Gendered labor and sex work in Taiwan's gig economy: sexual health information needs, sharing practices, and inequalities

Purpose: As sex work increasingly shifts online and takes on the characteristics of gig economy labor, individualized sex work has become more prevalent in Taiwan. Yet, little is known about how sex workers across sexual orientations and gender identities access, negotiate, and sustain their sexual health information needs. This gap in knowledge is particularly urgent given Taiwan's commitment to the global Ending AIDS target by 2030. Method: This study draws on focus groups with cis-male (n = 7) and cis-female (n = 9) sex workers, supplemented by qualitative interviews with transgender men, transgender women, and non-binary participants (n = 15). Guided by a sexual health and HIV-prevention framework, we explored perceptions of HIV and sexual health risks, engagement with public health services, medical practices, peer support, and psychosocial pressures. Thematic analysis was applied to identify both commonalities and divergences across groups. Results: Findings highlight sharp gendered disparities. Cis-male sex workers, supported by the prevalence of dating apps, reported relatively structured information networks, sharing resources such as PrEP, doxycycline-PEP, and other biomedical prevention strategies. They also benefited from interventions that primarily target gay and bisexual men. By contrast, cis-female sex workers had fragmented, uneven access to sexual health knowledge and services. Most relied primarily on condoms, with limited awareness of PrEP or biomedical prevention, and sometimes depended on male counterparts to meet their needs. Transgender and non-binary participants described additional obstacles, including stigma in healthcare settings, a lack of tailored interventions, and the compounded challenge of navigating both digital and structural barriers. Conclusions: Gig economy creates new opportunities for organizing sex work but also reproduces entrenched health inequalities. While cis-male sex workers may benefit from denser digital health ecologies, cis-female, transgender, and non-binary workers remain underserved. These findings underscore the urgency of designing inclusive, community-informed, and structurally attuned interventions that address the diverse realities of gig-based sex work in Taiwan.