Sex Workers Face Research Articles

User-Centered Design for Designing and Evaluating a Prototype of a Data Collection Tool to Submit Information About Incidents of Violence Against Sex Workers: Multiple Methods Approach.

Sex workers face an epidemic of violence in the United States. However, violence against sex workers in the United States is underreported. Sex workers hesitate to report it to the police because they are frequently punished themselves; therefore, an alternative for reporting is needed. We aim to apply human-centered design methods to create and evaluate the usability of the prototype interface for ReportVASW (violence against sex worker, VASW) and identify opportunities for improvement. This study explores ways to improve the prototype of ReportVASW, with particular attention to ways to improve the data collection tool. Evaluation methods included cognitive walkthrough, system usability scale, and heuristic evaluation. End users were enthusiastic about the idea of a website to document violence against sex workers. ReportVASW scored 90 on the system usability scale. The tool scored neutral on consistency, and all other responses were positive toward the app, with most being strong. Many opportunities to improve the interface were identified. Multiple methods identified multiple issues to address. Most changes are not overly complex, and the majority were aesthetic or minor. Further development of the ReportVASW data collection tool is worth pursuing.

Prevalence and correlates of prenatal HIV testing among female sex workers in Nigeria.

Female sex workers (FSWs) face a significant and persistent risk of contracting HIV. While evidence indicates high rates of pregnancy among FSWs in sub-Saharan Africa, studies on the coverage of HIV testing during pregnancy among them are sparse. The objective of this study was to estimate the prevalence of prenatal HIV testing and determine the associated factors among FSWs in Nigeria. This study was a secondary data analysis of the 2020 Integrated Biological & Behavioural Surveillance Survey (IBBSS) among key populations in Nigeria. We performed weighted descriptive statistics and multivariable binary logistic regression to assess the associations between prenatal HIV testing and sociodemographic characteristics, risk behaviours, HIV knowledge and risk awareness, stigma, and access to healthcare. Of the 1598 FSWs included in the study, 71.0% (95%CI = 68.7%-73.1%) had HIV testing during their last pregnancy. In the regression model, tertiary education (aOR = 2.98, 95%CI = 1.48-6.01), consistent condom use (aOR = 1.95, 95%CI = 1.39-2.75), and receipt of antenatal care (aOR = 35.52, 95%CI = 23.40-53.92) were associated with higher odds of prenatal HIV testing. Compared with the South South geopolitical zone, FSW residing in South East (aOR = 3.38, 95%CI = 1.80-6.35), South West (aOR = 2.97, 95%CI = 1.88-4.68), North Central (aOR = 4.43, 95%CI = 2.80-7.01), North East (aOR = 4.22, 95%CI = 1.64-10.34), North West (aOR = 4.40, 95%CI = 2.59-7.48) had higher odds of reporting prenatal HIV testing. However, being a non-brothel-based FSW (aOR = 0.66, 95%CI = 0.47-0.92), and engaging in sex work during pregnancy (aOR = 0.45, 95%CI = 0.31-0.66) were significantly associated with lower odds of prenatal HIV testing. The prenatal HIV testing among FSWs in this study was suboptimal. The results highlight the need to improve access to antenatal care and implement regional and typology-specific interventions to bridge the gap in prenatal HIV testing among FSWs.

Association between sex work occupational stigma and inconsistent condom use: findings from a community-based cohort of women sex workers in Vancouver, Canada (2014–2022)

BackgroundWomen sex workers face substantial health inequities due to structural barriers including criminalisation and stigma. Stigma has been associated with HIV-related inequities among marginalised populations, however, we know less about...

Health and well-being of refugee women in sex work: A systematic literature review

