Sex Work and Motherhood: Social and Structural Barriers to Health and Social Services for Pregnant and Parenting Street and Off-Street Sex Workers

The majority of sex workers are mothers. Although participation in sex work is primarily driven by the prioritization of their children’s needs over their own, mothers are stigmatized, subject to poorer health, and lack access to quality health care and social services. Interviews with 25 mothers in Mumbai, India, were analyzed using theory-driven coding to reexamine participation in sex work in context of Gilligan’s three-stage ethic of care, a feminist theory of moral reasoning. Stage 1 (decision making focused on self) themes were (a) sex work served as a means to survival and (b) exploitative and unfulfilling relationships required a focus on self. The transition from Stage 1 to 2 theme was language of selfishness versus responsibility. Stage 2 (selflessness is goodness) themes characterizing the majority of narratives were (a) sex work is justified, (b) duty to prioritize care of others, and (c) self-sacrifice to achieve aspirations for children. The transition from Stage 2 to 3 had one theme: consideration of self. While Stage 3 represents women taking holistic care of themselves and others, the data did not reflect this. Reframing mothers’ participation in sex work using the ethic of care framework may support destigmatization, decriminalization, and security of human rights.

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Factors associated with women’s entry into the sex industry: findings from interviews conducted with female sex workers in Chinese detention centres

Sexual Health ◽

10.1071/sh14009 ◽

2015 ◽

Vol 12 (6) ◽

pp. 541

Author(s):

Xiaohu Zhang ◽

Limin Mao ◽

Peter Aggleton ◽

Jun Zhang ◽

Jun Jing ◽

...

Keyword(s):

Social Services ◽

Sex Work ◽

Low Socioeconomic Status ◽

Sex Workers ◽

Urban Areas ◽

Chinese Women ◽

Contextual Factors ◽

Sex Industry ◽

Family Responsibilities ◽

Factors Associated

Background: To date, limited research has been conducted to identify the personal and contextual factors that contribute to women’s entry into the sex industry in China. Methods: The reasons for and factors associated with voluntary entry into the sex industry were explored through in-depth interviews conducted with 38 Chinese women who were held in detention centres for selling sex. Results: Women’s personal accounts reveal that entry into sex work is influenced by life aspirations, family responsibilities and social connections, which facilitate mobility to a new urban environment in which they encounter opportunities and challenges. Findings highlight the complex interactions between individual and contextual factors in relation to women’s entry into sex work. Conclusions: In a rapidly developing country such as China, entry into sex work may appeal to women of low socioeconomic status, particularly young women who have recently migrated to urban areas. For members of this mobile and relatively disadvantaged population, comprehensive social services and support are urgently needed.

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Access barriers to health and social services in Cambodia: experiences in healthcare use of people with disabilities

South East Asia Research ◽

10.1080/0967828x.2021.2016033 ◽

2022 ◽

pp. 1-17

Author(s):

Jamie Lee Harder ◽

Claus Wendt

Keyword(s):

Social Services ◽

People With Disabilities ◽

Access Barriers ◽

Healthcare Use ◽

Health And Social Services ◽

Barriers To Health

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Community-Based Responses to Negative Health Impacts of Sexual Humanitarian Anti-Trafficking Policies and the Criminalization of Sex Work and Migration in the US

Social Sciences ◽

10.3390/socsci9010001 ◽

2019 ◽

Vol 9 (1) ◽

pp. 1 ◽

Cited By ~ 2

Author(s):

Heidi Hoefinger ◽

Jennifer Musto ◽

P. G. Macioti ◽

Anne E. Fehrenbacher ◽

Nicola Mai ◽

...

