P Duff1,2, J Sou1,3, J Chapman4, S Dobrer1, M Braschel1, S Goldenberg1,5, K Shannon1,2,3. 1. British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 1081 Burrard Street, Vancouver, British Columbia V6Z 1Y6, Canada. 2. Department of Medicine, University of British Columbia, St. Paul's Hospital, 1081 Burrard Street, Vancouver, British Columbia V6Z 1Y6, Canada. 3. School of Population and Public Health, University of British Columbia, 5804 Fairview Avenue, Vancouver, British Columbia V6T 1Z3, Canada. 4. Sex Workers United Against Violence, Vancouver, British Columbia, Canada. 5. Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, British Columbia V5A 1S6, Canada.
Abstract
BACKGROUND: While sex work is often considered the world's oldest profession, there remains a dearth of research on work stress among sex workers (SWs) in occupational health epidemiological literature. A better understanding of the drivers of work stress among SWs is needed to inform sex work policy, workplace models and standards. AIMS: To examine the factors that influence work stress among SWs in Metro Vancouver. METHODS: Analyses drew from a longitudinal cohort of SWs, known as An Evaluation of Sex Workers' Health Access (AESHA) (2010-14). A modified standardized 'work stress' scale, multivariable linear regression with generalized estimating equations was used to longitudinally examine the factors associated with work stress. RESULTS: In multivariable analysis, poor working conditions were associated with increased work stress and included workplace physical/sexual violence (β = 0.18; 95% confidence interval (CI) 0.06, 0.29), displacement due to police (β = 0.26; 95% CI 0.14, 0.38), working in public spaces (β = 0.73; 95% CI 0.61, 0.84). Older (β = -0.02; 95% CI -0.03, -0.01) and Indigenous SWs experienced lower work stress (β = -0.25; 95% CI -0.43, -0.08), whereas non-injection (β = 0.32; 95% CI 0.14, 0.49) and injection drug users (β = 0.17; 95% CI 0.03, 0.31) had higher work stress. CONCLUSIONS: Vancouver-based SWs' work stress was largely shaped by poor work conditions, such as violence, policing, lack of safe workspaces. There is a need to move away from criminalized approaches which shape unsafe work conditions and increase work stress for SWs. Policies that promote SWs' access to the same occupational health, safety and human rights standards as workers in other labour sectors are also needed.
BACKGROUND: While sex work is often considered the world's oldest profession, there remains a dearth of research on work stress among sex workers (SWs) in occupational health epidemiological literature. A better understanding of the drivers of work stress among SWs is needed to inform sex work policy, workplace models and standards. AIMS: To examine the factors that influence work stress among SWs in Metro Vancouver. METHODS: Analyses drew from a longitudinal cohort of SWs, known as An Evaluation of Sex Workers' Health Access (AESHA) (2010-14). A modified standardized 'work stress' scale, multivariable linear regression with generalized estimating equations was used to longitudinally examine the factors associated with work stress. RESULTS: In multivariable analysis, poor working conditions were associated with increased work stress and included workplace physical/sexual violence (β = 0.18; 95% confidence interval (CI) 0.06, 0.29), displacement due to police (β = 0.26; 95% CI 0.14, 0.38), working in public spaces (β = 0.73; 95% CI 0.61, 0.84). Older (β = -0.02; 95% CI -0.03, -0.01) and Indigenous SWs experienced lower work stress (β = -0.25; 95% CI -0.43, -0.08), whereas non-injection (β = 0.32; 95% CI 0.14, 0.49) and injection drug users (β = 0.17; 95% CI 0.03, 0.31) had higher work stress. CONCLUSIONS: Vancouver-based SWs' work stress was largely shaped by poor work conditions, such as violence, policing, lack of safe workspaces. There is a need to move away from criminalized approaches which shape unsafe work conditions and increase work stress for SWs. Policies that promote SWs' access to the same occupational health, safety and human rights standards as workers in other labour sectors are also needed.
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