Mapping Workplace Neighborhood Mobility Among Sex Workers in an Urban Canadian Setting: Results of a Community-Based Spatial Epidemiological Study From 2010-2016

Abstract

Mobility among sex workers has been linked not only to improved economic and social opportunities, but also to concerns regarding displacement, criminalization, and violence. In 2014, new "end-demand" legislation criminalized new aspects of sex work in Canada (e.g., third-party advertising, purchasing) while leaving the sale of sex legal. Utilizing data from a longitudinal community-based cohort of women sex workers in Metro Vancouver (An Evaluation of Sex Workers Health Access [AESHA], 2010-2016), we used kernel density mapping to understand and identify geographic patterns of workplace neighborhood mobility (i.e., changing the primary neighborhood in which one worked in the last 6 months); multivariable logistic regression using generalized estimating equations was also used to model contextual (policing, violence, and safety) and individual correlates of workplace mobility among sex workers over the 6-year period, including potential changes in mobility patterns pre- and post-end-demand criminalization. A total of 543 sex workers were included in analyses, contributing 2,199 observations. A total of 402 (74.0%) experienced workplace neighborhood mobility during the study period. Neighborhood mobility was negatively correlated with age (adjusted odds ratio [AOR] = 0.98/year older, 95% confidence interval [CI] = [0.97, 0.99]) and positively correlated with homelessness (AOR = 1.43, 95% CI = [1.12, 1.82]), identifying as a gender/sexual minority (AOR = 1.31, 95% CI = [1.04, 1.70]), and servicing clients primarily outdoors (vs. informal indoor or in-call venues; AOR = 1.48, 95% CI = [1.21, 1.81]); police harassment (AOR = 1.19, 95% CI = [0.96, 1.48], p = .11) and changing one's neighborhood of work due to safety concerns (AOR = 1.37, 95% CI = [0.94, 2.00], p = .09) were both marginally correlated. Steps to promote safer working conditions for marginalized women in urban environments remain urgently needed, including shifts away from criminalized enforcement toward community-led initiatives and promoting access to safer indoor workspaces.

Keywords: displacement; mobility; sex work; spatial epidemiology; work environment.

Figure 1.

Kernel density map illustrating hotspots of workplace neighbourhood mobility amongst sex workers who worked within the City of Burnaby (2010–2016, N=183). Note: Data in this figure includes only those sex workers who solicited and/or serviced in the City of Burnaby between 2010–2016. Red hotspots indicate areas with the highest net rate of outward mobility while the green hotspots depict areas with the greatest net rate of in-migration during the study period. This figure shows high rates of work-related out-migration from the City of Burnaby into the City of Vancouver. As our modeling shows, out-migration was likely due to police harassment and unsafe environment. The Downtown Eastside (DTES) neighborhood is characterized by high rates of urban poverty, marginalized or unstable housing, and highly concentrated and visible substance use and indoor and outdoor sex work scenes. In contrast, the suburban community of Burnaby is home to large immigrant/newcomer populations, and has more dispersed sex work and drug use scenes, with a greater proportion of sex work taking place in formal indoor environments (e.g., massage parlours).

Figure 2.

Kernel density map illustrating hotspots of workplace neighbourhood mobility amongst sex workers who worked within the City of Vancouver (2010–2016; N=543, 2199 observations) This figure includes only those sex workers who solicited and/or serviced within the City of Vancouver from 2010–2016. Blue hotspots indicate areas of inward mobility while green hotspots depict areas of outward mobility within the study period. Most Inward mobility is concentrated in the Downtown Eastside (DTES) neighborhood. The DTES neighborhood is characterized by high rates of urban poverty, marginalized or unstable housing, and highly concentrated and visible substance use and indoor and outdoor sex work scenes.