Structural Determinants of Health among Im/Migrants in the Indoor Sex Industry: Experiences of Workers and Managers/Owners in Metropolitan Vancouver.
Structural Determinants of Health among Im/Migrants in the Indoor Sex Industry: Experiences of Workers and Managers/Owners in Metropolitan Vancouver.
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DOI：
10.1371/journal.pone.0170642
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发表时间：
2017
期刊：
影响因子：
3.7
通讯作者：
Shannon K
中科院分区：
文献类型：
--
作者：
Goldenberg SM;Krüsi A;Zhang E;Chettiar J;Shannon K
在全球范围内，移民/移徙妇女在性产业中的比例过高，并经历了不成比例的健康不平等。尽管有证据表明，移徙对健康的影响可能因移徙的时间和阶段而异（例如，早期到达vs.长期移徙），但关于不同移徙阶段健康的社会和结构决定因素的证据有限，特别是从事性工作的移民/移徙者。我们的目的是描述和分析在室内性产业的移民/移民抵达和定居过程中健康和安全的不断变化的社会和结构决定因素。我们分析了2011年在加拿大温哥华大都会对44名移民/移徙性工作者和室内性场所（如按摩院、微型妓院）的经理/老板进行的定性访谈；来自AESHA（一个更大的以社区为基础的队列）的定量数据被用来描述移民/移徙性工作者的社会人口和社会结构特征。根据AESHA的198名移民/移民工人的定量数据，78.3%是中国出生的，在加拿大的中位时间为6年，大多数（86.4%）在正式的室内场所服务。定性叙述揭示了抵达加拿大后进入性工作的多种途径，包括传统劳动力市场的语言障碍以及性工作的较高收入和相对灵活性。一旦从事性工作，与警察突袭有关的恐惧（例如，移民问题、性工作的披露）以及性谈判和健康、社会和法律支持方面的语言障碍对在加拿大长期定居期间的健康、安全和人权构成普遍挑战。调查结果强调了与性工作和移民/移民身份有关的定罪、语言障碍、污名化和歧视对从事性工作的移民/移民的职业健康和安全的重要影响。需要采取强调人权和职业健康的干预措施和政策改革，以促进整个抵达和定居过程中的健康和福祉。
Globally, im/migrant women are overrepresented in the sex industry and experience disproportionate health inequities. Despite evidence that the health impacts of migration may vary according to the timing and stage of migration (e.g., early arrival vs. long-term migration), limited evidence exists regarding social and structural determinants of health across different stages of migration, especially among im/migrants engaged in sex work. Our aim was to describe and analyze the evolving social and structural determinants of health and safety across the arrival and settlement process for im/migrants in the indoor sex industry. We analyzed qualitative interviews conducted with 44 im/migrant sex workers and managers/owners working in indoor sex establishments (e.g., massage parlours, micro-brothels) in Metropolitan Vancouver, Canada in 2011; quantitative data from AESHA, a larger community-based cohort, were used to describe socio-demographic and social and structural characteristics of im/migrant sex workers. Based on quantitative data among 198 im/migrant workers in AESHA, 78.3% were Chinese-born, the median duration in Canada was 6 years, and most (86.4%) serviced clients in formal indoor establishments. Qualitative narratives revealed diverse pathways into sex work upon arrival to Canada, including language barriers to conventional labour markets and the higher pay and relative flexibility of sex work. Once engaged in sex work, fear associated with police raids (e.g., immigration concerns, sex work disclosure) and language barriers to sexual negotiation and health, social and legal supports posed pervasive challenges to health, safety and human rights during long-term settlement in Canada. Findings highlight the critical influences of criminalization, language barriers, and stigma and discrimination related to sex work and im/migrant status in shaping occupational health and safety for im/migrants engaged in sex work. Interventions and policy reforms that emphasize human rights and occupational health are needed to promote health and wellbeing across the arrival and settlement process.