Journal of Urban Health

, Volume 92, Issue 5, pp 966–979 | Cite as

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

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


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.


Sex work Incarceration Criminalization Jail Sex workers Women 



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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Copyright information

© The New York Academy of Medicine 2015

Authors and Affiliations

  • M. E. Socías
    • 1
    • 2
  • K. Deering
    • 1
    • 3
  • M. Horton
    • 1
  • P. Nguyen
    • 1
  • J. S. Montaner
    • 1
    • 3
  • K. Shannon
    • 1
    • 3
    • 4
  1. 1.British Columbia Centre for Excellence in HIV/AIDSSt. Paul’s HospitalVancouverCanada
  2. 2.Interdisciplinary Studies Graduate ProgramUniversity of British ColumbiaVancouverCanada
  3. 3.Department of MedicineUniversity of British ColumbiaVancouverCanada
  4. 4.School of Population and Public HealthUniversity of British ColumbiaVancouverCanada

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