Abstract
AbstractThe setting in which sex workers live and work is a critical element shaping health outcomes, in so far that different venues afford different sets of risk and protective factors. Understanding how contextual factors differ across venue types and influence health outcomes is thus essential to developing and supporting programmes promoting the rights and safety of people in sex work. In this chapter, we focus primarily on indoor workplaces, with the goals of: (1) elucidating unique social, economic, physical, and policy factors that influence the well-being of sex workers in indoor workplaces; (2) highlighting sex worker-led efforts in the Thai context through a case study of the organisation Empower Thailand; (3) describing best practices for indoor settings; and (4) developing a framework of key factors that must be addressed to improve the rights and safety of sex workers in indoor workplaces, and to support their efforts to organise. The chapter draws attention to convergences and divergences in key challenges that sex workers encounter in indoor venues in different global contexts, as well as opportunities to advance comprehensive occupational health and safety programmes. Indoor venues pose important potential for establishing and implementing occupational health and safety standards in sex work and also may provide substantial opportunity for collective organising given the close proximity of people working together. However, any efforts to improve the health and safety of sex workers must explicitly address the structural conditions that lead to power imbalances and which undermine sex worker agency and equality.
Highlights
The physical space where sex work occurs, and its social, economic, and policy context, greatly influences sex workers’ health and safety [1, 2]
Understanding the variety of spaces in which people work and how the characteristics of sex work venues impact health and safety is essential to developing interventions, programmes, and policies that support sex worker needs
Attention to indoor venues is especially important because these spaces have greater potential for establishing occupational health and safety (OHS) standards, and may provide substantial opportunity for collective organising given the close proximity of people working together
Summary
The physical space where sex work occurs, and its social, economic, and policy context, greatly influences sex workers’ health and safety [1, 2]. The health and safety of sex workers are jeopardised by disproportionate experiences of structural violence, including stigma, discrimination, poor occupational conditions, high rates of policing, and systematic economic and social marginalisation, leading to higher rates of homelessness and poverty [8, 19] These experiences can contribute to a greater risk of sex workers developing a range of mental health conditions, like PTSD, depression, anxiety, suicide, and alcohol and drug use disorders [17, 20], as well as work-related stress [21, 22]. The collective result of these outcomes is a direct impact on sex worker health, through experiences of physical and sexual violence, decreased access to condoms and condom use, fear of carrying safer sex or injection supplies due to threat of arrest, increased risk for HIV/STIs, reduced negotiating power with clients, and fear of accessing health services, alongside the creation of a climate where economic vulnerability is systemic [49, 62, 63]. Art: We use art and performance to strengthen our advocacy
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