AIDS and Behavior

, Volume 21, Issue 3, pp 734–744 | Cite as

Food Insecurity Increases HIV Risk Among Young Sex Workers in Metro Vancouver, Canada

  • Daniella Barreto
  • Kate Shannon
  • Chrissy Taylor
  • Sabina Dobrer
  • Jessica St. Jean
  • Shira M. Goldenberg
  • Putu Duff
  • Kathleen N. Deering
Original Paper


This research aimed to determine the effect of food insecurity on sexual HIV risk with clients among youth sex workers (YSWs) <30 years in Metro Vancouver, Canada. Data were drawn from a prospective community cohort of sex workers (2010–2013). We examined the independent relationship between YSWs’ food insecurity and being pressured into sex without a condom by clients (“client condom refusal”). Of 220 YSWs, 34.5 % (n = 76) reported client condom refusal over the 3.5-year study period and 76.4 % (n = 168) reported any food insecurity. Adjusting for other HIV risk pathways, food insecurity retained an independent effect on client condom refusal (AOR 2.08, 95 % CI 1.23–3.51), suggesting that food insecurity is significantly associated with HIV risk among YSWs. This study indicates a critical relationship between food insecurity and HIV risk, and demonstrates YSWs’ particular vulnerability. Public policies for food assistance as a harm reduction measure may be key to addressing this disparity.


Sex work Youth HIV Food insecurity 



We thank all those who contributed their time and expertise to this project, particularly participants, AESHA community advisory board members and partner agencies. We wish to acknowledge Chrissy Taylor, Jennifer Morris, Tina Ok, Rachel Nicoletti, Julia Homer, Emily Leake, Rachel Croy, Emily Groundwater, Meenakshi Mannoe, Silvia Machat, Jasmine McEachern, Brittany Udall, Chris Rzepa, Jingfei Zhang, Xin (Eleanor) Li, Krista Butler, Peter Vann, Sarah Allan and Jill Chettiar for their research and administrative support. We would also like to thank Eugenia Socias for her feedback on earlier versions of this article. This research was supported by operating grants from the US National Institutes of Health (R01DA028648) and Canadian Institutes of Health Research (HHP-98835), and MacAIDS. KS is partially supported by a Canada Research Chair in Global Sexual Health and HIV/AIDS and Michael Smith Foundation for Health Research.


This research was supported by operating grants from the US National Institutes of Health (R01DA028648) and Canadian Institutes of Health Research (HHP-98835), and MacAIDS.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Daniella Barreto
    • 1
    • 2
  • Kate Shannon
    • 1
    • 3
  • Chrissy Taylor
    • 1
  • Sabina Dobrer
    • 1
  • Jessica St. Jean
    • 2
  • Shira M. Goldenberg
    • 1
    • 4
  • Putu Duff
    • 1
    • 3
  • Kathleen N. Deering
    • 1
    • 3
  1. 1.BC Centre for Excellence in HIV/AIDSSt. Paul’s HospitalVancouverCanada
  2. 2.YouthCO HIV & Hep C SocietyVancouverCanada
  3. 3.Department of MedicineUniversity of British ColumbiaVancouverCanada
  4. 4.Faculty of Health SciencesSimon Fraser UniversityBurnabyCanada

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