Shannon Kate, Kerr Thomas, Allinott Shari, Chettiar Jill, Shoveller Jean, Tyndall Mark W
British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC Canada.
Soc Sci Med. 2008 Feb;66(4):911-21. doi: 10.1016/j.socscimed.2007.11.008. Epub 2007 Dec 21.
High rates of violence among street-level sex workers have been described across the globe, while in cities across Canada the disappearance and victimization of drug-using women in survival sex work is ongoing. Given the pervasive levels of violence faced by sex workers over the last decades, and extensive harm reduction and HIV prevention efforts operating in Vancouver, Canada, this research aimed to explore the role of social and structural violence and power relations in shaping the HIV risk environment and prevention practices of women in survival sex work. Through a participatory-action research project, a series of focus group discussions were conceptualized and co-facilitated by sex workers, community and research partners with a total of 46 women in early 2006. Based on thematic, content and theoretical analysis, the following key factors were seen to both directly and indirectly mediate women's agency and access to resources, and ability to practice HIV prevention and harm reduction: at the micro-level, boyfriends as pimps and the 'everyday violence' of bad dates; at the meso-level, a lack of safe places to take dates, and adverse impacts of local policing; and at the macro-level, dopesickness and the need to sell sex for drugs. Analysis of the narratives and daily lived experiences of women sex workers highlight the urgent need for a renewed HIV prevention strategy that moves beyond a solely individual-level focus to structural and environmental interventions, including legal reforms, that facilitate 'enabling environments' for HIV prevention.
全球范围内都有关于街头性工作者暴力发生率高的描述，而在加拿大的各个城市，从事生存性工作的吸毒女性失踪和受害的情况仍在持续。鉴于过去几十年性工作者面临的暴力普遍存在，以及加拿大温哥华广泛开展的减少伤害和预防艾滋病毒工作，本研究旨在探讨社会和结构性暴力以及权力关系在塑造从事生存性工作的女性的艾滋病毒风险环境和预防措施方面所起的作用。通过一个参与式行动研究项目，2006年初由性工作者、社区和研究伙伴共同构思并共同主持了一系列焦点小组讨论，共有46名女性参与。基于主题、内容和理论分析，以下关键因素被认为直接或间接地影响了女性的能动性、获取资源的机会以及实施艾滋病毒预防和减少伤害措施的能力：在微观层面，充当皮条客的男友以及糟糕约会中的“日常暴力”；在中观层面，缺乏安全的约会场所以及当地治安的不利影响；在宏观层面，吸毒成瘾以及为获取毒品而进行性交易的需求。对女性性工作者的叙述和日常生活经历的分析凸显了迫切需要重新制定艾滋病毒预防策略，该策略应超越单纯的个人层面关注，转向结构性和环境干预措施，包括法律改革，以促进有利于艾滋病毒预防的“有利环境”。