Introduction: Refugees face many barriers when arriving in a new country, and these barriers are especially felt by women, who often travel alone or with children. These barriers create a situation where some women turn to sex work, either voluntarily or involuntarily. Both refugees and sex workers face adversities related to their mental health and well-being, however little research has examined the intersections between both identities outside of STI incidence and violence. Objective: This systematic literature review aimed to explore mental health and overall well-being of women refugees who engage in sex work. Themes were extracted to better understand experiences to inform clinical and community practice. Methods: A systematic literature review was conducted using PsycInfo, CINAHL, Scopus, Web of Science, PubMed, Google Scholar, ProQuest, and Medline, as well as grey literature for articles published between 2013 and 2023. The JBI Critical Appraisal Checklist for Qualitative Research was used to evaluate the quality of the primary research articles. 11 articles were included in the final synthesis. Results: The five themes included Fear, Mental/Psychological Health, Social Well-being, Economic/Financial Well-being, and Spiritual Struggles. These themes were interconnected to shape the experiences of these women within their circumstances. Engaging in sex work as a refugee, particularly in instances of sex trafficking, created significant challenges in all aspects of well-being, and the circumstances related to being a refugee often increased vulnerabilities to become involved in sex work for survival. Conclusion: These results suggest the need for policies, community programs, and clinical practice protocols to address the unique needs of women refugees to mitigate factors drawing them to sex work, and better support those who are currently involved in it.

Contextual factors influencing implementation of HIV treatment support strategies for female sex workers living with HIV in South Africa: A qualitative analysis using the Consolidated Framework for Implementation Research

Background: Female sex workers (FSW) face a confluence of multilevel barriers to HIV care. In South Africa, 63% of FSW are living with HIV and <40% are virally suppressed. The objective of this analysis was to identify implementation determinants of two HIV treatment support strategies. Methods: The Siyaphambili trial tested a decentralized treatment provision and an individualized case management strategy aimed to support FSW living with unsuppressed HIV viral loads. We identified a nested sample of trial participants using maximum variation sampling (n=36), as well as a purposively selected sample of implementors (n=12). We used semi-structured interview guides, developed using the Consolidated Framework for Implementation Research (CFIR), and deductively coded the transcripts using CFIR, systematically assessing the strength and valence of implementation. We compared construct ratings to determine whether any constructs distinguished implementation across strategies. Results: Across three CFIR domains (innovation characteristics, inner setting, and outer setting), 12 constructs emerged as facilitating, hindering, or having mixed effects on strategy implementation. The relative advantage, design, adaptability, and complexity constructs of the innovation characteristics, and the work infrastructure construct of the inner setting were strongly influential (±2 or +2). While the majority of construct valence and strength rating (9-12) were not distinguishing across strategies, we observed 3 weakly distinguishing CFIR constructs (relative advantage, complexity, and available resources). Conclusions: Given the potential benefits of differentiated service delivery strategies, identifying the relative importance of implementation determinants facilitates transparency and evaluation, supporting future strategy design and implementation. Optimizing implementation will support addressing inequities in HIV care and treatment services.

Beyond marginalisation: The changing dynamics of communication post‐COVID‐19 among the female sex workers of Kolkata

AbstractThe lives of sex workers feature varying issues of marginalisation. Regardless of the geographical location and surrounding culture, sex work and sex workers face a huge amount of stigma throughout the world. Over time, this prevailing stigma creates stereotypes that mainstream society reinforces through their attitude and daily discourse. Moreover, the inception of the COVID‐19 pandemic has deepened the inequalities and marginalisation experienced by this population group. This ethnographic research explores the changing dynamics of communication post‐COVID‐19 among female sex workers in the Kalighat red light district of Kolkata. To conclude, the researcher engages in audio‐recorded in‐depth interviews with 15 female sex workers chosen with the help of the snowball sampling technique. The findings of this research add to the almost non‐existent literature concerning sex work and communication and are also helpful to bureaucrats and other policymakers formulating policies for the vulnerable and marginalised. Please refer to the Supplementary Material section to find this article's Community and Social Impact Statement.

Determinants of depressive and alcohol use disorders among female sex workers in Ethiopia: evidence from a national bio-behavioral survey, 2020

