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Criminalizing Sex Work Clients and Rushed Negotiations among Sex Workers Who Use Drugs in a Canadian Setting

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Previous research indicates that criminalization of sex work is associated with harms among sex workers. In 2013, the Vancouver Police Department changed their sex work policy to no longer target sex workers while continuing to target clients and third parties in an effort to increase the safety of sex workers (similar to “end-demand sex work” approaches being adopted in a number of countries globally). We sought to investigate the trends and correlates of rushing negotiations with clients due to police presence among 359 sex workers who use drugs in Vancouver before and after the guideline change. Data were derived from three prospective cohort studies of people who use drugs in Vancouver between 2008 and 2014. We used sex-stratified multivariable generalized estimating equation models. The crude percentages of sex workers who use drugs reporting rushing client negotiations changed from 8.9% before the guideline change to 14.8% after the guideline change among 259 women, and from 8.6 to 7.1% among 100 men. In multivariable analyses, there was a significant increase in reports of rushing client negotiation after the guideline change among women (p = 0.04). Other variables that were independently associated with increased odds of rushing client negotiation included experiencing client-perpetrated violence (among both men and women) and non-heterosexual orientation (among women) (all p < 0.05). These findings indicate that despite the policing guideline change, rushed client negotiation due to police presence appeared to have increased among our sample of female sex workers who use drugs. It was also associated with client-perpetrated violence and other markers of vulnerability. These findings lend further evidence that criminalizing the purchase of sexual services does not protect the health and safety of sex workers.

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Acknowledgments

The authors sincerely appreciate the study participants of ACCESS, VIDUS, and ARYS for their contribution to the research, as well as current and past researchers and staff. The study was supported by the US National Institutes of Health (U01DA038886, R01DA021525) and the Canadian Institutes of Health Research (MOP–102742). This research was undertaken, in part, thanks to funding from the Canada Research Chairs program through a Tier 1 Canada Research Chair in Inner City Medicine which supports Dr. Evan Wood. Dr. Kanna Hayashi is supported by the Canadian Institutes of Health Research New Investigator Award (MSH-141971). Dr. Kora DeBeck is supported by a MSFHR/St. Paul’s Hospital Foundation-Providence Health Care Career Scholar Award and a Canadian Institutes of Health Research New Investigator Award. Dr. Milloy is supported in part by the US National Institutes of Health (R01-DA0251525), a CIHR New Investigator Award, and a Michael Smith Foundation for Health Research Scholar award. His institution has received unstructured funding from NG Biomed, Ltd., to support his research. Dr. Kate Shannon is partially supported through a Canada Research Chair in Global Sexual Health and HIV/AIDS and NIH (R01-DA028648).

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Authors and Affiliations

  1. British Columbia Centre for Excellence in HIV/AIDS, St. Paul’s Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada

    Adina Landsberg, Kate Shannon, Andrea Krüsi, Kora DeBeck, M-J Milloy, Ekaterina Nosova, Thomas Kerr & Kanna Hayashi

  2. Faculty of Health Sciences, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4L8, Canada

    Adina Landsberg

  3. Faculty of Medicine, University of British Columbia, St. Paul’s Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada

    Kate Shannon, Andrea Krüsi, M-J Milloy & Thomas Kerr

  4. School of Public Policy, Simon Fraser University, 515 West Hastings Street – Suite 3271, Vancouver, BC, V6B 5K3, Canada

    Kora DeBeck

  5. Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada

    Kanna Hayashi & Kanna Hayashi

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  1. Adina Landsberg
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Correspondence to Kanna Hayashi.

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All cohort studies have been approved by the University of British Columbia/Providence Health Care Research Ethics Board.

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Landsberg, A., Shannon, K., Krüsi, A. et al. Criminalizing Sex Work Clients and Rushed Negotiations among Sex Workers Who Use Drugs in a Canadian Setting. J Urban Health 94, 563–571 (2017). https://doi.org/10.1007/s11524-017-0155-0

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