British Columbia Centre for Excellence in HIV/AIDS, St. Paul’s Hospital, Vancouver, BC, Canada.
Cult Health Sex. 2012;14(2):139-50. doi: 10.1080/13691058.2011.628411. Epub 2011 Nov 15.
Individuals working in the sex industry continue to experience many negative health outcomes. As such, disentangling the factors shaping poor health access remains a critical public health priority. Within a quasi-criminalised prostitution environment, this study aimed to evaluate the prevalence of occupational stigma associated with sex work and its relationship to barriers to accessing health services. Analyses draw on baseline questionnaire data from a community-based cohort of women in street-based sex work in Vancouver, Canada (2006-2008). Of a total of 252 women, 141 (55.9%) reported occupational sex work stigma (defined as hiding occupational sex work status from family, friends and/or home community), while 125 (49.6%) reported barriers to accessing health services in the previous six months. In multivariable analysis, adjusting for sociodemographic, interpersonal and work environment risks, occupational sex work stigma remained independently associated with an elevated likelihood of experiencing barriers to health access. Study findings indicate the critical need for policy and societal shifts in views of sex work as a legitimate occupation, combined with improved access to innovative, accessible and non-judgmental health care delivery models for street-based sex workers that include the direct involvement of sex workers in development and implementation.
从事性行业的个体持续面临诸多负面健康后果。因此，厘清影响健康服务获取的因素仍然是公共卫生的当务之急。在准刑事化的卖淫环境下，本研究旨在评估与性工作相关的职业污名的流行程度及其与获取健康服务障碍之间的关系。分析基于加拿大温哥华基于社区的街头性工作女性队列的基线问卷调查数据（2006-2008 年）。在总共 252 名女性中，141 名（55.9%）报告存在职业性工作污名（定义为向家人、朋友和/或家乡社区隐瞒职业性工作身份），而 125 名（49.6%）报告在过去六个月中存在获取健康服务的障碍。在多变量分析中，调整了社会人口统计学、人际和工作环境风险因素后，职业性工作污名仍然与健康服务获取障碍的可能性增加独立相关。研究结果表明，迫切需要政策和社会观念的转变，将性工作视为合法职业，同时需要改善创新、可及且无歧视的健康服务提供模式，包括让性工作者直接参与制定和实施。
