1. Lack of full citizenship rights linked to heightened client condom refusal among im/migrant sex workers in Metro Vancouver (2010–2018).
- Author
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McBride, Bronwyn, Shannon, Kate, Braschel, Melissa, Mo, Minshu, and Goldenberg, Shira M.
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SEX work laws , *CIVIL rights , *HIV infection risk factors , *CITIZENSHIP , *SEXUALLY transmitted disease risk factors , *IMMIGRANTS , *STATISTICS , *HEALTH services accessibility , *CONFIDENCE intervals , *MULTIPLE regression analysis , *CONSUMER attitudes , *SOCIAL stigma , *MANN Whitney U Test , *FISHER exact test , *QUESTIONNAIRES , *DESCRIPTIVE statistics , *CHI-squared test , *GOVERNMENT policy , *RESEARCH funding , *CONDOMS , *LOGISTIC regression analysis , *ODDS ratio , *STATISTICAL correlation , *LONGITUDINAL method , *SEXUAL health - Abstract
In Canada, im/migrant sex workers face stigma, health access barriers, and overlapping marginalisation, with end-demand law reforms in 2014 postulated to exacerbate these inequities. Yet, little quantitative evidence on how immigration status shapes HIV/STI risk exists. Drawing on community-based longitudinal cohort data (AESHA, 2010–2018), we used multivariable confounder models with logistic regression to model (1) the independent effect of precarious immigration status (any status revocable under criminal charges: permanent residency/temporary residency/undocumented) on client condom refusal, and (2) the moderating effect of precarious status on the relationship between condom refusal and exposure to end-demand law reform (2015–2018). Over this 8-year study involving 758 sex workers in Metro Vancouver, 16.0% were im/migrants, of whom 57% had precarious immigration status at baseline. 16.5% of participants experienced client condom refusal. Precarious immigration was associated with increased odds of facing condom refusal (adjusted odds ratio [AOR] 2.53, 95% confidence interval [CI] 1.37–4.68), and these odds were heightened post-end-demand law reforms (AOR 4.35, 95%CI 1.21–15.66). Our findings suggest that lack of citizenship rights may enhance barriers to safer sex negotiation and increase HIV/STI risk among sex workers, highlighting the need for sex work and immigration policy reforms. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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