The impact of end-demand legislation on sex workers' access to health and sex worker-led services: A community-based prospective cohort study in Canada
The impact of end-demand legislation on sex workers' access to health and sex worker-led services: A community-based prospective cohort study in Canada
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DOI：
10.1371/journal.pone.0225783
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发表时间：
2020-04-06
期刊：
影响因子：
3.7
通讯作者：
Shannon, Kate
中科院分区：
文献类型：
--
作者：
Argento, Elena;Goldenberg, Shira;Shannon, Kate
背景：在全球性的最终需求性工作定罪浪潮之后，加拿大实施了《保护社区和被剥削者法》，这对性工作者的健康和安全产生了影响。本研究旨在评估ppca对性工作者获得健康、暴力和性工作者主导的服务的影响。方法纵向数据来自加拿大温哥华一个以社区为基础的约900名顺性和变性女性性工作者队列。多变量逻辑回归检验了pcepa实施后（2015-2017年）与pcepa实施前（2010 - 2013年）对性工作者获得健康、暴力支持和性工作者/社区主导服务的时间更新措施的独立影响。结果ppcpa与需要时获得卫生服务的几率降低（AOR 0.59; 95%CI: 0.45-0.78）和社区主导的服务（AOR 0.77; 95%CI: 0.62-0.95）独立相关。在经历过身体暴力/性暴力或创伤的性工作者中，在ppcpa后获得咨询支持方面没有显著差异（AOR 1.24; 95%CI: 0.93-1.64）。结论新法律实施后，性工作者获得关键卫生服务和性工作者/社区主导服务的机会明显减少。研究结果表明，在加拿大，最终需求法可能会加剧和再现先前将性工作定为犯罪的危害。这项研究是全球首批评估最终需求方法对性工作影响的研究之一。我们迫切需要在全球范围内摆脱对性工作的刑事定罪，以确保性工作者享有充分的劳动和人权。调查结果警告其他城市或司法管辖区不要采用终端需求方法。
BackgroundFollowing a global wave of end-demand criminalization of sex work, the Protection of Communities and Exploited Persons Act (PCEPA) was implemented in Canada, which has implications for the health and safety of sex workers. This study aimed to evaluate the impact of the PCEPA on sex workers' access to health, violence, and sex worker-led services.MethodsLongitudinal data were drawn from a community-based cohort of similar to 900 cis and trans women sex workers in Vancouver, Canada. Multivariable logistic regression examined the independent effect of the post-PCEPA period (2015-2017) versus the pre-PCEPA period (20102013) on time-updated measures of sex workers' access to health, violence supports, and sex worker/community-led services.ResultsThe PCEPA was independently correlated with reduced odds of having access to health services when needed (AOR 0.59; 95%CI: 0.45-0.78) and community-led services (AOR 0.77; 95%CI: 0.62-0.95). Among sex workers who experienced physical violence/sexual violence or trauma, there was no significant difference in access to counseling supports post-PCEPA (AOR 1.24; 95%CI: 0.93-1.64).ConclusionSex workers experienced significantly reduced access to critical health and sex worker/community-led services following implementation of the new laws. Findings suggest end-demand laws may exacerbate and reproduce harms of previous criminalized approaches to sex work in Canada. This study is one of the first globally to evaluate the impact of end-demand approaches to sex work. There is a critical evidence-based need to move away from criminalization of sex work worldwide to ensure full labor and human rights for sex workers. Findings warn against adopting end-demand approaches in other cities or jurisdictions.