Sex workers face health-care barriers
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Local sex workers face barriers to cervical screening, says a recent Vancouver study — but advocates say it extends to health-care services as a whole.
Stigma, discrimination and a distrust of authority remain in the way for street sex workers to access the health-care system. The study Barriers to Cervical Screening among Sex Workers was published in the American Journal of Public Health, drawing on analysis from 2010 to 2013 from a survey of 611 sex workers.
Only 38% of them received a cervical screening, 23% didn’t receive their results, and while HIV-positive sex workers were more likely to have an annual test, 46% reported having missed their scheduled test.
“Even when physical access to cervical screening sites appears to be sufficient, social and structural barriers continue to impede regular, voluntary cervical screening among sex workers,” the study states.
Language barriers pose another issue for accessing services and the study suggests an in-depth examination into preferred models of communicating results to sex workers in Vancouver is warranted.
“Innovative, tailored occupational sexual health models such as sex worker-led strategies will remain critical ... and will help reduce issues surrounding sex work stigma sometimes projected by health-care workers,” the study states. “Active engagement of sex workers in outreach services also may help reach marginalized and hidden sex workers operating in more isolated settings.”
Laura Dilley, executive director of PACE Society, which provides help for 500 sex workers in the Downtown Eastside, agreed about the barriers.
“They do fear going to an emergency or walk-in clinic because often time we hear stories from members who said ... ‘They kicked me out because I was loitering and I didn’t look like I belonged there,’” she said. “It’s just really rude (health-care) professionals using really stigmatized language and not really respecting them.”
The society has an indigenous-led outreach team — due to aboriginal women being disproportionately represented in the outdoor sex trade in the DTES — that hands out harm reduction supplies and approach workers without “judgment or stigma,” Dilley said.
The society started a peer health navigator program to act as an advocate to hospital visits. A peer will attend a doctor’s appointment with a worker to “ensure they’re being respected,” according to Dilley.
“We just find they’re avoiding it altogether,” she said. “I think sex workers have become so used to getting such bad services they end up not accessing it.”