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Original research
Internet solicitation linked to enhanced occupational health and safety outcomes among sex workers in Metro Vancouver, Canada 2010–2019
  1. Sylvia Machat1,
  2. Tara Lyons1,2,
  3. Melissa Braschel1,
  4. Kate Shannon1,3,
  5. Shira Goldenberg1,4
  1. 1 AESHA, Centre for Gender & Sexual Health Equity, Vancouver, British Columbia, Canada
  2. 2 Department of Criminology, Kwantlen Polytechnic University, Surrey, British Columbia, Canada
  3. 3 Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
  4. 4 School of Public Health, San Diego State University, San Diego, California, USA
  1. Correspondence to Dr Shira Goldenberg, Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, CA, USA; dr.goldenberg{at}cgshe.ubc.ca

Abstract

Objectives Examine the independent association between online solicitation and sex workers’ (SWs’) occupational health and safety (OHS), particularly violence and work stress.

Methods Data were drawn from a cohort of women SWs (N=942, 2010–2019) in Vancouver, Canada. Analyses used descriptive statistics and bivariate and multivariable logistic and linear regression using generalised estimating equations (GEE); explanatory and confounder modelling approaches were used.

Results 33.9% (n=319) of participants solicited online and 14.1% (n=133) primarily solicited online in the last 6 months in at least one study visit. In multivariable GEE analysis, factors associated with primarily soliciting online included younger age (adjusted OR (AOR) 0.95 per year older, 95% CI 0.93 to 0.97), sexual minority status (AOR 2.57, 95% CI 1.61 to 4.10), gender minority status (AOR 3.09, 95% CI 1.80 to 5.28), higher education (AOR 2.13, 95% CI 1.34 to 3.40), higher sex work income (AOR 1.03 per $100 weekly, 95% CI 1.01 to 1.06), being an im/migrant to Canada (AOR 2.40, 95% CI 1.26 to 4.58) and primarily servicing in informal indoor workspaces (AOR 3.47, 95% CI 2.32 to 5.20). In separate GEE confounder models, primarily soliciting online significantly (1) reduced odds of physical/sexual workplace violence (AOR 0.64, 95% CI 0.39 to 1.06) and (2) reduced work stress (β coefficient −0.93, 95% CI −1.59 to −0.26).

Discussion/conclusions Younger workers, gender/sexual minorities, im/migrants and those in informal indoor spaces had higher odds of soliciting online. Confounder models indicate access to online solicitation methods may support enhanced OHS. Decriminalisation of sex work—including advertising via online platforms—remains necessary to support SWs’ OHS.

  • occupational health
  • public health
  • violence
  • occupational stress
  • wounds and injuries

Data availability statement

Data are available upon reasonable request. Due to our ethical and legal requirements related to protecting participant privacy and current ethical institutional approvals, de-identified data are available only upon request and require ethical approval.

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Data availability statement

Data are available upon reasonable request. Due to our ethical and legal requirements related to protecting participant privacy and current ethical institutional approvals, de-identified data are available only upon request and require ethical approval.

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Footnotes

  • Contributors SM, TL, MB, KS and SG contributed to conception and design of this study, as well as analysis and/or interpretation of data. SM and SG developed theoretical models and MB provided computational support. SM drafted the manuscript, while TL, MB, KS and SG revised the manuscript critically for important intellectual content. SG supervised this project and is responsible for all content as guarantor. Approval of the version of the manuscript to be published granted by: SM, TL, MB, KS and SG. All persons who made additional contributions (eg, acquisition of data, administrative support), but who do not meet criteria for authorship, are named in the acknowledgements section.

  • Funding This research was supported by grants from the US National Institutes of Health (R01DA028648) and Canadian Institutes of Health Research (165855). KS is partially supported by a Canada Research Chair in Global Sexual Health and NIH. SG is partially supported by a CIHR New Investigator Award and NIH.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.