ArticlePLOS global public health2025
Everyday discrimination and barriers to primary care, mental health, and substance use services: Findings from a community-based cohort of sex workers in Vancouver, Canada (2015-2024).
Article in PLOS global public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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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
3 citing papers in PubMed.
- Mental health and substance use among women frequenting high-risk venues in Haiphong, Vietnam: findings from an adapted PLACE survey.The International journal on drug policy · 2026Article
- Incorporating a Veteran's lived and living expertise of sex work and substance use into clinician education.BMC medical education · 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
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
We evaluated the association between discrimination and access to primary, mental health, and substance use services among sex workers. Using baseline and semi-annual questionnaire data from a community-based cohort of sex workers in Vancouver, Canada (09/2015-02/2024), we used bivariate and multivariable logistic regression with generalized estimating equations to analyze the relationship between discrimination and access to primary care, mental health, and substance use services. Among 518 participants (2768 observations), the median discrimination score was 19 (IQR:11-25), indicating substantial discrimination. In separate multivariate models, every one-point increase in discrimination was associated with increased odds of experiencing barriers to health services (adjusted odds ratio (AOR):1.03, 95%CI:1.02-1.04), unable to access health services when needed (AOR:1.03, 95%CI:1.01-1.04), unmet need for mental health services (AOR:1.04, 95%CI:1.03-1.06), experiencing barriers to counseling for sexual trauma (AOR:1.04, 95%CI:1.02-1.05), and unmet need for substance use treatment (AOR:1.07, 95%CI:1.04-1.09). Discrimination is highly prevalent and associated with reduced access to primary, mental health, and substance use services among sex workers. There is a need for anti-discrimination efforts, including provider training and sex worker partnerships in primary care, alongside policy reforms.
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Registered trials
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