Chris Atchison

Structure and agency: reflections from an exploratory study of Vancouver indoor sex workers

Sex work research continues to be characterised by debates around decriminalization. Central to these debates are claims about the agency of those involved in the sex trade. Some researchers argue that individuals involved in the sex trade are victims of structural and interpersonal constraint, whilst others depict them as workers exercising choice. Drawing on structure-agency theory, a review of legal and media accounts of the sex trade and qualitative interviews with 21 indoor sex workers in Vancouver, Canada, we argue that both of these perspectives are insufficient. Rather than reducing the sex trade to part of a binary, we suggest that it is necessary to analyse sex work through the complex interplay of both structure and agency. Specifically, structural analyses undercover the numerous ways that sex workers are controlled, observed and influenced whilst agency perspectives elicit the means that sex workers continue to exercise control in spite of disadvantage. While we do not finalise decriminalisation debates, we do critique current Canadian laws for the lack of responsiveness to the lives of sex workers and their exploitative and contradictory stance on sex work.

Addressing Underrepresentation in Sex Work Research: Reflections on Designing a Purposeful Sampling Strategy.

Men, transgender people, and those working in off-street locales have historically been underrepresented in sex work health research. Failure to include all sections of sex worker populations precludes comprehensive understandings about a range of population health issues, including potential variations in the manifestation of such issues within and between population subgroups, which in turn can impede the development of effective services and interventions. In this article, we describe our attempts to define, determine, and recruit a purposeful sample for a qualitative study examining the interrelationships between sex workers’ health and the working conditions in the Vancouver off-street sex industry. Detailed is our application of ethnographic mapping approaches to generate information about population diversity and work settings within distinct geographical boundaries. Bearing in mind the challenges and the overwhelming discrimination sex workers experience, we scope recommendations for safe and effective purposeful sampling inclusive of sex workers’ heterogeneity.

Recruitment of Sex Buyers: A Comparison of the Efficacy of Conventional and Computer Network-Based Approaches

In this article we draw upon data from a large-scale mixed methods investigation of clients of commercial sex workers in Canada to illustrate the potential value that understanding and integrating computer and network technology has for enhancing access to, and participation from, marginalized and stigmatized populations. In particular, we present qualitative data from analysis of our research field notes as well as an analysis of quantitative data from response monitoring and feedback features built into the actual data collection process to help support our argument that, for some populations, network technology–based recruitment strategies should be recognized as the preferred recruitment option. In addition, we discuss the potential utility and application of viral solicitation, a newly emerging computer network-based nonprobability technique, for contacting and securing the participation of stigmatized and marginalized research participants. Our recruitment of sex buyers through web-based listserves was the most successful participant solicitation strategy, generating 63.18% (n = 544) of our survey respondents. Conventional recruitment (advertising in print-based media and in adult-oriented businesses) generated few participants (2.90%, n = 25). Viral solicitation acted as an important low-cost supplemental means of recruitment, generating a further 164 survey participants (19.05% of survey participants).

Sex workers as peer health advocates: community empowerment and transformative learning through a Canadian pilot program

BackgroundSocial marginalization and criminalization create health and safety risks for sex workers and reduce their access to health promotion and prevention services compared to the general population. Community empowerment-based interventions that prioritize the engagement of sex workers show promising results. Peer-to-peer interventions, wherein sex workers act as educators of their colleagues, managers, clients and romantic partners, foster community mobilization and critical consciousness among sex workers and equip them to exercise agency in their work and personal lives.MethodsA pilot peer health education program was developed and implemented, with and for sex workers in one urban centre in Canada. To explore how the training program contributed to community empowerment and transformative learning among participants, the authors conducted qualitative interviews, asked participants to keep personal journals and to fill out feedback forms after each session. Thematic analysis was conducted on these three data sources, with emerging themes identified, organized and presented in the findings.ResultsFive themes emerged from the analysis. Our findings show that the pilot program led to reduced internalized stigma and increased self-esteem in participants. Participants’ critical consciousness increased concerning issues of diversity in cultural background, sexual orientation, work experiences and gender identity. Participants gained knowledge about how sex work stigma is enacted and perpetuated. They also became increasingly comfortable challenging negative judgments from others, including frontline service providers. Participants were encouraged to actively shape the training program, which fostered positive relationships and solidarity among them, as well as with colleagues in their social network and with the local sex worker organization housing the program. Resources were also mobilized within the sex worker community through skills building and knowledge acquisition.ConclusionThe peer education program proved successful in enhancing sex workers’ community empowerment in one urban setting by increasing their knowledge about health issues, sharing information about and building confidence in accessing services, and expanding capacity to disseminate this knowledge to others. This ‘proof of concept’ built the foundation for a long-term initiative in this setting and has promise for other jurisdictions wishing to adapt similar programs.

Sexual safety practices of massage parlor-based sex workers and their clients

The Outreach and Research in Community Health Initiatives and Development (ORCHID) project examines social and structural factors that contribute to HIV/AIDS risk among women working in Vancouvers indoor sex industry and their clients. From 2006 to 2009, two mixed method studies were undertaken in ORCHID: one exploring experiences of women working in the indoor sex industry, mainly in massage parlors, and the other exploring experiences of men as sex “buyers.” Both studies emphasize sexual health and safety, risk and protective behaviors, and related contextual factors. No analyses examining the sexual health and safety practices of massage parlor-based sex workers and clients exist in the Canadian context. To address this gap, we analyze two survey datasets – with 118 sex workers and 116 clients. Upon comparing demographics of sex workers and clients, we discuss their condom use and sexually transmitted infections (STI) and HIV testing practices. Sex workers and clients reported high rates of condom use for vaginal/anal intercourse. While both groups reported lower rates of condom use for oral sex during sex transactions, clients did so to a greater extent (p < 0.001). Condom use with noncommercial sex partners was reported to be less consistent by both groups. STI testing was higher among sex workers than clients (p < 0.001). Initiatives targeting clients of massage parlor-based sex workers for STI education and testing are needed. Future research should investigate how different types of relationships between sex workers and clients impact their sexual safety practices.

Managing Conflict: An Examination of Three-Way Alliances in Canadian Escort and Massage Businesses

Weitzer (2009) notes that the sex work employment triangle involves three groups: workers, clients, and various third parties; the latter includes pimps, facilitators, brokers, managers, and others who help organize or facilitate sex work. Our research focuses on the third group, and in particular on managers who work in legal or licensed sex industry businesses. We gathered data in 2013 from 43 managers of escort agency and massage parlor businesses in five Canadian census metropolitan areas. Following Weitzer’s (2009) recommendation, managers were interviewed as part of larger study that included people who sell and who purchase sexual services. We argue that one central responsibility of managers is to prevent and intercede in conflicts between workers and clients, as well as between workers, and that managers play an important role in the occupational health and safety of sex industry populations. These findings make a novel contribution to the sociology of service work literature; they are also important in the context of recent legal changes in Canada which made commercial-sex businesses and third-party material benefits from them, illegal.