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Abel et al., 2012 [101]
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New Zealand
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Survey and qualitative interviews
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58 sex workers (all genders)
|
Decriminalization & Safer Work Environments. In context of decriminalization of sex work, risk perception influenced workers’ decisions to operate in street-based, managed or private sectors of the sex industry.
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Alongside decriminalization, social and economic policies are required to address risk and develop enabling environments across sex work sectors of sex work industry.
|
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Anderson et al., 2015 [86]
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Canada
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46 qualitative interviews
|
Migrant/immigrant women (trans inclusive) sex workers and managers/owners of indoor establishments
|
Decriminalization & Safer Work Environments. Women described how policing practices and licensing requirements for indoor sex work establishments shape violence and conflict with clients.
|
Removing prohibitive municipal licensing and legislation reform is needed to improve safety of sex work environments.
|
|
Argento et al., 2016 [106]
|
Canada
|
61 qualitative interviews
|
Cis and trans men who buy and/or sell sex
|
Community Empowerment & Safer Work Environments. Community-based project; narratives describe how gentrification and online sex work shape social networks, safety, and control.
|
Critical need to include voices of men and trans sex workers in policy discussions. Supports decriminalization of sex work.
|
|
Cohan et al., 2006 [96]
|
USA
|
Cross-sectional
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783 sex workers (all genders) accessing care at peer-based clinic (St. James Infirmary)
|
Community-led Programming & Integrative Care. Sex worker-led, free medical clinic provides substantial care to sex workers of all genders.
|
Sex worker-led and integrative, non-judgmental health and support services are key to reducing STBBIs.
|
|
Kim et al., 2015 [98]
|
Canada
|
Cross-sectional 2010–2013
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547 street-involved women (trans inclusive) sex workers accessing women-only drop-in service
|
Community-led Programming & Integrative Care. Sex worker-specific drop-in service had high uptake (60% used services in last 3 years), associated with increased access to sexual and reproductive health services.
|
Low-threshold and sex work-specific models for sexual health should be scaled-up.
|
|
Krusi et al., 2012 [76]
|
Canada
|
39 qualitative interviews & 6 focus groups
|
Marginalized women (trans inclusive) sex workers living/working in low-barrier, supportive housing for women
|
Safer Work Environments. Unsanctioned indoor sex work environments in the context of supportive housing programs increased sex workers’ control over negotiating transactions and condom use with clients.
|
Removing social and legal barriers to women-only supportive housing models are critical to facilitate safer indoor sex work environments.
|
|
Krusi et al., 2014 [71]
|
Canada
|
31 qualitative interviews and ethnographic observation
|
Street-involved women sex worker (trans inclusive)
|
Decriminalization. Criminalization of sex work and policing practices targeting clients increase risk of HIV/STBBIs.
|
Decriminalization of sex work is needed to ensure health and human rights for sex workers.
|
|
Lyons et al., 2015 [78]
|
Canada
|
Qualitative interviews
|
33 trans women sex workers
|
Decriminalization & Safer Work Environments. Transphobia and criminalized approaches to sex work shape violence and safety with clients and police.
|
Need for legal reform of sex work laws and culturally competent anti-stigma programs/policies to reduce transphobia.
|
|
Matthen et al., 2016 [81]
|
Canada
|
Qualitative interviews
|
45 men and trans sex workers and clients
|
Community-led Research. Narratives revealed highly diverse gender and sexual identities, underscoring importance of giving voice to gender and sexual minority sex workers through community-based research.
|
Policies and services must reflect diversity and needs of sex workers. Critical need to address homophobia/transphobia and reduce stigma.
|
|
Mimiaga et al., 2008 [45]
|
USA
|
Survey and qualitative interviews
|
31 MSM sex workers (19 street-involved and 13 internet-based escorts)
|
Safer Work Environments. Narratives highlight contextual differences in sexual risk-taking among street vs. internet-based workers. 69% reported unprotected serodiscordant sex.
|
Need for tailored interventions that acknowledge heterogeneity of sex workers and contextual and psychosocial factors influencing workplace safety.
|
|
Parsons et al., 2007 [109]
|
USA
|
Qualitative interviews
|
46 male sex workers (internet escorts)
|
Community Empowerment. Highlights the individual and community needs of male escorts.
|
Importance of addressing community-identified needs beyond safer sex, such as support with business and legal advice.
|
|
Reisner et al., 2008 [51]
|
USA
|
Brief survey and qualitative interviews
|
32 male sex workers
|
Integrative Care. Findings highlight valuable intervention components: trauma-informed mental health and substance abuse treatment, access to HIV/STI testing and treatment services, support groups to address isolation/loneliness, skill-building for risk reduction with partners, and paid incentives as add-ons to behaviour change interventions.
|
Multipronged interventions to reduce sexual risk-taking are needed for male sex workers, including addressing unique socioeconomic and legal needs.
|
|
Sausa et al., 2007 [80]
|
USA
|
Focus groups
|
48 trans women (85% had ever engaged in sex work); ethnic minorities
|
Community Empowerment. Participation in sex work and risks were influenced by social networks, cultural norms, immigration, racism, and transphobia
|
Highlights unique needs of trans sex workers who are ethnic minorities. Further research and polices must be tailored to this key subpopulation.
|
|
Shannon et al., 2008 [70]
|
Canada
|
Participatory-based focus groups
|
46 marginalized women sex workers (trans inclusive)
|
Safer Work Environments & Decriminalization. Lack of safe working environment and policing displace sex workers and elevate risk of violence and STBBI. Peer networks improve safe sexual practices with clients.
|
Socio-structural environment plays key role in shaping drug and sexual risk of HIV. Need for safer work environment supported by legislative reform.
|
|
Underhill et al., 2015 [74]
|
USA
|
31 qualitative interviews
|
Male sex workers
|
Decriminalization. Narratives highlight how experiencing discrimination and medical distrust can impede access to biomedical HIV prevention strategies such as PrEP.
|
There is a need to address multiple stigmas and discrimination that create barriers to STBBI prevention.
|
|
Williams et al., 2006 [108]
|
USA
|
Questionnaires to evaluate brief interventions to increase condom use
|
112 street-based male sex workers
|
Safer Work Environments & Integrative Care. Two-thirds of men enrolled in a brief risk reduction intervention completed it. Condom use during paid sex increased post-intervention.
|
Brief interventions tailored to male sex workers to reduce unprotected anal sex with clients are acceptable and efficacious.
|
|
Whitaker et al., 2011 [75]
|
Ireland
|
Qualitative interviews
|
31 female and 4 male sex workers (drug users)
|
Decriminalization & Integrative Care. Sex workers described experiencing stigma and discrimination from healthcare providers, which increased risk of HIV and HCV.
|
Training for service providers is needed to change language and reduce stigma around sex work.
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