Sex worker safety highlighted in BC-CfE study, Ontario’s recent court ruling

Dr. Kate Shannon, the director of Gender and Sexual Health Initiative at the B.C. Centre for Excellence in HIV/AIDS (BC-CfE), was at the centre of debate following the release of a key study on sex worker safety this month and a landmark court decision in Ontario on Canada’s anti-prostitution laws.

The Ontario court ruling, handed down September 28, struck down Canada’s criminal code provisions related to adult consensual prostitution in response to substantial evidence that the current laws endanger the lives of sex workers. As Justice Himel stated: “By increasing the risk of harm to street prostitutes, the communicating law is simply too high a price to pay for the alleviation of social nuisance.” On October 12, the B.C. Court of Appeal gave the green light for a similar constitutional challenge by sex workers to go ahead.

Dr. Shannon welcomed both rulings.

Canada’s prostitution laws struck down

“The court decisions are a critical step forward in ensuring the health and safety of sex workers,” said Dr. Shannon, who’s also an assistant professor of medicine at the University of British Columbia (UBC). “The Ontario decision recognizes that the current criminalized approach to prostitution has not only failed to protect the health and safety of sex workers in the country, but has actually exacerbated exposure to harms, including violence and murder.”

BC-CfE research shows that when sex work is criminalized, enforcement pushes the most marginalized women in street-based sex work away from health services. This directly elevates the risk of violence and reduces sex workers’ ability to negotiate condom use with clients, thus increasing the risk of sexually transmitted infections such as HIV.

In fact, several international bodies have advocated for the removal of criminal sanctions on sex workers as a necessary step for HIV prevention. Still, the federal government has announced it will appeal the Ontario court ruling, a step that Dr. Shannon says defies the scientific evidence regarding reducing harm to sex workers.

“While there are many examples of policies and interventions that appear effective in reducing harms among sex workers in other countries, none of these strategies can even be piloted and evaluated in Canada until the laws are repealed,” said Dr. Shannon. “In the meantime, sex workers continue to be left with few options to protect their health and safety.”

Sex worker outreach effective

As the court rulings were handed down, Dr. Shannon released a BC-CfE and UBC study conducted with the WISH Drop-In Centre Society and the Prostitution Alternatives Counselling & Education (PACE) Society. The study showed that a Vancouver-based mobile outreach program staffed by current and former sex workers is associated with increased entry to detoxification and residential drug treatment among women in street-based sex work.

The study, recently published in the peer-reviewed medical journal Drug and Alcohol Dependence, examined the link between accessing Vancouver’s Mobile Access Project, or “the MAP van,” and uptake of addiction treatment services by women engaged in street-based sex work who use drugs.

The MAP van functions as a nightly (10:30 p.m. to 5:30 a.m.) service run by women, most of whom are former sex workers. The van provides a safe space for sex workers to rest and have water, juice and coffee. Outreach staff members collect and distribute reports of bad dates; distribute prevention resources such as condoms, syringes, mouthpieces, and alcohol swabs; and provide referrals to health, support, and addiction treatment services.

The study interviewed 242 women in street-based sex work and followed them over a period of 18 months from 2006 to 2008. During this time, 42 per cent of women reported using the MAP van. Women who accessed the MAP van were four times more likely to have entered detox and/or residential drug treatment as compared to women not accessing the MAP van. The van is also more likely to reach the most marginalized sex workers in isolated public spaces such as alleys and industrial settings.