Violence Drives HIV Risk for Women in Street-Based Sex Work

Vancouver, April 3, 2008 — Everyday violence experienced by women engaged in street-based sex work results in a heightened risk of HIV transmission, finds a new study authored by the B.C. Centre for Excellence in HIV/AIDS (BC-CfE).
The qualitative study published in Social Science and Medicine included responses from 46 participants, from focus groups conducted between December 2005 and March 2006. The average age of the respondents was 34 years and 57 per cent identified themselves as being of Aboriginal ancestry.

“These women are struggling daily to survive and yet there continues to be a lack of response to promote their basic health and safety on the streets,” says BC-CfE lead-author Kate Shannon. “Pervasive violence and police enforcement strategies are key elements that need to be addressed to ensure the health and safety of female sex workers.”

The study focus groups explored in detail definitions of sex work; what defines a safe environment for sex work; and circumstances that affect a woman’s power and control to protect herself. The research was a direct result of a partnership between the BC-CfE and the Women’s Information Safe Haven (WISH) Drop-In Centre called the Maka Project.

“There are so many women working on the street – where we see the largest number of new HIV infections – and they are unprotected and shunned by society,” says Kate Gibson, executive director of WISH. “The study includes very candid comments from these women, and they help break down the subject into meaningful pieces.”

Five key themes about sex workers’ experiences emerged from the study: at the micro-level, boyfriends as pimps and the ‘everyday violence’ of bad dates; at the meso-level, a lack of safe places to take dates, and the adverse impacts of local policing; and at the macro-level, ‘dope-sickness’ and the need to sell sex for drugs. The study also demonstrated the role of violence in reducing women’s ability to safely negotiate condom use for sexual services.

“I think just going out there [working] takes a big risk whether you use a condom or not, and I mean gambling every time you go out,” states one of the sex workers quoted in the study. “If he doesn’t want to use a condom, we’re in extreme danger.”

The findings suggest that public health strategies fail to address social and structural violence, and gendered power relations will continue to fall short in stemming the multiple harms, including HIV burden, faced by women. The authors note sex work in this population is also a direct result and economic response to entrenched poverty, homelessness and addiction, and for many women, sex work serves as the only viable means to daily survival.

Several recommendations outlined in the study address interventions for female sex workers. These interventions need to resolve the paramount role of adequate and supportive housing, and access to detoxification and other drug treatment services, say the authors. Interventions should also consider offering long-term, alternative economic opportunities to support transition out of survival sex work, as well as the potential benefits of expanded drug-maintenance therapy for this population.

For a full copy of the study or interview requests, contact Stephen Burega, media relations, 604-506-3734 (c),, or contact William Mbaho and Karyo Edelman at 604-623-3007 or by email at

About the BC Centre for Excellence in HIV/AIDS
Founded in 1992 by St. Paul’s Hospital and the provincial Ministry of Health, the BC Centre for Excellence in HIV/AIDS is a key provincial resource seeking to improve the health of people with HIV through the development, ongoing monitoring and dissemination of comprehensive investigative and treatment programs for HIV and related diseases. St. Paul’s Hospital is one of seven care facilities operated by Providence Health Care, Canada’s largest faith-based health care organization.

About the WISH Drop-In Centre Society
For the past 23 years the WISH Drop-In Centre has provided a place of respite and safety for women working in the survival sex trade in Vancouver. Over the years WISH has expanded from serving coffee to a few women a few nights a week to serving dinner and meeting some of the basic needs of 100 to 150 participants each night, six nights a week. WISH provides consistency in lives of women who constantly experience violence, trauma, and discrimination out on the street.