Abstract
BackgroundMigrant women are over-represented in the sex industry, and migrant sex workers experience disproportionate health inequities, including those related to health access, HIV and sexually transmitted infections (STIs), and violence. Despite calls for occupational sex work interventions situated in labour rights frameworks, there remains a paucity of evidence pertaining to migrant sex workers’ needs and realities, particularly within Mexico and Central America. This study investigated migrant sex workers’ narratives regarding the ways in which structural features of work environments shape vulnerability and agency related to HIV/STI prevention and violence at the Guatemala-Mexico border.MethodsDrawing on theoretical perspectives on risk environments and structural determinants of HIV in sex work, we analyzed in-depth interviews, focus groups, and ethnographic fieldwork conducted with 39 migrant sex workers in indoor work environments between 2012 and 2015 in Tecún Umán, Guatemala.ResultsParticipant narratives revealed the following intersecting themes to be most closely linked to safety and agency to engage in HIV/STI prevention: physical features of indoor work environments (e.g., physical layout of venue, proximity to peers and third parties); social norms and practices for alcohol use within the workplace; the existence and nature of management practices and policies on health and safety practices; and economic influences relating to control over earnings and clients. Across work environments, health and safety were greatly shaped by human rights concerns stemming from workplace interactions with police, immigration authorities, and health authorities.ConclusionsPhysical isolation, establishment norms promoting alcohol use, restricted economic agency, and human rights violations related to sex work policies and immigration enforcement were found to exacerbate risks. However, some establishment policies and practices promoted ‘enabling environments’ for health and safety, supporting HIV/STI prevention, economic agency, and protection from violence and exploitation; these practices and policies were especially crucial for recent migrants. Policy reforms and structural workplace interventions tailored to migrant sex workers’ needs are recommended to promote improved working conditions and migrant sex workers’ health, safety, and human rights.
Highlights
Migrant women are over-represented in the sex industry, and migrant sex workers experience disproportionate health inequities, including those related to health access, HIV and sexually transmitted infections (STIs), and violence
Whereas this research illustrates that migrant sex workers often face different health outcomes and risks than nonmigrants [11, 13, 15], few studies have examined structural conditions underpinning these health inequities, including the potential role played by working conditions
Evidence indicates that migrant sex workers may be more likely to face poor working conditions resulting from intersecting concerns and stressors related to their immigration status, criminalization, human rights violations, social isolation, and dislocation from health and social supports [8]
Summary
Migrant women are over-represented in the sex industry, and migrant sex workers experience disproportionate health inequities, including those related to health access, HIV and sexually transmitted infections (STIs), and violence. This study investigated migrant sex workers’ narratives regarding the ways in which structural features of work environments shape vulnerability and agency related to HIV/STI prevention and violence at the Guatemala-Mexico border. Migrant women are over-represented within precarious and informal employment where they are more likely to face insecurity and unsafe working conditions [2, 3], including the sex industry. Previous research on migrant sex workers’ health has emphasized vulnerability to HIV, sexually transmitted infections (STIs), barriers to health access, and high levels of violence faced by this population [7,8,9,10,11,12,13,14]. Evidence indicates that migrant sex workers may be more likely to face poor working conditions resulting from intersecting concerns and stressors related to their immigration status, criminalization, human rights violations, social isolation, and dislocation from health and social supports [8]
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