Journal of Immigrant and Minority Health

, Volume 19, Issue 5, pp 1235–1244 | Cite as

Exploring the Context and Implementation of Public Health Regulations Governing Sex Work: A Qualitative Study with Migrant Sex Workers in Guatemala

  • Teresita Rocha-Jiménez
  • Kimberly C. Brouwer
  • Jay G. Silverman
  • Sonia Morales-Miranda
  • Shira M. Goldenberg
Original Paper


Public health regulations practices surrounding sex work and their enforcement can have unintended consequences for HIV and sexually transmitted infection (STI) prevention and care among sex workers. This analysis was based on qualitative in-depth (n = 33) and focus groups interviews (n = 20) conducted with migrant female sex workers in Tecún Umán and Quetzaltenango, Guatemala, and explored the implementation of sex work regulations and related consequences for HIV prevention and care among migrant sex workers. Sex work regulations were found to have health-related benefits (e.g., access to HIV/STI testing) as well as negative impacts, such as abuse by police and harassment, detention/deportation of migrant sex workers. Whereas public health regulations may improve access to HIV/STI testing, their implementation may inadvertently jeopardize sex workers’ health through unintended negative consequences. Non-coercive, evidence-based public health and sex work policies and programs are needed to expand access to HIV/STI prevention and care among migrant sex workers, while protecting their dignity and human rights.


Sex work Public health regulations Guatemala Migration 



The authors wish to acknowledge staff from EDUCAVIDA, Universidad del Valle de Guatemala, and University of California, San Diego (UCSD), including Itzel Loya, Valerie Mercer and Alicia Vera. This research was funded by the UC Global Health Institute Center of Expertise on Migration and Health (COEMH), the UC Pacific Rim Research Program, and the Fordham University HIV Prevention Research Ethics Training Institute/National Institutes of Drug Abuse (R25DA031608-01; Director, Celia B. Fisher). S.G. receives support as a postdoctoral fellow from the Canadian Institutes of Health Research and the Michael Smith Foundation for Health Research/Women’s Health Research Initiative. T.R. was supported by Consejo Nacional de Ciencia y Tecnología (CONACYT, Mexico).


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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Teresita Rocha-Jiménez
    • 1
  • Kimberly C. Brouwer
    • 1
  • Jay G. Silverman
    • 1
  • Sonia Morales-Miranda
    • 2
  • Shira M. Goldenberg
    • 1
    • 3
    • 4
  1. 1.Division of Global Public HealthUniversity of CaliforniaLa JollaUSA
  2. 2.Unidad de VIH/SIDAUniversidad del Valle de GuatemalaGuatemalaGuatemala
  3. 3.Faculty of Health SciencesSimon Fraser UniversityBurnabyCanada
  4. 4.Gender and Sexual Health Initiative, British Columbia Centre for Excellence in HIV/AIDS, Department of Medicine, St. Paul’s HospitalUniversity of British ColumbiaVancouverCanada

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