BackgroundFemale sex workers (FSWs) face an elevated risk of developing mental health disorders and alcohol use disorders (AUD), which in turn increase their vulnerability to HIV and other sexually transmitted infections (STIs) and other negative outcomes. To effectively address both of these health issues, it is crucial to understand the shared key determinants underlying these illnesses, which is a substantial knowledge gap in Ethiopia and elsewhere in the world. Therefore, this study aimed to identify the common key determinants of depression and AUD among FSWs in Ethiopia using a bivariate multivariable ordinal logistic model.MethodsWe analyzed cross-sectional biobehavioral data collected in 2020 from 16 cities and major towns in Ethiopia using the respondent-driven sampling (RDS) technique, which involved a total of 6,085 FSWs. FSWs who had lived at the study sites for at least a month before the study period were deemed eligible for recruitment. Major depressive disorder (DD) and AUD were screened using the Patient Health Questionnaire (PHQ9) and alcohol use disorder identification test (AUDIT), respectively. We used descriptive statistics to summarize study population characteristics and bivariate multivariable ordinal logistic regression (BMOLR) to identify common determinants of DD and AUD combined and their nonnormal correlation.ResultsAmong 6085 FSWs screened for DD and AUD, 13.5% and 4.0% have met the criteria for moderate and severe depressive disorder, respectively, and 20.3% and 34.7% have met the AUDIT criteria for harmful or hazardous behavior and alcohol dependence, respectively. FSW with experience of inconsistent condom use, condom failure, violence, mobility, use of any drugs, non-paying partners, abortion, and selling sex for more than five years were associated with an increase in the severity of both disorders. A high average income from selling sex and the number of paying partners reduced the severity of depression and increased the level of alcohol dependence. Being HIV positive and ever having anal sex were associated only with an increase in depression.ConclusionMajor DD and AUD are prevalent among FSWs in Ethiopia. The findings revealed that common key determinants, which exacerbated the severity of both disorders, were also risk factors for HIV and other STIs. Consequently, integrated STI strategies are essential in the screening, referral, and treatment of depression and AUD. Intervention packages should encompass determinants of depression and AUD, including condom utilization, drug use, mobility between towns, abortion, violence, and counseling services. Additionally, strategies to ensure economic security should be incorporated.

Assessing high-risk sexual practices associated with human immunodeficiency virus infection among young female sex workers in Lubumbashi, Democratic Republic of the Congo: a cross-sectional study

IntroductionYoung female sex workers (YFSWs) face a higher risk of HIV infection compared to older workers, but there is a lack of comprehensive data on their sexual practices and HIV infection risks, which may present unique challenges and vulnerabilities. The study aimed to identify high-risk sexual practices associated with HIV infection among YFSWs in Lubumbashi.MethodsWe conducted an analytical cross-sectional study and used a comprehensive sample of all YFSWs who presented to the HIV/Sexually Transmitted Infections Screening and Treatment Center in Lubumbashi between April 2016 and December 2017. We collected data on socio-demographic characteristics and behavioral risk factors of female sex workers were collected using a structured questionnaire. Using STATA version 16, multivariate logistic regression was fitted and the results were presented as adjusted odds ratios (aORs) with their 95% confidence intervals (95% CIs).ResultsA total of 572 YFSWs were included in the study, 19 of whom were HIV-positive (3.3%; 95% CI: 2.1–5.1%). Participants who were forced to have sex (aOR = 12.2; 95% CI: 3.2–46.4; p < 0.0001), those who did not use condoms systematically (aOR = 4.1; 95% CI: 1.3–13.0; p = 0.018), and those who had anal sex (aOR = 23.8; 95% CI: 6.9–82.4; p < 0.0001) were more likely to be HIV-positive.ConclusionThe study reveals a concerning trend of higher hospital HIV prevalence among YFSWs compared to the general Congolese population. It also highlights a significant link between high-risk sexual practices and HIV infection, highlighting the need for urgent interventions.

Sex Workers in Canada Face Unequal Access to Healthcare: A Systems Thinking Approach.

Despite Canada's universal health system, sex workers across the country face an alarmingly high number of barriers when they seek to healthcare services. This has resulted in unmet healthcare needs and substantially poorer health outcomes than the general Canadian population. The objective of this study was to use a systems thinking approach to gain an in-depth understanding of the barriers sex workers face and how access could be improved. The analysis was conducted using a systems thinking methodology, which incorporates systems tools and inquiry processes. The methodology comprised 2 domains of inquiry: (1) Problem Landscape, (2) Solutions Landscape. Systems tools and methods, such as causal loop diagrams, iceberg diagram, and systems mapping, investigated the problem landscape for understanding the interconnected nature of the issue, alongside review of both published and gray literature. An environmental scan explored the current solutions landscape. These methods connected through systemic inquiry processes, including ongoing review and application of diverse perspectives, boundary judgments, interrelationships; enabled gaps and levers of change to be determined. The main barriers sex workers face are stigma, criminalization, accessibility, and cost of healthcare. The stigma of sex work stems from otherization, paternalism, and moralistic, faith-based beliefs. The barriers unique to sex work are stigma and criminalization; both of which surface as avoidance, dislike, and/or fear of medical professionals. Five gaps each with a lever of change to improve access were identified: (1) Stigma - Collectivization and external collaboration, (2) Criminal status of sex work - Decriminalization, (3) Lack of adequate education - Improved healthcare professional training and anti-discriminatory health policies, (4) Lack of support - Increased community-based healthcare services, (5) Cost of healthcare - Universal coverage of "secondary" healthcare components. Through reducing the stigma surrounding sex work, making changes that improve the healthcare services that sex workers receive, and collaboration between involved parties, sex workers can be prevented from falling through the cracks of the Canadian healthcare system; lessening the health inequities sex workers face and improving their health outcomes.