Keyword(s):

Health Care ◽

Health Outcomes ◽

Social Services ◽

Sex Work ◽

Sex Workers ◽

Health Impacts ◽

Community Based ◽

The Us ◽

And Migration ◽

Negative Health Outcomes

System-involvement resulting from anti-trafficking interventions and the criminalization of sex work and migration results in negative health impacts on sex workers, migrants, and people with trafficking experiences. Due to their stigmatized status, sex workers and people with trafficking experiences often struggle to access affordable, unbiased, and supportive health care. This paper will use thematic analysis of qualitative data from in-depth interviews and ethnographic fieldwork with 50 migrant sex workers and trafficked persons, as well as 20 key informants from legal and social services, in New York and Los Angeles. It will highlight the work of trans-specific and sex worker–led initiatives that are internally addressing gaps in health care and the negative health consequences that result from sexual humanitarian anti-trafficking interventions that include policing, arrest, court-involvement, court-mandated social services, incarceration, and immigration detention. Our analysis focuses on the impact of criminalization on sex workers and their experiences with sexual humanitarian efforts intended to protect and control them. We argue that these grassroots community-based efforts are a survival-oriented reaction to the harms of criminalization and a response to vulnerabilities left unattended by mainstream sexual humanitarian approaches to protection and service provision that frame sex work itself as the problem. Peer-to-peer interventions such as these create solidarity and resiliency within marginalized communities, which act as protective buffers against institutionalized systemic violence and the resulting negative health outcomes. Our results suggest that broader public health support and funding for community-led health initiatives are needed to reduce barriers to health care resulting from stigma, criminalization, and ineffective anti-trafficking and humanitarian efforts. We conclude that the decriminalization of sex work and the reform of institutional practices in the US are urgently needed to reduce the overall negative health outcomes of system-involvement.

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Structural barriers to condom access in a community-based cohort of sex workers in Vancouver, Canada: influence of policing, violence and end-demand criminalisation

BMJ Sexual & Reproductive Health ◽

10.1136/bmjsrh-2019-200408 ◽

2020 ◽

pp. bmjsrh-2019-200408

Author(s):

Shira Goldenberg ◽

Ruchi Liyanage ◽

Melissa Braschel ◽

Kate Shannon

Keyword(s):

Hiv Prevention ◽

Sex Work ◽

Workplace Violence ◽

Sex Workers ◽

Scale Up ◽

Structural Barriers ◽

Community Based ◽

Research Attention ◽

Sti Prevention ◽

Condom Access

ObjectivesSex workers (SWs) face a disproportionate burden of HIV/sexually transmitted infections (STIs), violence and other human rights violations. While recent HIV prevention research has largely focused on the HIV cascade, condoms remain a cornerstone of HIV prevention, requiring further research attention. Given serious concerns regarding barriers to condom use, including policing, violence and ‘end-demand’ sex work criminalisation, we evaluated structural correlates of difficulty accessing condoms among SWs in Vancouver over an 8-year period.MethodsBaseline and prospective data were drawn from a community-based cohort of women SWs (2010–2018). SWs completed semi-annual questionnaires administered by a team that included lived experience (SWs). Multivariable logistic regression using generalised estimating equations (GEE) modelled correlates of difficulty accessing condoms over time.ResultsAmong 884 participants, 19.1% reported difficulty accessing condoms during the study. In multivariable GEE analysis, exposure to end-demand legislation was not associated with improved condom access; identifying as a sexual/gender minority (adjusted odds ratio (aOR) 1.62, 95% CI 1.16 to 2.27), servicing outdoors (aOR 1.52, 95% CI 1.17 to 1.97), physical/sexual workplace violence (aOR 1.98, 95% CI 1.44 to 2.72), community violence (aOR 1.79, 95% CI 1.27 to 2.52) and police harassment (aOR 1.66, 95% CI 1.24 to 2.24) were associated with enhanced difficulty accessing condoms.ConclusionsOne-fifth of SWs faced challenges accessing condoms, suggesting the need to scale-up SW-tailored HIV/STI prevention. Despite the purported goal of ‘protecting communities’, end-demand criminalisation did not mitigate barriers to condom access, while sexual/gender minorities and those facing workplace violence, harassment or those who worked outdoors experienced poorest condom accessibility. Decriminalisation of sex work is needed to support SWs’ labour rights, including access to HIV/STI prevention supplies.

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