Third Parties (Venue Owners, Managers, Security, etc.) and Access to Occupational Health and Safety Among Sex Workers in a Canadian Setting: 2010–2016

Abstract

Objective. To determine the impact of engagement with third parties (i.e., managers, receptionists, or owners of in-call venues; advertisers; security; spotters; and others) on sex workers’ occupational health access. Methods. We drew longitudinal data from An Evaluation of Sex Workers’ Health Access, a community-based cohort of more than 900 women sex workers. We used multivariable logistic regression and generalized estimating equations to (1) examine factors correlated with accessing third-party administrative or security services and (2) evaluate the impact of third-party services on access to mobile condom distribution and sex worker and community-led services (2010–2016). Finally, we evaluated changes in accessing third-party services pre–post end-demand criminalization (2010–2017). Results. Im/migrant sex workers (persons with any type of legal status who were born in another country; adjusted odds ratio [AOR] = 2.32; 95% confidence interval [CI] = 1.35, 3.98) had higher odds of accessing third-party services. In confounder models, third-party services were independently correlated with increased access to mobile condom distribution (AOR = 1.84; 95% CI = 1.47, 2.31) and sex worker and community-led services (AOR = 1.61; 95% CI = 1.15, 2.24). End-demand criminalization was linked to a decrease in access to third-party services (AOR = 0.79; 95% CI = 0.63, 0.99). Conclusions. This research suggests that access to administrative and security services from third parties increases sex workers’ occupational health and safety. Policy reforms to ensure sex workers’ labor rights, including access to hiring third parties, are recommended.

Structural barriers to condom access in a community-based cohort of sex workers in Vancouver, Canada: influence of policing, violence and end-demand criminalisation

“…Criminalisation can undermine health and human rights by encouraging rushed transactions and pushing SWs to hidden areas where outreach or peer supports may be limited 9. SWs and third parties (eg, managers) often avoid carrying or storing sufficient condoms due to fear that this will be used as evidence of criminalised activities;27 31 given the continued criminalisation of third-party activities under ‘end-demand’, such concerns are likely to persist 22. Additionally, SWs may avoid interacting with health or outreach services due to stigma and fear of legal ramifications 20 23 27 31.…”

“…Despite the purported goal of ‘protecting communities’, we found no significant difference in condom access following implementation of ‘end-demand’ criminalisation after adjustment for other variables, suggesting that such legislation may perpetuate barriers faced under previous legislation. Whereas ‘end-demand’ legislation typically aims to combat exploitation and support linkage to support services, evidence suggests that such legislation may exacerbate harms for SWs – including barriers to health services and HIV/STI prevention, violence, and poor working conditions 18 19 21 22…”

“…Where sex work is uniquely stigmatised and singled out from other occupations, SWs’ use of public space becomes restricted by community, which can exacerbate stigma, perpetuate barriers to health and safety, and increase adversarial police interactions due to community complaints 12 15 22. The barriers faced by sexual/gender minorities may relate to intersectional stigmas related to sex work, sexual orientation, and gender identity.…”

“…This new legislation conflates sex work with trafficking19 and was enacted despite concerns that it could recreate or worsen harms faced under previous laws 18 20. Research has shown that laws and enforcement targeting the purchase of sex may encourage rushed sexual transactions to avoid police; increase police surveillance; cause displacement to new work environments; increase pressure to see more dangerous clients; impede access to third-party supports; and reduce access to healthcare and community-based supports 19 21–23…”

The Role of Local Business Employees and Community Members in The HIV Risk Environment of Female Sex Workers in An Urban Setting: Associations Between Negative Interactions and Inconsistent Condom Use

“…A growing body of evidence has identi ed a complexity of factors that impact the HIV risk of female sex workers (FSWs) in their work environments. (1)(2)(3)(4)(5) Over the last decade, complex physical, social, economic, and policy environmental features have been articulated and examined in their shaping of HIV transmission and related behaviors.…”