Complexities of Short-Term Mobility for Sex Work and Migration among Sex Workers: Violence and Sexual Risks, Barriers to Care, and Enhanced Social and Economic Opportunities

Despite research on the health and safety of mobile and migrant populations in the formal and informal sectors globally, limited information is available regarding the working conditions, health, and safety of sex workers who engage in short-term mobility and migration.

The objective of this study was to longitudinally examine work environment, health, and safety experiences linked to short-term mobility/migration (i.e., worked or lived in another city, province, or country) among sex workers in Vancouver, Canada, over a 2.5-year study period (2010–2012). We examined longitudinal correlates of short-term mobility/migration (i.e., worked or lived in another city, province, or country over the 3-year follow-up period) among 646 street and off-street sex workers in a longitudinal community-based study (AESHA). 

Of 646 sex workers, 10.84 % (n = 70) worked or lived in another city, province, or country during the study. In a multivariate generalized estimating equations (GEE) model, short-term mobility/migration was independently correlated with older age, soliciting clients in indoor (in-call) establishments, intimate partner condom refusal, and barriers to health care. In a second multivariate GEE model, short-term mobility for sex work (i.e., worked in another city, province, or country) was correlated with client physical/sexual violence. 

In this study, mobile/migrant sex workers were more likely to be younger, work in indoor sex work establishments, and earn higher income, suggesting that short-term mobility for sex work and migration increase social and economic opportunities. However, mobility and migration also correlated with reduced control over sexual negotiation with intimate partners and reduced health care access, and mobility for sex work was associated with enhanced workplace sexual/physical violence, suggesting that mobility/migration may confer risks through less control over work environment and isolation from health services. 

Structural and community-led interventions, including policy support to allow for more formal organizing of sex work collectives and access to workplace safety standards, remain critical to supporting health, safety, and access to care for mobile and migrant sex workers.

TABLE 3

Factors longitudinally associated with recent mobility for sex work among female sex workers (n = 646) over time, 2010–2012

Variable	Unadjusted odds ratio	Unadjusted 95 % confidence interval	Adjusted odds ratio	Adjusted 95 % confidence interval
Age, per year older	0.92	0.88–0.96	0.94	0.90–0.98
HIV/STI seropositive	0.30	0.12–0.76
Condom refusal by:
Clients (any type)	1.88	0.95–3.70
Non-commercial partners	5.55	1.90–16.20	3.48	1.17–10.38
Primary place of solicitation
Street/public (ref)
Indoor establishment	1.21	0.58–2.52	1.54	0.70–3.37
Independent	1.60	0.87–2.95	1.85	0.98–3.50
Homelessness	2.69	1.63–4.44
Physical/sexual violence by:
Clients (any type)	2.61	1.45–4.67	1.92	1.02–3.61
Intimate partners	1.70	0.94–3.09
Paid a third party	2.50	1.37–4.56
Experienced any barrier to health care access	2.36	1.31–4.27	2.18	1.17–4.08

All variables refer to the last 6 months, except for age, which was treated as a time-fixed covariate

Full article at: http://goo.gl/GmyIu7

By: Shira M. Goldenberg, Jill Chettiar, Paul Nguyen, Sabina Dobrer, Julio Montaner, and Kate Shannon

Gender and Sexual Health Initiative, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC CANADA

Department of Medicine, University of British Columbia, St. Paul’s Hospital, 608-1081 Burrard St., Vancouver, BC V6Z 1Y6 Canada

Kate Shannon, Phone: (604) 804-9459, Email: ac.cbu.tenefc@ihsg.

   

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