Food Insecurity Increases HIV Risk Among Youth Sex Workers in Metro Vancouver

Research has shown food insecurity is highly related to gender, and current food assistance programming in Metro Vancouver is rarely designed for women, lesbian, gay, bisexual, trans, queer, and two-spirit (LGBTQ2S), and youth. There has been little research focused on marginalized youth, particularly street-involved sex workers in high-income countries like Canada.

Daniella Barreto, a GSHI Research Assistant and MSc student at the University of British Columbia, sought to understand how food insecurity (the limited or uncertain availability of nutritionally adequate, safe foods, or the inability to acquire foods in a socially acceptable way), impacts sexual risk negotiation for marginalized youth in sex work in Metro Vancouver.

Daniella brings a strong youth lens to her work with GSHI, having worked for eight years with the YouthCO HIV/Hepatitis C (HCV) Society. Most recently, she was asked to join a youth panel for the City of Vancouver, building on her work with AESHA on youth food insecurity and gender-based violence.

The GSHI community-based research (CBR) team conducted semi-annual interviews with 220 youth up to 29 years of age between 2010 and 2013. Participants were recruited as part of the AESHA project.

Of the 220 youth up to 29 years of age:

- One-third (31%) identified as a gender/sexual minority (LGBTQ2S)

Over the four-year study period, the majority of youth were moderately-to-severely food insecure:

 - 67% reported struggling with acquiring money for food

 - 72% were worried about food running out and

 - 14% had exchanged sex directly for food

Over the follow-up period, the prevalence of food insecurity among marginalized youth was more than nine times the national average of 8.3%.

Youth who struggled with money for food had twice the odds of client condom refusal (being pressured to not use a condom), demonstrating the relationship between food insecurity and sexual risk negotiation for HIV and other STIs amongst youth.

This research calls attention to the need for public policies for food support as part of sexual health promotion. It suggests HIV and other STI programming should be gender - and youth-centred, address food insecurity, sexual health education, and focus on gender/sexual minority and indigenous youth.

It also supports the critical need for laws and polices (including decriminalization of sex work) to support sex workers’ human rights, agency, safety in negotiating condom use and the ability to access health services and food. 

You can read the entire paper here, or find our community summary here

Photo by Daniella Barreto.