Understanding sexual violence in sex working populations-Law, legal consciousness and legal practice in four countries (2021-2023): Study Protocol v2.5.

Globally, the most important human rights and public health issue that sex workers face is their experience of high levels of violence (Kinnell, 2006, Kinnell, 2008, Alexander, 1999). Deering's systematic review estimated levels of sexual violence in sex working populations as being between 14% and 54% (Deering et al, 2014). This international, robust mixed methods study will explore the frequency of sexual violence against sex workers, barriers in criminal justice and the legal consciousness of sex workers regarding their rights and consent. The hypothesis to be tested is that the safety of sex workers from sexual violence is mediated by the differing legal contexts of sex work environments. We will compare experiences across research sites in the context of legalisation (Nevada USA), client criminalisation (Northern Ireland), decriminalisation (New Zealand) and partial criminalisation (England, Scotland and Wales) [henceforth ESW]. An international survey (n = 1,000) will be translated into several languages, to disaggregate experiences by demographic categories (gender, ethnicity, sexual orientation) and sex work sector (including online, street-based and brothels). Interviews (n = 100) with sex workers, police, prosecutors and service providers will be thematically analysed to explore legal consciousness, why the patterns occur and contextualise the statistical findings. These data will be supplemented with comparative legislative, policy and case analysis. Research study data will be used to compare the social factors and legal norms shaping sex workers experiences of sexual violence, justice and support interventions. Recommendations for a 'best practice' review of legal improvements and support interventions will be produced following completion of the study. Given the sensitive nature of the research, robust ethical and data protection mechanisms are in place. The research has ethical approval from each research site, an Advisory Board and trained, paid peer researchers to assist with data gathering, analysis and dissemination. The study will report findings in 2023/2024.

Communicating Sex Work Online: A Content Analysis of Client and Provider Discourse in r/SexWorkers

ABSTRACT The growth of digital technologies has enabled the creation of online platforms for sex workers to share, create, and gather information. To elucidate how this community leverages social media, the current study analyzed how sex workers and related groups (e.g. clients) communicate in a pseudonymous online space – r/SexWorkers. A content analysis of 103 posts and 967 comments submitted to r/SexWorkers between March 13, 2021, and February 22, 2022 was performed, evaluating 1) the prevalence of risk (i.e. to sex workers and clients) within the community’s discourse, 2) types of information shared within the community (e.g. legal, health, and support), 3) features of information exchange (e.g. seeking and providing), and 4) the emergence and confrontation of stigma. The findings of this study indicate that users took specific interest in the risks sex workers face (as opposed to clients), providing information predominantly about economic and health concerns, discussing potential abuses, and providing support to one another. Moreover, while stigma was not commonly discussed by the community, users who did engage with stigma (especially professional stigma) sought to counteract prevailing beliefs about sex work. Accordingly, r/SexWorkers seemingly provides a beneficial online space for sex workers and clients to discuss risk, safety, and stigma.

Attitudes towards sex workers: a nationwide cross-sectional survey among German healthcare providers.

