Grant: CIHR New Investigator

Migration is a globally recognized social determinant of HIV, sexually transmitted infections (STIs), and Hepatitis C (HCV). Yet, little is known regarding how migration patterns and experiences impact transmission, risk, and prevention of these infections in high-income settings such as Canada. Women in sex work often face high prevalence of HIV/STIs and are highly mobile, yet little is known regarding the ways in which migration patterns influence health outcomes and access to care for migrant sex workers. In Canada, as in other settings, migration patterns generally relate to unequal social and economic opportunities, which attract women from other countries, provinces, and communities to urban areas such as Metropolitan Vancouver. Among women of Aboriginal (First Nations, Inuit, and Métis) ancestry, migration between Northern BC and Vancouver is embedded within a legacy of colonization and racialized policies, yet has received little attention in relation to HIV or HCV. Despite efforts to scale-up access to the continuum of care in BC (e.g., the STOP HIV/AIDS program), migrants, sex workers, and populations of Aboriginal ancestry remain disproportionately impacted by HIV, STIs and HCV. This research is investigating how migration influences HIV, STI and HCV risks and prevention among sex workers (e.g., exposure to new working conditions, violence). Based on a cohort study of 1000 female sex workers in Vancouver, including 600 non-migrants and 400 migrants, the research described in this application is evaluating and informing policies and programs to improve the health of migrant sex workers, including international migrants as well as internal migrants who move within Canadian or provincial borders. It will establish a broader program of innovative research and training in Migration and Global Sexual Health to facilitate comparative work with marginalized migrant women across international settings, including Canada, Mexico and Central America, and elsewhere.