The ‘HIV Coalition’
The Gender and Sexual Health Initiative (GSHI) of the BC Centre for Excellence in HIV/AIDS (BCCfE), the Canadian HIV/AIDS Legal Network, and the HIV/AIDS Legal Clinic of Ontario, formed the ‘HIV Coalition’ to intervene in Bedford v. Canada at the Supreme Court. GSHI contributed evidence drawn from years of research and dozens of peer-reviewed publications that resulted largely from two major research projects: AESHA – An Evaluation of Sex Worker’s Health Access: a longitudinal cohort of street and off-street sex workers; and the Ethnographic- Qualitative study of the physical, social and policy features of the work environment. These studies are led by GSHI of BCCfE and UBC, with a range of community partners, and include ongoing street/ off-street outreach.
Policing, Fear of Arrest: Under the current criminal laws in Canada, policing is both directly (violence, intimidation) and indirectly (displacement) linked to increased risk of physical violence and rape of sex workers (Shannon et al., BMJ, 2009; Shannon & Csete, JAMA, 2010) and reduced ability to negotiate condom use (Shannon et al., AJPH, 2009). Arrest and intimidation by police can cause fear and mistrust, and make sex workers less likely to report violence to authorities (Shannon et al., SSM, 2008; Anderson et al., 2013). These fears were amplified by distrust and apathy by police during the botched investigation of the Missing Women in Vancouver (Shannon et al., SSM, 2008).
Enforced Displacement: The criminal law prohibiting communicating in public spaces for the purposes of sex work often pushes the most marginalized sex workers to dark alleys and industrial settings where they have little protection or ability to screen clients. Our longitudinal study shows that displacement is directly linked to increased risk of physical violence and rape (Shannon et al., BMJ, 2009) and HIV risks (Deering et al., IJDP, 2013), including reduced ability to insist on condom use by clients (Shannon et al., AJPH, 2009).
Violence: The current criminal laws remove most protections for sex workers. Those working on the street or hidden indoor spaces are often forced to rush negotiations and have limited time to screen clients due to fear of arrest (Shannon et al., SSM, 2008; JAMA, 2010). Violence, intimidation and displacement by police, and lack of access to safer indoor work spaces are directly linked to increased risk of violence against sex workers (Shannon et a., BMJ, 2009).
Condom Use: Heavy policing of the current laws, and extreme violence and murder of sex workers, have forced many to forgo condoms for fear of violence or arrest (Shannon et al. SSM, 2008). Court-ordered sanctions, police displacement, lack of access to safer indoor spaces, and elevated violence directly impact sex workers ability to negotiate condom use with clients (Shannon et al., AJPH, 2009; Deering et al., JAIDS, 2013).
Health Access, Stigma: Stigma (fear of disclosing sex work status), social isolation and displacement, and language barriers are the strongest barriers to accessing health care for sex workers (Lazarus et al., SSM, 2010).
Youth: Youth are more likely to be displaced away from health and support services (Shannon et al., IJDP, 2008) and arrested for prostitution as adults (Goldenberg et al., JAIDS, 2013) suggesting these laws are not only failing to protect vulnerable youth but are further criminalizing and isolating them.
Safer Indoor Work Spaces: Indoor “in-call” venues with increased safety protections (e.g. managers/ security, client sign-in) and ability to work together promote sex workers ability to control transactions, including avoiding violence, refusing unwanted clients or risky services (Krusi et al., AJPH, 2012) and insisting on condom use (Deering et al., JAIDS, 2013). Removal of the criminal code prohibition on “bawdy houses” will allow formal implementation of indoor/in-call venues, in accordance with workplace safety standards, regulation and licensing as with other businesses, and ensure sex workers have the ability to access safety precautions.