Worldwide, sex workers face stigmatization and discrimination, also within healthcare. Only few studies on healthcare providers' attitudes towards care of sex workers have been performed. This study assessed attitudes and knowledge of healthcare providers in Germany towards sex workers and their specific health risks. German healthcare professionals and medical students were invited to participate in a nationwide cross-sectional study in 2022. The online survey used a German translation of the "Attitudes towards Prostitutes and Prostitution Scale" by Levin and Peled for assessment of attitudes towards sex work and workers, together with prevalence estimates of common mental and physical disorders. A total of 469 questionnaires were included into analysis. Older participants tended to regard sex work as less of a choice (p < 0.004) and sex workers as more victimized (p < 0.001). The frequency of professional contact to sex workers neither affected the perception of sex workers' status as victims vs. independent individuals, nor the perceived moral status. Moreover, healthcare professionals overestimated the prevalence of various disorders which was influenced by participants' attitudes towards sex workers. A comparison to a recent Allensbach survey demonstrated similar attitudes of healthcare providers and the general population towards sex workers. Our results suggest that German healthcare professionals are not free of prejudices against sex workers, as has been shown for other marginalized groups in society. Instead, they seem to be influenced by personal opinion rather than by objective facts which they should have acquired during their professional education. Future interventions (e.g., better training regarding marginal societal groups) are necessary to encounter these issues in order to improve healthcare for sex workers.

Experiences of interpersonal violence among a diverse sample of male sex workers

A notable portion of men who have sex with men engage in exchange sex—i.e. the trading of sex for money, drugs, shelter or other material goods. Despite the risks for physical and sexual violence, threatening behaviour and robbery that male sex workers confront, very little is known about their experiences of such actions by clients. To gain more insight into male sex workers’ experiences of interpersonal violence, we analysed qualitative interview data from 180 men who have sex with men from 8 US cities who engaged in sex work with clients they had met primarily through dating/hookup websites and apps. Participants discussed their experiences of a range of untoward behaviours by clients including physical violence, sexual violence, threats and robbery. Healthcare and social services providers can play a significant role in violence prevention among male sex workers. The decriminalisation of sex work could also potentially reduce the risks many sex workers face by facilitating their reporting of harms suffered.

Sex Work, Sex Workers and Forms of Inequality: A Policy Brief

Sex work has always been here. It has many types and expressions. According to existing scholarship, sex work is associated with a variety of inequalities. Evidence from academic literature shows that, worldwide, sex workers face serious inequalities with severe effects on their lives. Through this policy brief, inequalities are classified by context in some main categories. Social, economic, racial/ethnic, gender, age and “beauty” as well as health inequalities, as demonstrated by international literature, plague sex workers at a global scale. Taking all the above into account, conclusions are drawn and possible solutions are recommended for the mitigation and -if possible- elimination of these inequalities, utilizing means at a local, national and international scale.

Violence Victimization and Alcohol Use Among Venue-Based Female Sex Workers in Pattaya, Thailand: Unpacking the Temporal Relationship.

Female sex workers (FSWs) face prevalent violence victimization and alcohol consumption at work, yet the bidirectional pathways between these factors are not well defined. Using cohort data from 232 venue-based FSWs in Pattaya, associations of violence and alcohol use were examined within a time period and prospectively via structural equation models. Within the time period, violence victimization and alcohol use were consistently associated; by contrast, violence was not prospectively associated with FSW alcohol use. Findings define alcohol as an important risk factor for violence in sex work environments. Alcohol safety interventions should be explored as a vital component of FSW violence prevention.

Housing Instability and Evictions Linked to Elevated Intimate Partner and Workplace Violence Among Women Sex Workers in Vancouver, Canada: Findings of a Prospective, Community-Based Cohort, 2010-2019.

Objectives. To model the relationship of unstable housing and evictions with physical and sexual violence perpetrated against women sex workers in intimate and workplace settings. Methods. We used bivariate and multivariable logistic regression with generalized estimating equations to model the association of unstable housing exposure and evictions with intimate partner violence (IPV) and workplace violence among a community-based longitudinal cohort of cisgender and transgender women sex workers in Vancouver, Canada, from 2010 through 2019. Results. Of 946 women, 85.9% experienced unstable housing, 11.1% eviction, 26.2% IPV, and 31.8% workplace violence. In multivariable generalized estimating equation models, recent exposure to unstable housing (adjusted odds ratio [AOR] = 2.04; 95% confidence interval [CI] = 1.45, 2.87) and evictions (AOR = 2.45; 95% CI = 0.99, 6.07) were associated with IPV, and exposure to unstable housing was associated with workplace violence (AOR = 1.46; 95% CI = 1.06, 2.00). Conclusions. Women sex workers face a high burden of unstable housing and evictions, which are linked to increased odds of intimate partner and workplace violence. Increased access to safe, women-centered, and nondiscriminatory housing is urgently needed. (Am J Public Health. 2023;113(4):442-452. https://doi.org/10.2105/AJPH.2022.307207).

