Grant: CIHR Fellowship

Women in sex industry work in urban Canadian settings continue to experience high rates of HIV and sexually transmitted infections (STIs), violence and poor access to health services. Despite increasing evidence of the limitations of individual-level focused interventions, there remain major research gaps in our understanding of the social and structural determinants of HIV/STI risk to inform evidence-based policies and programs. Therefore, in the proposed fellowship project I aim to investigate the intersecting relationships between neighbourhood and sex work environment at the macro level and the distribution of individual sexual HIV/STI risk patterns and access to health services among a sample of sex industry workers in an urban Canadian setting (Metropolitan Vancouver). This project is part of a larger study, a five-year longitudinal cohort of women in sex industry work in Metropolitan Vancouver that began enrolment in Jan-10, in partnership with local sex work and service agencies. Women will be followed up every six months over five years through interviews. I will use empirical data gathered in the larger project, and combine advanced social epidemiology methods and Geographic Information Systems (GIS) mapping technology, developing a GIS database. I will also explore the use of novel complex adaptive systems approaches and develop a unique model that incorporates factors at multiple levels of influence, including social, structural and environmental, in understanding how neighbourhood environment impacts sexual risk patterns and health services access. The results from the research conducted during this fellowship will be exceedingly important in informing the ongoing development of health policy and structural interventions that improve the health of women involved in sex industry work in Canadian settings and will support ongoing knowledge translation of evidence into policy and practice through our extensive community partnerships.