Mapping and contextualizing public sex work spaces and their impact on HIV transmission dynamics: a community-based pilot research project

In British Columbia, thousands of women continue to struggle daily with poverty and addiction, exchanging sex on the streets for drugs, money, shelter or other commodities as a means of daily subsistence (female survival sex workers [FSWs]). The estimated HIV prevalence among street-based FSWs in Vancouver is 23% and most have a history of using injection drugs and crack cocaine. Emerging evidence has identified the crucial role of gender and environmental-structural inequities in shaping FSWs? poor access to health and support resources and vulnerability to HIV infection. However, there remains a dearth of evidence regarding how characteristics of public sex work spaces may impact FSWs? health and safety. Building on a three-year community-based research partnership with a local sex work group, the proposed study will pilot innovative mapping of public sex work spaces in Vancouver and document the role of environmental-structural factors in shaping FSWs? working conditions and transactions with clients, and the impact of these factors on HIV risk. Participatory mapping using global positioning system and geographic information system (GIS) technology, combined with questionnaires and regular outreach stats sheets by FSWs, will provide information regarding volume, typology and characteristics of sex work strolls over time. Group and individual in-depth interviews with FSWs will be conducted to help contextualize environmental-structural factors shaping risky sex work spaces. This proposed project is extremely relevant to the health of some of the most marginalized women in British Columbia, who are frequently overlooked in planning/policy decisions that impact their health, safety and well-being. Results will be used to develop a larger GIS mapping project on access to HIV prevention and treatment services among FSWs, and inform the development of place-based interventions that facilitate safer sex work settings and improve access to HIV-related health services.