Shira M. Goldenberg, Andrea Krüsi, Jessica Xi Jia, Solanna Anderson, Jill Chettiar, Kate Shannon

Transcription

1 Page 1 Structural Determinants of Health among Migrants in the Indoor Sex Industry: Experiences of Migrant Sex Workers and Managers/Owners in Metropolitan Vancouver Shira M. Goldenberg, Andrea Krüsi, Jessica Xi Jia, Solanna Anderson, Jill Chettiar, Kate Shannon May 25, 2015 Gender and Sexual Health Initiative, BC Centre for Excellence in HIV/AIDS Department of Medicine, University of British Columbia

2 Migration, Sex Work, and Health ~ 214 international migrants* worldwide Resulting from restrictive policies & social inequities, migrants often work in the informal sector (e.g, sex work, domestic work), face insecurity, unsafe work conditions Women comprise approximately half of international migrants, yet much research on migrant workers health has focused on male workers Migration often results in changes in health and working conditions Yet, limited research has examined the evolving determinants of health over time among migrants within the sex industry * The term migrant refers to a broad array of individuals who move across international and national borders, including those with and without legal status (e.g., permanent residents, temporary workers, undocumented) and those who move for different reasons. International migrant refers to persons who leave their country of origin or of habitual residence, to establish themselves either permanently or temporarily in another country (IOM, 2004)

3 Page 3 Objective (1) To explore structural determinants of health and safety among migrant workers and managers/owners in the indoor sex industry (2) To investigate potential variations in these determinants across the process of arrival and longterm settlement in Canada

4 Page 4 Setting: Metropolitan Vancouver, BC Major destination for migrant workers >50% of the population are immigrants, primarily from Asia Indoor sex establishments Licensed body rub studios, massage parlours, spas, beauty parlours, and health enhancement centres, and unlicensed micro-brothels Most workers in licensed indoor establishments are migrant workers Legal context: Many aspects of the purchasing, advertising and selling of sex continue to be criminalized

5 Data Collection Qualitative Study of Health & Safety in Indoor Establishments Interviews with 44 purposively sampled migrant workers, owners, and managers in indoor sex establishments Eligibility: Female; 18 years old; born outside Canada; worked in an indoor establishment within the last month Recruitment via outreach to indoor venues and online Semi-structured interviews in Mandarin or English Interviews coded in Atlas.ti for thematic content Sister study to An Evaluation of Sex Workers Health Access (AESHA), a cohort of >800 female sex workers across Metro Vancouver Collaboration with >15 community partners Eligibility: Female or transgender woman; 14 years old; exchanged sex for money in last month Biannual interview questionnaires and HIV/STI/HCV testing

6 Participant Characteristics (N=44) Variable n (%) Age, in years (median, range) 42 (24-52) Duration in Canada, in years (median, range) 7 (1-35) Sex Industry Role Worker 38 (84.4%) Manager/Owner 23 (51.1%) Both 16 (35.5%) City Vancouver/North Vancouver 22 (48.9%) Burnaby 12 (26.7%) Richmond 7 (15.6%) Surrey 4 (8.9%) Type of work environment license Health & beauty (health enhancement/wellness centre) 18 (40.0%) Body rub salon 19 (42.2%) Other (acupressure, aesthetician) 6 (13.0%) Unlicensed (micro-brothel) 2 (4.4%)

7 Overview of Results Diversity of pathways into sex work upon arrival to Canada Migrants typically began sex work for economic/family reasons Barriers to conventional labour markets common upon arrival Intersecting vulnerabilities resulting from policing, language barriers, and immigration status posed key challenges to health and safety during longterm settlement in Canada

8 Page 8 Sex Work as a Flexible Employment Opportunity for Recent Migrants Sex work as higher-paying than minimum-wage jobs typically available to new immigrants: Sex work as more flexible for meeting family commitments: When I first came to Canada I wanted to find a better job. At the factory where I worked, the wage was about $8 an hour, [whereas] for the Caucasian factories, the starting wage may be $10 I d make only $700 a month. It isn't even enough to sustain my home. [QE25, manager/worker, 5y in Canada] In factories, you make just $8 an hour. You are a new immigrant, your English isn t good, and you can t really find those better jobs. [QE16, worker, 3y in Canada] [When I first arrived] I could only find jobs that don t require a lot of English [such as] a Chinese restaurant or factory it pays only 8 bucks an hour you start around 10 or 11 am, and finish work at night the working hours were very inconvenient for me to look after my child. The work I m doing right now offers me more flexibility to take care of my child. A lot of the workers are like me. [QE34, worker, 6y in Canada]

