Negotiating safety and sexual risk reduction with clients in unsanctioned safer indoor sex work environments: a qualitative study.

Andrea Krüsi, Jill Chettiar, Amelia Ridgway, Janice Abbott, Steffanie A Strathdee, Kate Shannon
Author Information
  1. Andrea Krüsi: British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada.

Abstract

OBJECTIVES: We examined how unique, low-barrier, supportive housing programs for women who are functioning as unsanctioned indoor sex work environments in a Canadian urban setting influence risk negotiation with clients in sex work transactions.
METHODS: We conducted 39 semistructured qualitative interviews and 6 focus groups with women who live in low-barrier, supportive housing for marginalized sex workers with substance use issues. All interviews were transcribed verbatim and thematically analyzed.
RESULTS: Women's accounts indicated that unsanctioned indoor sex work environments promoted increased control over negotiating sex work transactions, including the capacity to refuse unwanted services, negotiate condom use, and avoid violent perpetrators. Despite the lack of formal legal and policy support for indoor sex work venues in Canada, the environmental-structural supports afforded by these unsanctioned indoor sex work environments, including surveillance cameras and support from staff or police in removing violent clients, were linked to improved police relationships and facilitated the institution of informal peer-safety mechanisms.
CONCLUSIONS: This study has drawn attention to the potential role of safer indoor sex work environments as venues for public health and violence prevention interventions and has indicated the critical importance of removing the sociolegal barriers preventing the formal implementation of such programs.

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Grants

  1. R01 DA028648/NIDA NIH HHS
  2. /CIHR
  3. R01DA028648/NIDA NIH HHS

MeSH Term

Adult
British Columbia
Female
Focus Groups
Housing
Humans
Interviews as Topic
Middle Aged
Occupational Health
Police
Qualitative Research
Risk Reduction Behavior
Sex Work
Sex Workers
Substance-Related Disorders
Violence
Young Adult

Word Cloud

Created with Highcharts 10.0.0sexworkindoorunsanctionedenvironmentsclientslow-barriersupportivehousingprogramswomenrisktransactionsqualitativeinterviewsuseindicatedincludingviolentformalsupportvenuespoliceremovingstudysaferOBJECTIVES:examineduniquefunctioningCanadianurbansettinginfluencenegotiationMETHODS:conducted39semistructured6focusgroupslivemarginalizedworkerssubstanceissuestranscribedverbatimthematicallyanalyzedRESULTS:Women'saccountspromotedincreasedcontrolnegotiatingcapacityrefuseunwantedservicesnegotiatecondomavoidperpetratorsDespitelacklegalpolicyCanadaenvironmental-structuralsupportsaffordedsurveillancecamerasstafflinkedimprovedrelationshipsfacilitatedinstitutioninformalpeer-safetymechanismsCONCLUSIONS:drawnattentionpotentialrolepublichealthviolencepreventioninterventionscriticalimportancesociolegalbarrierspreventingimplementationNegotiatingsafetysexualreductionenvironments:

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