Street-based sex workers needs assessment

Street-based sex workers face many challenges: social marginalization, criminalized work environments, homelessness, poverty, violence, and mental health and addiction issues. To overcome these barriers, there is a need for specific social and health services tailored to the complex experiences and needs of sex workers.

In order to gain a better understanding of these issues in Toronto, Barrie and Oshawa, a research team led by women previously involved in sex work, Street Health, and Regent Park Community Health Center has carried out a needs assessment. EENet has developed a Research Report Round-up of the resulting report, “Street-based Sex Workers Needs Assessment.” To read it click on the “download” button below.

Research Report Round-ups are brief summaries of research reports, presented in a user-friendly format.

Read the summary below or download the PDF.

Title and link to report: Street-based Sex Workers Needs Assessment 
Authors: Street Health, Regent Park Community Health Centre, and the Needs Assessment Team 
Year of report: 2014
Location: Toronto, Barrie, and Oshawa, Ontario
Population addressed: Street-based sex workers

Type of study: Community-based research; needs assessment

What this report is about

Street-based sex workers face many challenges: social marginalization, criminalized work environments, homelessness, poverty, violence, and mental health and addition issues. To overcome these barriers, there is a need for specific social and health services tailored to the complex experiences and needs of sex workers. More specifically, research has shown that social and health services need to be non-judgmental, accessible, and non-stigmatizing. After all, many women engaged in sex work will avoid seeking care because of negative past experiences and fear of judgment, increasing the chances that their health and social service needs go unmet.

In order to gain a better understanding of these issues in Toronto, Barrie and Oshawa, the needs assessment research team, led by women previously involved in sex work, Street Health, and Regent Park Community Health Center, used a community-based research approach to conduct a needs assessment to: 

  • Get an understanding of demographic profile of street based sex workers in the Greater Toronto region
  • Assess their health condition, experiences in accessing health care and social services
  • Analyze the barriers they face in accessing services if any and the gaps in health and social services

 

  • Work collaboratively with agencies and network members to strategize and develop a plan to help improve health outcomes for sex workers

The research team developed a survey tool for use in face to face interviews and over a period of four months interviewed 100 women and transgendered women living in Toronto, Barrie, and Oshawa. 

The findings in this assessment were categorized into demographic profile, health conditions, experiences accessing health and social services, and barriers to accessing health and social services. 

When asked about the barriers to accessing health and social services, the women indicated the following responses: 

  • Judgment from providers 
  • Time of day services were offered (not being open in the evening/night)
  • Lack of long-term relationships with providers
  • Personal safety
  • Social isolation
  • Lack of information about the types of services and supports
  • Personal barriers (addiction, lack of transportation, other urgent priorities like accessing food and shelter) 

Respondents were asked to make suggestions on how health care and social service agencies could serve them better. They suggested that services should: 

  • Be non-judgmental, compassionate and understanding 
  • Make more education about services available
  • Employ peer workers alongside health and social service providers
  • Involve sex workers in developing and facilitating programs
  • Change operating hours to include after hours services
  • Offer drop-in spaces, safe spaces, and initiatives such as the health bus

Recommendations

The assessment demonstrates that sex workers face significant challenges and barriers related to their demographic profile and health conditions. Stigma and discrimination play an important role in determining access to health and social services. The report outlines nine recommendations to enhance services and ultimately improve health and social outcomes for street based sex workers:

  • Increase access to health services for street-based sex workers and provider non-judgmental/non-discriminatory services
  • Develop a coalition to advocate for street-based sex workers
  • Employ more peer workers to help sex workers access services
  • Increase awareness about harm reduction and provide harm reduction services to sex workers
  • Strengthen and Expand the Bad Date Coalition
  • Improve access to affordable and supportive housing
  • Increase access to safe spaces
  • Develop services specific to street-based workers
  • Develop alternatives for sex workers planning to exit sex work

How can this report be used

This report can be used to improve existing services for street-based sex workers and demonstrate the need to develop new services where necessary that are accessible and non-stigmatizing. It shows the importance of working with sex workers to assess their needs, and involve them in the planning and delivery of health and social services. 

Key words: Sex workers, women, needs assessment, health and social service providers 

Contact person/source: Mary Kay MacVicar marykay [at] streethealth [dot] ca  

Language of report: English

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