Structural and Environmental Barriers to Condom Use Negotiation With Clients Among Female Sex Workers: Implications for HIV-Prevention Strategies and Policy

Shannon, Kate; Strathdee, Steffanie A.; Shoveller, Jean; Rusch, Melanie; Kerr, Thomas; Tyndall, Mark W.

doi:10.2105/ajph.2007.129858

Cited by 285 publications

(303 citation statements)

References 38 publications

Supporting

Mentioning

279

Contrasting

Unclassified

Order By: Relevance

“…Violence experienced by SWs in family, social, and work relationships is contextualized by broader social and structural violence feeding social stigma and discrimination [97,140,141]. Indirect pathways that mediate the risk of violence include low self-esteem and the inability to negotiate safer practices for fear of further violence; increasing drug use to manage the stress of violence; or forced relocation of sex work to less familiar or safe areas [84,[142][143][144].…”

Section: Sex Workersmentioning

confidence: 99%

HIV Epidemics in the European Region: Vulnerability and Response

Platt¹,

Jolley²,

Hope³

et al. 2015

View full text Add to dashboard Cite

Section: Sex Workersmentioning

confidence: 99%

HIV Epidemics in the European Region: Vulnerability and Response

Platt¹,

Jolley²,

Hope³

et al. 2015

View full text Add to dashboard Cite

“…15 Sex workers are forced to work in public spaces, which has been shown to be associated with an increased risk of coercive unprotected sex. 16 A substantial number of participants engaged in sex work. Sex work and unprotected sex with multiple partners have been identified as major risk factors for HIV-transmission.…”

Section: Resultsmentioning

confidence: 99%

Sexual health, vulnerabilities and risk behaviours among homeless adults

et al. 2014

View full text Add to dashboard Cite

Sexual health variablesTotal sample Women % (n) Men % (n) P-value % (n) 95% CI Abstract. It is well known that homeless individuals are at risk for a variety of health problems, including sexually transmissible infections. Optimisation of health services for the homeless requires knowledge of their sexual health. The sexual health and sexual vulnerability factors of 500 homeless adults (196 women) were assessed in a cross-sectional survey in three Canadian cities. Our data indicate that a significant proportion of individuals and more women than men reported multiple experiences that compromise their sexual health exponentially. These findings may inform health policies related to sexuality to foster positive sexual health outcomes for all people, including marginalised populations.

show abstract

“…It has been associated with greater risk of experiencing violence, abuse, discrimination, and increased risk of human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs) among sex workers [1-3, 6, 7]. In areas where sex work is criminalized, street-based sex workers may be displaced to more isolated areas, where they are at an elevated risk of intimidation, violence, theft, and rape, as there are fewer witnesses to protect them [1,[7][8][9][10][11] and they experience a lack of legal protection [8]. When sex workers are more concerned about risk of violence, their ability to negotiate condom use is limited [1,8,10,11], as they must prioritize their immediate safety over risk for infectious disease acquisition [11][12][13].…”

Section: Introductionmentioning

confidence: 99%

“…Although sex work itself has never been illegal in Canada, laws governing sex work have resulted in a restrictive environment for sex workers since before the Act passed [10,11].…”

Section: Introductionmentioning

confidence: 99%

“…For example, sex workers experienced pressure from potential clients to quickly negotiate terms of the sexual transactions. This served to impede sex worker's ability to screen clients for potential weapons or intoxication and check 'bad date' sheets for past violent clients, which are well documented techniques for sex workers to reduce harms such as risk of violence, abuse and HIV/STIs [7,11,13,[23][24][25].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Criminalizing Sex Work Clients and Rushed Negotiations among Sex Workers Who Use Drugs in a Canadian Setting

et al. 2017

Self Cite

View full text Add to dashboard Cite

Previous research indicates that criminalization of sex work is associated with harms among sex workers. In 2013, the Vancouver Police Department changed their sex work policy to no longer target sex workers while continuing to target clients and third parties in an effort to increase safety of sex workers (similar to "end-demand sex work" approaches being adopted in a number of countries globally). We sought to investigate the trends and correlates of rushing negotiations with clients due to police presence among 359 sex workers who use drugs in Vancouver before and after the guideline change. Data were derived from three prospective cohort studies of people who use drugs in Vancouver between 2008 and 2014. We used sex-stratified multivariable generalized estimating equation models. The crude percentages of sex workers who use drugs reporting rushing client negotiations changed from 8.9% before the guideline change to 14.8% after the guideline change among 259 women, and from 8.6% to 7.1% among 100 men. In multivariable analyses, there was a significant increase in reports of rushing client negotiation after the guideline change among women (p=0.04). Other variables that were independently associated with increased odds of rushing client negotiation included: experiencing client-perpetrated violence (among both men and women) and non-heterosexual orientation (among women) (all p<0.05). These findings indicate that despite the policing guideline change, rushed client negotiation due to police presence appeared to have increased among our sample of female sex workers who use drugs. It was also associated with client-perpetrated violence and other marker of vulnerability. These findings lend further evidence that criminalizing the purchase of sexual services does not protect the health and safety of sex workers.Word Count: 273

show abstract

Structural and Environmental Barriers to Condom Use Negotiation With Clients Among Female Sex Workers: Implications for HIV-Prevention Strategies and Policy

Cited by 285 publications

References 38 publications

HIV Epidemics in the European Region: Vulnerability and Response

HIV Epidemics in the European Region: Vulnerability and Response

Sexual health, vulnerabilities and risk behaviours among homeless adults

Criminalizing Sex Work Clients and Rushed Negotiations among Sex Workers Who Use Drugs in a Canadian Setting

Contact Info

Product

Resources

About