Stigma, fear keeps sex workers from doctors, researchers say

Nearly 40 per cent of sex workers surveyed say their health-care needs were not met in the past year, compared with about 12 per cent in the general population, according to researchers.

“That’s an indication that the system is not working as equitably as it should,” said lead investigator Cecilia Benoit, a professor of sociology at the University of Victoria and a scientist at the Centre for Addictions Research of B.C.

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The findings, to be published in January, are part of a larger study involving interviews with 218 sex workers in Victoria, Fort McMurray, Alta., Calgary, Kitchener-Waterloo, Ont., Montreal and St. John’s, N.L.

The goal is to learn more about people and their experiences in the Canadian sex industry, whose workers the researchers described as one of Canada’s most vulnerable populations.

While sex workers had a generally positive view of the health-care system, they were much less likely to say they received the care they needed.

They also reported poorer physical and mental health.

About 54 per cent said availability was an issue and they had trouble finding a doctor or found wait-times too long. About one-third cited accessibility barriers, including a lack of transportation.

Most interesting to Benoit was the third category, “acceptability,” which about two-thirds of sex workers named as a barrier. While it covers a wide range of factors, much of it involves stigma, as well as a fear or dislike of doctors, she said.

Twenty-nine per cent of participants said they feared being judged and 4.6 per cent said a lack of culturally relevant care was a barrier.

“That’s especially important for aboriginal peoples or visible minorities — a fear that the culture of the health-care system makes them feel uncomfortable or unsafe,” she said.

On Friday, Benoit and fellow CARBC researcher Mikael Jansson will present their findings to health-care providers at the Royal Jubilee Hospital, in hopes of improving service delivery.

“There’s a big move in health care to be more patient-centred,” she said.

“We have to be careful. It’s our body language as much as what we say or we don’t say. It’s very hard for some people to go into health services, so we want to try and make people feel as comfortable as possible.”

Benoit’s team of researchers, who hail from six universities, plan to release further results over the course of the year.

Their project is funded by the Canadian Institutes of Health Research and focuses on the reasons for variability in health and safety among sex workers, many of whom face elevated risks of violence and premature death.

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