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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

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Abstract

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 (adjusted odds ratio (AOR) 0.95, 95 % confidence interval (CI) 0.92–0.98), soliciting clients in indoor (in-call) establishments (AOR 2.25, 95 % CI 1.27–3.96), intimate partner condom refusal (AOR 3.00, 1.02–8.84), and barriers to health care (AOR 1.77, 95 % CI 1.08–2.89). 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 (AOR 1.92, 95 % CI 1.02–3.61). 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.

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Notes

  1. Mobility broadly refers to the movement of populations, including temporary and circular movements, whereas migration refers to movement from one country, city, or locality to another.

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Acknowledgments

We thank all those who contributed their time and expertise to this project, including participants, partner agencies, and the AESHA Community Advisory Board. We wish to acknowledge Sarah Allan, Ofer Amram, Eva Breternitz, Jill Chettiar, Kathleen Deering, Sabina Dobrer, Julia Homer, Rhiannon Hughes, Emily Leake, Jane Li, Vivian Liu, Sylvia Machat, Meenakshi Mannoe, Jen Morris, Paul Nguyen, Rachel Nicoletti, Tina Ok, Saba Tadesse-Lee, Chrissy Taylor, Brittney Udall, Peter Vann, Gina Willis, and Jingfei Zhang for their research and administrative support.

Project Support

This research was supported by operating grants from the US National Institutes of Health (R01DA028648) and Canadian Institutes of Health Research (HHP-98835). SG is supported by fellowships from the Canadian Institutes of Health Research and Michael Smith Foundation for Health Research/Women’s Health Research Initiative. KS is supported by the US National Institutes of Health (R01DA028648), Michael Smith Foundation for Health Research, and the Canadian Institutes of Health Research. The authors declare no conflict of interest.

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Authors and Affiliations

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

    Shira M. Goldenberg, Jill Chettiar, Paul Nguyen, Sabina Dobrer, Julio Montaner & Kate Shannon

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

    Shira M. Goldenberg, Julio Montaner & Kate Shannon

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  1. Shira M. Goldenberg
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Correspondence to Kate Shannon.

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Goldenberg, S.M., Chettiar, J., Nguyen, P. et al. 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. J Urban Health 91, 736–751 (2014). https://doi.org/10.1007/s11524-014-9888-1

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