Centre for Gender & Sexual Health Equity, Vancouver, British Columbia, Canada.
Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
PLoS One. 2020 Apr 6;15(4):e0225783. doi: 10.1371/journal.pone.0225783. eCollection 2020.
Following a global wave of end-demand criminalization of sex work, the Protection of Communities and Exploited Persons Act (PCEPA) was implemented in Canada, which has implications for the health and safety of sex workers. This study aimed to evaluate the impact of the PCEPA on sex workers' access to health, violence, and sex worker-led services.
Longitudinal data were drawn from a community-based cohort of ~900 cis and trans women sex workers in Vancouver, Canada. Multivariable logistic regression examined the independent effect of the post-PCEPA period (2015-2017) versus the pre-PCEPA period (2010-2013) on time-updated measures of sex workers' access to health, violence supports, and sex worker/community-led services.
The PCEPA was independently correlated with reduced odds of having access to health services when needed (AOR 0.59; 95%CI: 0.45-0.78) and community-led services (AOR 0.77; 95%CI: 0.62-0.95). Among sex workers who experienced physical violence/sexual violence or trauma, there was no significant difference in access to counseling supports post-PCEPA (AOR 1.24; 95%CI: 0.93-1.64).
Sex workers experienced significantly reduced access to critical health and sex worker/community-led services following implementation of the new laws. Findings suggest end-demand laws may exacerbate and reproduce harms of previous criminalized approaches to sex work in Canada. This study is one of the first globally to evaluate the impact of end-demand approaches to sex work. There is a critical evidence-based need to move away from criminalization of sex work worldwide to ensure full labor and human rights for sex workers. Findings warn against adopting end-demand approaches in other cities or jurisdictions.
在全球范围内，性工作的最终需求被刑事定罪之后，加拿大实施了《保护社区和被剥削者法案》（PCEPA），这对性工作者的健康和安全产生了影响。本研究旨在评估 PCEPA 对性工作者获得健康、暴力和性工作者主导服务的影响。
从加拿大温哥华一个基于社区的约 900 名 cis 和跨性别女性性工作者的队列中提取了纵向数据。多变量逻辑回归分析了 PCEPA 后时期（2015-2017 年）与 PCEPA 前时期（2010-2013 年）对性工作者获得健康服务、暴力支持和性工作者/社区主导服务的时间更新措施的独立影响。
PCEPA 与需要时获得健康服务的机会减少独立相关（AOR 0.59；95%CI：0.45-0.78）和社区主导的服务（AOR 0.77；95%CI：0.62-0.95）。在经历过身体暴力/性暴力或创伤的性工作者中，获得咨询支持后，PCEPA 并没有显著差异（AOR 1.24；95%CI：0.93-1.64）。
在新法律实施后，性工作者获得关键健康和性工作者/社区主导服务的机会明显减少。研究结果表明，需求终结法律可能会加剧和复制加拿大以前对性工作的刑事化方法所带来的危害。本研究是全球范围内评估终结需求方法对性工作影响的首批研究之一。全世界都迫切需要摆脱性工作的刑事化，以确保性工作者的充分劳动和人权。研究结果警告说，其他城市或司法管辖区不应采用终结需求方法。
