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Sex work and the public health impacts of the 2010 Olympic Games Deering, Kathleen N.; Chettiar, Jill; Chan, Keith; Taylor, Matthew; Montaner, Julio; Shannon, Kate Jun 30, 2012

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Sex work and the public health impacts of the 2010 OlympicGamesKathleen N Deering1,2, Jill Chettiar2, Keith Chan2, Matthew Taylor3, Julio SG Montaner1,2,and Kate Shannon1,2,41Division of AIDS, Department of Medicine, Faculty of Medicine, University of British Columbia,Vancouver, Canada2B.C. Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada3HUSTLE, PEERS Vancouver Resource Society, Vancouver, British Columbia, Canada4School of Population and Public Health, Faculty of Medicine, University of British Columbia,Vancouver, CanadaAbstractObjectives—The authors examined the impact of exposure to the 2010 Winter Olympics timeperiod on outcomes measuring disruption of local sex work environments in Vancouver, Canada.Methods—The authors conducted a before-and-after study, using multivariable logisticregression, to assess the relationship between exposure to the Olympics period (19 January–14March 2010) versus the post-Olympics period (1 April–1 July 2010) and outcomes.Results—This study included 207 youth (14+ years) and adult sex workers (SWs) (Olympics:n=107; post-Olympics: n=100). SWs in the two periods were statistically similar, with an overallmedian age of 33 years (IQR: 28–40), and 106 (51.2%) of indigenous ancestry or ethnic minority.In separate multivariable logistic regression models, the Olympics period remained statisticallysignificantly associated with perceived heightened police harassment of SWs without arrest(adjusted ORs (AOR): 3.95, 95% CIs 1.92 to 8.14), decreased availability of clients (AOR: 1.97,95% CIs 1.11 to 3.48) and increased difficulty meeting clients due to road closures/construction(AOR: 7.68, 95% CIs 2.46 to 23.98). There were no significantly increased odds in perceivedreports of new (0.999), youth (0.536) or trafficked SWs (zero reports) in the Olympic period.Conclusions—To reduce potential adverse public health impacts of enhanced police harassmentand displacement of local sex work markets, results suggest that evidence-based public healthstrategies need to be adopted for host cities of future events (eg, the London 2012 OlympicGames), such as the removal of criminal sanctions targeting sex work and the piloting andrigorous evaluation of safer indoor work spaces.Correspondence to Dr Kate Shannon, Assistant Professor, Division of AIDS, Department of Medicine, Faculty of Medicine,University of British Columbia; Director, Gender and Sexual Health Initiative, St. Paul’s Hospital, 608-1081 Burrard Street,Vancouver, British Columbia, Canada, V6Z 1Y6; gshi@cfenet.ubc.ca.Contributors KS had full access to all of the data in the study and takes full responsibility for the integrity of the data and theaccuracy of the data analysis. KND and KS made substantial contributions to conception and design of the study. JC and KS madesubstantial contributions to the acquisition of the data. KC conducted the statistical analysis. KND drafted the manuscript. KS, JC,MT, KC and JSGM made substantial contributions to the interpretation of the data and revised the article critically for importantintellectual content. All authors have approved the final version to be published.Competing interests None.Ethics approval Approval provided by the Providence Health Care/University of British Columbia Research Ethics Board.Provenance and peer review Not commissioned; externally peer reviewed.NIH Public AccessAuthor ManuscriptSex Transm Infect. Author manuscript; available in PMC 2013 June 01.Published in final edited form as:Sex Transm Infect. 