311041
Occupational health, stigma, and healthcare access in the lives of San Francisco sex workers
![142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual](images/banner.jpg)
METHODS. I conducted a secondary analysis of data from the SWEAT study (Sex Worker Environmental Assessment Team), a respondent-driven sampling cross-sectional study of 247 female sex workers conducted 2006-7 in San Francisco. I assessed univariate statistics to describe experiences of occupational stigma, occupational injury, and healthcare access.
RESULTS. Perceived stigma from at least one source was reported by 73.0%, while 38.7% felt bad or very bad about doing sex work and 27.2% reported sex work made them feel cut off from society. 77% reported ≥1 work-related injury or condition. The most frequent occupational injuries were Depression (55.1%), Anxiety (42.5%), back pain (31%), and jaw pain (26%). 54% obtained medical care for work-related conditions; 25.6% did not disclose sex work was the cause of injury. Most common reasons for nondisclosure were “none of [provider’s] business” (29.1%), provider not asking (21%), and confidentiality concerns (13%). 95.5% had accessed healthcare in the past year, primarily through community health centers or hospital clinics (51.1% and 46.4%) despite the availability of local sex-worker-specific health services.
CONCLUSION. Sex workers’ occupational health needs go beyond HIV/STI prevention, detection and treatment. By understanding the occupational health experienced and access to care trajectories of sex workers, providers can better meet those needs by asking about sex work while emphasizing confidentiality.
Learning Areas:
Occupational health and safetyLearning Objectives:
Explain occupational health risks for urban female sex workers in the US.
Identify opportunities to meet sex workers’ occupational health needs in community health settings.
Keyword(s): Sex Workers, Occupational Health and Safety
Qualified on the content I am responsible for because: This analysis was conducted as part of a mentored research program and approved by NIH-funded investigators with expertise in HIV epidemiology and hard-to-reach populations. Since 2009 I have volunteered at St. James Infirmary, a Harm Reduction clinic serving Sex Workers in San Francisco.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.