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Social and Structural Factors Shaping High Rates of Incarceration among Sex Workers in a Canadian Setting

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Abstract

In light of the emphasis on enforcement-based approaches towards sex work, and the well-known negative impacts of these approaches on women’s health, safety and well-being, we conducted a study to investigate the prevalence and correlates of recent incarceration among a cohort of women sex workers in Vancouver, Canada. Data were obtained from an open prospective community cohort of female and transgender women sex workers, known as An Evaluation of Sex Workers’ Health Access (AESHA). Bivariate and multivariable logistic regression analyses, using generalized estimating equations (GEE), were used to model the effect of social and structural factors on the likelihood of incarceration over the 44-month follow-up period (January 2010–August 2013). Among 720 sex workers, 62.5 % (n = 450) reported being incarcerated in their lifetime and 23.9 % (n = 172) being incarcerated at least once during the study period. Of the 172 participants, about one third (36.6 %) reported multiple episodes of incarceration. In multivariable GEE analyses, younger age (adjusted odds ratio [AOR] = 1.04 per year younger, 95 % confidence interval [CI] 1.02–1.06), being of a sexual/gender minority (AOR = 1.62, 95 % CI 1.13–2.34), heavy drinking (AOR = 1.99, 95 % CI 1.20–3.29), being born in Canada (AOR = 3.28, 95 % CI 1.26–8.53), living in unstable housing conditions (AOR = 4.32, 95 % CI 2.17–8.62), servicing clients in public spaces (versus formal sex work establishments) (AOR = 2.33, 95 % CI 1.05–5.17) and experiencing police harassment without arrest (AOR = 1.82, 95 % CI 1.35–2.45) remain independently correlated with incarceration. This prospective study found a very high prevalence and frequency of incarceration among women sex workers in Vancouver, Canada, with the most vulnerable and marginalized women at increased risk of incarceration. Given the well-known social and health harms associated with incarceration, and associations between police harassment and incarceration in this study, our findings further add to growing calls to move away from criminalized and enforcement-based approaches to sex work in Canada and globally.

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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 Peter Vann, Jill Chettiar, Sabina Dobrer, Gina Willis, Ofer Amram, Jennifer Morris, Brittney Udall, Rachel Nicoletti, Julia Homer, Emily Leake, Chrissy Taylor, Vivian Liu, Jane Li, Tina Ok, Rhiannon Hughes, Eva Breternitz and Sylvia Machat for their research and administrative support. This research was supported by operating grants from the US National Institutes of Health (R01DA028648), 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. JM is supported with grants paid to his institution by the British Columbia Ministry of Health and by the US National Institutes of Health (R01DA036307). MES is a Canadian Institutes of Health Research Bridge Fellow

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Authors and Affiliations

  1. British Columbia Centre for Excellence in HIV/AIDS, St. Paul’s Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada

    M. E. Socías, K. Deering, M. Horton, P. Nguyen, J. S. Montaner & K. Shannon

  2. Interdisciplinary Studies Graduate Program, University of British Columbia, 270-2357 Main Mall, Vancouver, BC, V6T 1Z4, Canada

    M. E. Socías

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

    K. Deering, J. S. Montaner & K. Shannon

  4. School of Population and Public Health, University of British Columbia, 5804 Fairview Avenue, Vancouver, BC, V6T 1Z3, Canada

    K. Shannon

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  1. M. E. Socías
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  2. K. Deering
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  3. M. Horton
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  4. P. Nguyen
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Correspondence to K. Shannon.

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This research was supported by operating grants from the US National Institutes of Health (R01DA028648) and Canadian Institutes of Health Research (HHP-98835). KS is partially supported by a Canada Research Chair in Global Sexual Health and HIV/AIDS and Michael Smith Foundation for Health Research. JSM is supported with grants paid to his institution by the British Columbia Ministry of Health and by the US National Institutes of Health (R01DA036307). He has also received limited unrestricted funding, paid to his institution, from Abbvie, Bristol-Myers Squibb, Gilead Sciences, Janssen, Merck, and ViiV Healthcare.

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Socías, M.E., Deering, K., Horton, M. et al. Social and Structural Factors Shaping High Rates of Incarceration among Sex Workers in a Canadian Setting. J Urban Health 92, 966–979 (2015). https://doi.org/10.1007/s11524-015-9977-9

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