweigh practical realities and pragmatic solutions on the ground.

Global evidence since has borne this out. Studies in Asia and the US show clamping down on sex work drives such activity underground rather than eliminating it, creating gaps that complicate public health and public health outreach efforts.

Sex work has been part of Singapore's social landscape for centuries — a feature common in many port cities where mobility, trade and transient labour shape urban life. As Singapore evolved from a maritime settlement into a global hub for business and travel, the industry adapted.

Digital platforms, encrypted messaging apps and freelance arrangements now shape much of the trade, with many workers operating across online, informal or private settings. Brothel-based work now forms only a fraction of it.

Recent data reflect this shift. A study by the NUS Saw Swee Hock School of Public Health suggests there may be up to 16,200 sex workers in Singapore. Community groups like Project X estimate that fewer than 1,000 work in regulated brothels - the only segment covered by Singapore’s longstanding Medical Surveillance Scheme (MSS).