Grant: Doctoral Research Award - PA: Aboriginal Research Methodologies

In Canada and globally, sex workers continue to experience high rates of HIV/STI (sexually transmitted infection), violence, and poor access to health care services. Despite the significance of socio-structural factors (e.g., laws, stigma, social support) in influencing the HIV epidemic, large research gaps remain in our understanding of how these factors affect HIV/STI risks for sex workers. For the first time in Canadian history, new sex work legislation (C-36, implemented December 2014), criminalizes purchasing (clients) and advertising the sale of sexual services, while the selling of sex remains legal. These policies have been adopted in Canada despite the lack of evidence supporting this legal framework and an absence of research on health impacts and HIV/STI risks for sex workers. The aim of the proposed study is to investigate the impact of new sex work laws and enforcement-based policies on HIV/STI risks (e.g., drug use patterns, violence, condom use, access to care) among sex workers and clients in Vancouver, Canada. This project will draw on empirical survey data gathered from a larger longitudinal cohort study of women sex workers in Vancouver and will employ advanced social epidemiological modelling techniques to make use of the longitudinal data before and after the legal reforms. This work will be complimented by in-depth interviews with sex workers and clients recruited through a paired cohort study of men who purchase and sell sex. Given the high HIV/STI burden among sex workers and lack of research on the health impacts of criminalization of sex work in Canada and globally, there is a critical need to translate the findings into health policy and practice. Knowledge translation of the research findings to local community and international partners will help to inform ongoing developments in public health policies to reduce the risks for HIV, as well as provide evidence for upcoming Charter challenges.