St. James Infirmary Occupational Health and Safety Handbook: A peer-based participatory approach towards sex worker health

The St. James Infirmary (SJI) is a peer-based Occupational Health and Safety Clinic in San Francisco for sex workers and their families. Because sex work is highly stigmatized, and aspects are criminalized, sex work is not formally recognized as a legitimate form of labor. Sex workers are not provided the legal and protective regulations provided to other types of workers.

The SJI Occupational Health and Safety Handbook was created specifically to address occupational injury and disease prevention as it relates to sex work. Originally created by SJI staff the first edition was published in 2001 and the second edition was published in 2003. In 2007 we begin to work on the 3rd Edition, published in 2010. To inform the direction of the 3rd Edition, a needs assessment was conducted to gather input from the sex worker community. 85 people participated in the needs assessment and 85% of respondents identified as sex workers, representing a cross section of gender and types of sex work. Feedback from respondents allowed SJI to narrow the editorial scope to what the community reported they actually needed. A peer-driven participatory approach was utilized in writing the book. Priority was given to sex workers. 24 individuals, 4 agencies and 2 Community Advisory Groups were recruited to write the subchapters, design and edit the book. We will present data from the needs assessment, analysis of the process of working with the community for 3 years to write the book, lessons learned and the impact of the book itself.