Addressing Underrepresentation in Sex Work Research

Abstract

Men, transgender people, and those working in off-street locales have historically been underrepresented in sex work health research. Failure to include all sections of sex worker populations precludes comprehensive understandings about a range of population health issues, including potential variations in the manifestation of such issues within and between population subgroups, which in turn can impede the development of effective services and interventions. In this article, we describe our attempts to define, determine, and recruit a purposeful sample for a qualitative study examining the interrelationships between sex workers' health and the working conditions in the Vancouver off-street sex industry. Detailed is our application of ethnographic mapping approaches to generate information about population diversity and work settings within distinct geographical boundaries. Bearing in mind the challenges and the overwhelming discrimination sex workers experience, we scope recommendations for safe and effective purposeful sampling inclusive of sex workers' heterogeneity.

A Content Analysis of Health and Safety Communications Among Internet-Based Sex Work Advertisements: Important Information for Public Health

“…Finally, Internet-based sex workers are often considered a hard-to-reach group particularly because their businesses operate in limitless Web-based spaces afforded by Internet-based advertising services [20]. Isolation and barriers in access to health promotions services have been noted among this population [7-13].…”

“…The empirically driven sample [32] was selected from a database of 226 Web-based Canadian advertisements of women (n=173), men (35), and transgender (n=20) workers collected during ethnographic mapping activities of a larger study examining the relationships between health, safety, and the organizational features of an indoor sex industry. Ethnographic mapping involved a series of key informant interviews to detail prominent classified websites and search strategies for personal business websites situated within the local context, visiting the websites and classifieds 2 times per week over a 4-week period to collate number of posts and strategize for duplication removal, and narrowing to 3 Web-based classified platforms that were used most consistently; the details of which are described elsewhere [20]. Purposeful sampling was used to capture the diversity in Web-based sex advertisement formats including advertisements from 35 personal websites and 40 from 3 Web-based classified advertising platforms.…”

Reaching the “Hard-to-Reach”: Recruitment of Rural-Dwelling Adults With Disabilities

“…Underrepresentation in research also denies excluded groups from attaining any of the benefits associated with research participation (Dhalla & Poole, 2013). Finally, addressing the imbalance of underrepresentation of hard-to-reach populations is an issue of social justice as exclusion from health research may serve to perpetuate existing power imbalances and inequities by impeding action to improve the situation of all members of society (Bungay, Oliffe, & Atchison, 2016; Rugkåsa & Canvin, 2011). Thus, researchers interested in improving the health of the population must seek to include adequate representation of hard-to-reach and socially disadvantaged populations into research studies.…”

Correlates of unprotected sex with male clients among female sex workers in 13 Mexican cities

“…These include both individual approaches (e.g., promoting condom use) and structural approaches (e.g., modifying venue-based policies); the latter, along with longer term empowerment approaches, have demonstrated the largest impact on HIV prevention and treatment for FSWs (Blanchard et al, 2013; Kerrigan et al, 2013; Moore et al, 2014). Finally, men and transgender sex workers who carry a high burden of HIV/STI risk have been underrepresented in sex work research in Mexico and other LMIC (Bungay, Oliffe, & Atchison, 2015). Future studies should address heterogeneity among sex workers by including these subgroups and developing targeted interventions and services.…”