Transgender women sex workers' experiences accessing sexual health care in Iran: a qualitative study.

This study aimed to examine the experiences of transgender women who work in the sex industry regarding their access to health care facilities for sexual health. Transgender women sex workers are recognised worldwide as a high-risk group for HIV and sexually transmitted infections (STIs). In Iran, between January and May 2022, we employed a snowball sampling technique to recruit a diverse group of 22 transgender women sex workers aged 19-42 years. Semi-structured interviews were conducted with these participants to provide insights into their experiences with accessing sexual health care. The data was analysed using thematic analysis, revealing four overarching themes: experiences of violence, contextual barriers to health, socioeconomic challenges and HIV/STI risk practices, and 11 sub-themes. The results demonstrate that many participants experienced difficulties in accessing sexual health services due to violence, discrimination, financial difficulties and lack of awareness about STIs. Sex workers face extraordinarily challenging occupational risks, including sexual and physical abuse, mental health issues, and HIV and STIs. Targeted public intervention programs and research for this group are urgently needed. Outreach programs engaging with underserved transgender women sex workers have the potential to enhance access to healthcare services, and contribute to the reduction of HIV transmission rates.

Validating a measure of anticipated sex work-related stigma among male and female sex workers in Kenya

ABSTRACT Sex workers face different types of sex work-related stigma, which may include anticipated, perceived, experienced, or internalized stigma. Sex work stigma can discourage health care seeking and hamper STI and HIV prevention and treatment efforts. There is a paucity of validated sex work-related stigma measures, and this limits the ability to study the stigma associated with sex work. A cross-sectional survey was conducted that measured anticipated sex work-related stigma among male and female sex workers in Kenya (N = 729). We examined the construct validity and reliability of the anticipated stigma items to establish a conceptually and statistically valid scale. Our analysis supported a 15-item scale measuring five anticipated sex work stigma domains: gossip and verbal abuse from family; gossip and verbal abuse from healthcare workers; gossip and verbal abuse from friends and community; physical abuse; and exclusion. The scale demonstrated good face, content, and construct validity. Reliability was good for all subscales and the overall scale. The scale demonstrated good model fit statistics and good standardized factor loadings. The availability of valid and reliable stigma measures will enhance efforts to characterize and address stigma among sex workers and ultimately support the protection, health and well-being of this vulnerable population.

Decriminalizing Sex Work: How The Protection of Communities and Exploited Persons Act Harms Consensual Sex Workers and Creates Further Stigmatization in Society

This paper will explore the current legislation in place in Canada regarding sex work, the Protection of Communities and Exploited Persons Act (PCEPA), and how it harms and stigmatizes those engaging in consensual sex work. The PCEPA was established as a response to the decision made in Bedford v. Canada in that the previous provisions governing sex work were unconstitutional. The intention of this Act is to criminalize the payment of sexual services, the procurement of sexual services and third party advertising of sexual services. Its main goal was to reduce the human trafficking that often occurs within the sex work environment. While human trafficking is undeniably an issue in today’s society, the PCEPA fails to acknowledge other perspectives of individuals that it is impacting including those choosing to engage in sex work. Throughout this paper, topics such as the harms the PCEPA has had on sex work, the stigmatization and discourses that exist around sex work, and what decriminalization of sex work would look like will be explored and deconstructed. This paper will argue that a move towards decriminalization of sex work will be beneficial for those engaging in sex work and reduce the harms and stigmatization that many sex workers face and that finding a balance between combating human trafficking and protecting consensual sex workers is essential.

Peer Counsellor Training for Sex Workers: A Pilot Program in Lekwungen Territory (Victoria, BC)

Sex workers face significant stigma when accessing mental health services, due to the history of criminalization of sex work and the resulting negative biases in the healthcare sector. Peers Victoria Resources Society is a sex worker advocacy organization who partnered with the researchers to develop and implement a pilot program on peer-counsellor skills development for sex workers incorporating trauma informed practice. The course sought to build on leadership, capacity and strengthen solidarity while acknowledging societal stigma, in hopes that this pilot could result in supplementary care to mainstream mental health services for this underserved community. Interviews were conducted with eight participants prior to and following the 10-week course. Participants reported increased competency in basic counselling skills such as reflective listening, and all noted the applicability of these skills in their personal and working lives. Suggestions were made to scaffold future course content to manage both academic and emotional learning.