Grant: Travel Awards - Institute Community Support

Background: Despite evidence of the harms associated with criminalization, many countries continue to criminalize aspects of the sex industry, including third parties (e.g., receptionists, security). Given limited research on third parties in sex work, we aimed to examine the impact of third party supports on access to HIV prevention and outreach services among sex workers in Vancouver (2010-2016). Methods: Data were drawn from AESHA, a community-based open cohort of 900+ cis and trans women sex workers working in diverse indoor, outdoor, and online spaces in Metro Vancouver. Women with lived experience (sex workers) are represented across interviewer, nursing and coordinator teams. Women are invited through outreach and complete interviewer-administered questionnaires semi-annually. Bivariate and multivariable logistic regression were used to 1) examine factors correlated with accessing third party support, and b) evaluate the impact of third party supports on HIV prevention and outreach services access. Results: Of 816 cis and trans women sex workers, 29.5% (n=241) accessed third party support over the six-year study. In multivariable analyses, sex workers who were im/migrants (adjusted odds ratio[AOR] 2.32, 95% confidence interval[CI] 1.35-3.98), and worked in in-call venues (e.g. massage parlours) (AOR 3.41, 95%CI 1.89-6.15) had higher odds of accessing third party supports. In separate multivariable confounder models, accessing third party support was independently correlated with accessing condoms through mobile outreach (AOR 1.84, 95%CI 1.47-2.31) and using community-led services (AOR 1.61, 95%CI 1.15-2.24). Discussion: This research suggests that access to third party supports increases sex workers' access to access to HIV/STI prevention and outreach services. Given continued criminalization of third parties in Canada, this evidence suggests policy reforms are needed to ensure sex workers' labour rights, including access to third party supports.