Grant: CIHR New Investigator

This new investigator award application aims to investigate the social (violence, work conditions) and structural (laws, regulations, urban renewal) contexts of HIV/STIs among youth and women working in the sex industry in Vancouver, BC. The persistently high rates of health-related harms, violence and mortality among sex workers both in Canada and globally highlight a desperate need for renewed public health interventions targeting the reduction of harms in the sex industry. Building on international guidelines and the CIHR priorities for sex and gender-based analyses, we will aim to evaluate longitudinally the broader risk environment that shapes gendered negotiation of partner-level risk and HIV/STI acquisition among youth and adult women in sex industry work. To meet these objectives, the proposed research will be based upon the assembly and follow-up of a real cohort consisting of: 1) 500 existing and new adult women working in both the street and indoor sex industry in the AESHA (An Evaluation of Sex Workers' Health Access) I cohort; and 2) 500 female youth aged 14-20 years who have exchanged sex for money, drugs, gifts, shelter or other commodities in the previous 30days in the AESHA II cohort (youth arm). The novel integration of individual mapping data and neighborhood environment data from publicly- available data sources (such as, housing, violence) will increase the potential for directly informing interventions to reduce harm. To our knowledge this study is among the first prospective studies of sex work in North America. The team I have assembled brings a wealth of expertise in observational and intervention research, policy and sex work, and as such, is uniquely positioned to conduct this study, which aims to directly improve the health of some of the most marginalized youth and women in Canadian society.