9 Page 9 Barriers to Conventional Labour Markets on Arrival Language barriers to labour markets: Language was a barrier I only knew Mandarin. My job selection was quite limited I needed income to cover living costs. I wasn t in a position to wait until my English skills improved, I needed to work. [QE44, worker, 1y in Canada] Foreign credentials unrecognized: Limited social networks: If you don't didn't know anyone to refer you [to a better job], you wouldn't be able to get in But I didn't know anyone with these kinds of relationships we went to job referral centres, but we just waited a long time and didn't get any jobs either For new immigrants, this is a big issue. [QE25, manager/worker, 5y in Canada] It s hard to survive in Vancouver. The professional status we received or achieved in China are not recognized here. Our diplomas and certificates are not recognized. [QE30, manager, 10y in Canada]

10 Negative Interactions with Police as a Barrier to Wellbeing during Long-Term Settlement Discriminatory and disrespectful treatment by police in indoor venues The police are driving me crazy. Why do they come here? They scrutinize us so closely it s discrimination Even though we are Canadian citizens, we do not feel we are treated equally as local people. [QE30, manager, 10y in Canada] Fear of disclosure, immigration consequences, or criminal charges We re afraid of leaving a bad record, and we are afraid our identity or names would be exposed I d be afraid of this affecting my immigration status and losing it. [QE41, worker, 2y in Canada] I worry about being found out by my family. It would have a psychological impact on my daughter and cause conflicts between my husband and I. [QE44, worker, 1y in Canada] Resulted in lack of occupational health/safety support by managers The manager just tells us to be careful but she doesn t have the ability to do too much. She s afraid of the police coming here and knowing that we re doing this work. It would shut down her parlour. [QE28, worker, 3y in Canada]

11 Intersecting Impacts of Policing, Immigration Status, and Language Barriers on Health & Safety Participants emphasized the importance of ensuring their status as good immigrants : Went to great efforts to avoid law enforcement Language barriers + legal status + limited access to legal information unique vulnerabilities for migrant workers We don t want to cause trouble. That s what Chinese people are used to, living in a foreign country; we very carefully protect ourselves, and try to not to commit any violations, because if we were to bring ourselves any hassle, our English isn t good, and we don t really understand too much about the law...so of course, the further we stay away, the more careful we can be, the better. [QE18, manager/worker, 9y in Canada] Precautions taken to avoid interacting with police often jeopardized health and safety: E.g., accepting unsafe client demands, client violence, lack of access to justice There was a client who asked for service without condom and tried to take advantage of my poor English skill. After I refused, he intentionally broke the condom, but fortunately I found out. So I figured to provide the service again, and asked him to use a new condom he got mad He also threatened to call the police he was trying to threaten to report me. [QE44, worker, 1y in Canada]

12 Page 12 Discussion: Occupational Health & Safety for Migrant Sex Workers Migrant workers often enter sex work for economic and family reasons not trafficking Migrant sex workers health & safety in Canada shaped by prohibitive laws and policies Fear generated by criminalization, restrictive immigration policies, and their enforcement Undermines access to occupational health, safety, and justice Actions needed to ensure migrant sex workers health & human rights: Community-based efforts to support occupational health and safety Addressing discriminatory treatment by police Culturally safe outreach/services (health, safety, legal) Decriminalization of sex work & non-conflation with trafficking

13 Bill C-36: Concerns of Negative Impacts for Migrant Sex Workers

14 Page 14 Acknowledgements We thank all those who contributed their time and expertise to this project, particularly participants, community advisory board members and partner agencies. Research & administrative support: Andrea Krusi, Chrissy Taylor, Solanna Anderson, Elena Argento, Krista Butler, Peter Vann, Sarah Allan, and Jill Chettiar. Community Advisory Board/Partners: WISH, SWAN, SWUAV, ORCHID/ ASIA, Options for Sexual Health, VCH, BCCDC Street Nurses, UNYA, PEERS, PACE, BCCEC, ATIRA, RainCity, Pivot Legal, PWN. Funding: U.S. National Institutes of Health (R01DA033147, R01DA028648), Canadian Institutes of Health Research (HHP-98835), Canadian Institutes for Health Research/Public Health Agency of Canada (HEB ), and MAC AIDS. SG is supported by the Michael Smith Foundation for Health Research/Women s Health Research Initiative.