ArticlePloS one2020
The impact of end-demand legislation on sex workers' access to health and sex worker-led services: A community-based prospective cohort study in Canada.
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
18 citing papers in PubMed, 44 citations in OpenAlex.
- Use of clinic- and community-based overdose prevention services by sex workers who use drugs: findings from a community-based cohort in Vancouver, Canada (2017-2024).Harm reduction journal · 2026Article
- Sex workers' engagement with mutual aid on-the-ground and online: Exploring access to grassroots support networks among a community-based cohort in Vancouver, Canada (2020-2024).Social science & medicine (1982) · 2025Article
- 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).Journal of epidemiology and community health · 2024Article
- AN EVALUATION OF INDOOR SEX WORKERS' PSYCHOSOCIAL OCCUPATIONAL HEALTH AND SAFETY IN METRO VANCOUVER, CANADA.Occupational health science · 2024Article
- Decriminalisation and the end of AIDS: keep the promise, follow the science, and fulfill human rights.Sexual and reproductive health matters · 2023Review
- Negative changes in illicit drug supply during COVID-19: Associations with use of overdose prevention and health services among women sex workers who use drugs (2020-2021).The International journal on drug policy · 2023Article
- Increasing trends and incidence of nonfatal overdose among women sex workers who use drugs in British Columbia: The role of criminalization-related barriers to harm reduction.Drug and alcohol dependence · 2023Article
- An Evaluation of Indoor Sex Workers' Sexual Health Access in Metro Vancouver: Applying an Occupational Health & Safety Lens in the Context of Criminalization.International journal of environmental research and public health · 2023Article
- Article
- BARRIERS TO GOVERNMENTAL INCOME SUPPORTS FOR SEX WORKERS DURING COVID-19: RESULTS OF A COMMUNITY-BASED COHORT IN METRO VANCOUVER.Social sciences (Basel, Switzerland) · 2022Article
- Interest in receiving psychedelic-assisted therapy among marginalized women: Implications and findings from a community-based study in Canada.Drug and alcohol dependence reports · 2022Article
- Sex work community participation in criminalized environments: a community-based cohort study of occupational health impacts in Vancouver, Canada: 2010-2019.International journal for equity in health · 2022Article
- Article
- COVID-19, Stigma, and the Ongoing Marginalization of Sex Workers and their Support Organizations.Archives of sexual behavior · 2022Article
- Disparities in HIV-related risk and socio-economic outcomes among trans women in the sex trade and effects of a targeted, anti-sex-trafficking policy.Social science & medicine (1982) · 2021Article
- HIV Vulnerability Among Survival Sex Workers Through Sexual Violence and Drug Taking in a Qualitative Study From Victoria, Canada, With Additional Implications for Pre-exposure Prophylaxis for Sex Workers.Frontiers in sociology · 2021Article
- Structural barriers to condom access in a community-based cohort of sex workers in Vancouver, Canada: influence of policing, violence and end-demand criminalisation.BMJ sexual & reproductive health · 2020Article
- Sex Workers in Canada Face Unequal Access to Healthcare: A Systems Thinking Approach.Journal of primary care & community healthArticle
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundFollowing a global wave of end-demand criminalization of sex work, the Protection of Communities and Exploited Persons Act (PCEPA) was implemented in Canada, which has implications for the health and safety of sex workers. This study aimed to evaluate the impact of the PCEPA on sex workers' access to health, violence, and sex worker-led services.
methodsLongitudinal data were drawn from a community-based cohort of ~900 cis and trans women sex workers in Vancouver, Canada. Multivariable logistic regression examined the independent effect of the post-PCEPA period (2015-2017) versus the pre-PCEPA period (2010-2013) on time-updated measures of sex workers' access to health, violence supports, and sex worker/community-led services.
resultsThe PCEPA was independently correlated with reduced odds of having access to health services when needed (AOR 0.59; 95%CI: 0.45-0.78) and community-led services (AOR 0.77; 95%CI: 0.62-0.95). Among sex workers who experienced physical violence/sexual violence or trauma, there was no significant difference in access to counseling supports post-PCEPA (AOR 1.24; 95%CI: 0.93-1.64).
conclusionSex workers experienced significantly reduced access to critical health and sex worker/community-led services following implementation of the new laws. Findings suggest end-demand laws may exacerbate and reproduce harms of previous criminalized approaches to sex work in Canada. This study is one of the first globally to evaluate the impact of end-demand approaches to sex work. There is a critical evidence-based need to move away from criminalization of sex work worldwide to ensure full labor and human rights for sex workers. Findings warn against adopting end-demand approaches in other cities or jurisdictions.
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Registered trials
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