Author:
Frost Elizabeth,Shannon Kate,Braschel Melissa,Kestler Mary,Pearson Jennie,Perry Chelsey,Goldenberg Shira M.
Abstract
Abstract
Introduction
Globally, the COVID-19 pandemic upended healthcare services and created economic vulnerability for many. Criminalization of sex work meant sex workers were largely ineligible for Canada’s government-based financial pandemic relief, the Canadian Emergency Response Benefit. Sex workers’ loss of income and inability to access financial support services during the pandemic resulted in many unable to pay rent or mortgage, and in need of assistance with basic needs items including food. Little is known about the unique experiences of sex workers who faced challenges in accessing food during the pandemic and its impact on healthcare access. Thus, we aimed to identify the association between pandemic-related challenges accessing food and primary healthcare among sex workers.
Methods
Prospective data were drawn from a cohort of women sex workers in Vancouver, Canada (An Evaluation of Sex Workers’ Health Access, AESHA; 2010-present). Data were collected via questionnaires administered bi-annually from October 2020-August 2021. We used univariate and multivariable logistic regression with generalized estimating equations to assess the association between pandemic-related challenges accessing food and challenges accessing primary healthcare over the study period.
Results
Of 170 participants, 41% experienced pandemic-related challenges in accessing food and 26% reported challenges accessing healthcare. Median age was 45 years (IQR:36–53), 56% were of Indigenous ancestry, 86% experienced intimate partner violence in the last six months, and 62% reported non-injection substance use in the last six months. Experiencing pandemic-related challenges accessing food was positively associated with challenges accessing primary healthcare (Adjusted Odds Ratio: 1.99, 95% Confidence Interval: 1.02–3.88) after adjustment for confounders.
Conclusions
Findings provide insight about the potential role community-based healthcare delivery settings (e.g., community clinics) can play in ameliorating access to basic needs such as food among those who are highly marginalized. Future pandemic response efforts should also take the most marginalized populations’ needs into consideration by establishing strategies to ensure continuity of essential services providing food and other basic needs. Lastly, policies are needed establishing basic income support and improve access to food resources for marginalized women in times of crisis.
Funder
National Institutes of Health
Canadian Institutes of Health Research
Publisher
Springer Science and Business Media LLC
Reference35 articles.
1. Baral S, Beyrer C, Muessig K, Poteat T, Wirtz AL, Decker MR et al. Burden of HIV among female sex workers in low-income and middle-income countries: a systematic review and meta-analysis. Lancet Infect Dis [Internet]. 2012 Jul 1 [cited 2022 May 18];12(7):538–49. http://www.thelancet.com/article/S147330991270066X/fulltext.
2. Shannon K, Strathdee SA, Goldenberg SM, Duff P, Mwangi P, Rusakova M, et al. Global epidemiology of HIV among female sex workers: influence of structural determinants. Lancet. 2015;385:55–71.
3. Moret W. Economic strengthening for female sex workers: A review of the literature [Internet]. 2014 May [cited 2022 Jan 29]. https://www.fhi360.org/resource/economic-strengthening-female-sex-workers-review-literature.
4. UNAIDS. UNAIDS Data 2019 [Internet]. 2019 [cited 2022 Dec 5]. https://www.unaids.org/en/resources/documents/2019/2019-UNAIDS-data.
5. Benoit C, Unsworth R. COVID-19, stigma, and the ongoing marginalization of sex workers and their support organizations. Arch Sex Behav [Internet]. 2022;51:331–42. https://doi.org/10.1007/s10508-021-02124-3.