2012 June ; 88(4): 301–303. doi:10.1136/sextrans-2011-050235.NIH-PA Author ManuscriptNIH-PA Author ManuscriptNIH-PA Author ManuscriptINTRODUCTIONThe 2010 Winter Olympic Games in Vancouver, Canada, generated substantial internationalmedia attention regarding concerns of intensified human trafficking, supply and demand forpaid sex,12 and risks for HIV/sexually transmitted infections (STIs), which are known to belargely concentrated among the street-based sex work market.3 Similar reports were madeduring the FIFA World Cup events in Germany (2006) and South Africa (2010),4 and for theupcoming 2012 Olympics in the UK.5 Against these growing concerns, evidence suggestssignificant potential for disruption of more visible street-based sex work environments dueto event-related construction and road closures,6 as well as municipal ‘clean up’ efforts inresponse to international scrutiny. In Vancouver, an estimated security budget of $900million and an infiux of federal/regional law enforcement officers generated furtherconcerns regarding enhanced police crackdowns and potential human rights violations.7 Themain objective of this analysis was to examine the potential public health impacts of theOlympics on disruption of local sex work environments in the context of HIV/STI risk inVancouver.METHODSUsing time–location sampling, women (including transgendered) who exchanged sex formoney within the last 30 days (sex workers (SWs)) were recruited through outreach tooutdoor sex work locations (ie, streets), as previously,3 and indoor sex work venues (ie,massage parlours). The study holds ethical approval through Providence Health Care/University of British Columbia Research Ethics Board. SWs completed informed consentand a brief interviewer-administered cross-sectional screening questionnaire (part ofenrolment to a longitudinal cohort, An Evaluation of Sex Workers’ Health Access) on socio-demographics (eg, age, ethnicity), sex work patterns (eg, clients/week) and workenvironment (eg, solicitation spaces, geographic neighbourhoods). The main exposurevariable was the 2010 Winter Olympic Games time period. The Olympics took place from12 to 28 February 2010, with pre-events, heightened security and road closures beginning inJanuary. Time period 1, constituting the period immediately before and during the Olympics(‘Olympics period’), was therefore defined as 19 January–14 March 2010 and time period 2(‘Post-Olympics period’) was defined as 1 April–13 July 2010. The 2-week gap from 15March to 31 March 2010 was dropped to better capture the period when city-wide changesoccurred.The relationships between the Olympics period and multiple outcomes were examined.Outcomes measured experiences with police, construction, traffic/road closures and otherdisruption of sex work (eg, ability to meet clients). Using multivariable logistic regression,we fitted separate confounder models for the relationship between our exposure variable(Olympics period) and outcomes. Details on model fitting are provided in table 1.RESULTSBetween January and July 2010, 207 SWs were interviewed (n=107 in the Olympics period;n=100 in the post-Olympics period). The two groups had statistically similar age andethnicity. The overall median age was 33 years (IQR: 28–40 years), with 101 (48.8%)Caucasian/white SWs and 106 (51.2%) indigenous/ethnic minority SWs. In addition tooutdoor/public places (82.5%), SWs worked in a range of indoor venues, including: 54(26.2%) indoor managed brothels (eg, massage parlours, beauty establishments; micro-brothels); 65 (31.6%) home; and 33 (16.0%) entertainment industry (eg, exotic dance clubs,escort agencies). In the Olympics period compared with the post-Olympics period, we foundno statistically significant difference in reporting of an infiux in the numbers of SWs withinDeering et al. Page 2Sex Transm Infect. Author manuscript; available in PMC 2013 June 01.NIH-PA Author ManuscriptNIH-PA Author ManuscriptNIH-PA Author Manuscriptthe neighbourhood of recruitment (p=0.183), from other neighbourhoods in the city(p=0.165) or outside Vancouver (p=0.399). Similarly, we found no statistically significantdifference in reporting of a perceived increase in the number of new sex work initiatesoverall (p=0.999) nor underage youth (<19 years of age) (p=0.536). Finally, there were noreports of perceptions of women being trafficked/sold into sex work in either period.Table 1 presents changes in disruption of sex work environments in the Olympics periodcompared with post-Olympics period. In separate multivariable confounder models, theOlympics period remained statistically significantly associated with perceived heightenedpolice harassment of SWs without arrest (adjusted OR; AOR: 3.95, 95% CIs 1.92 to 8.14),decreased availability of clients (AOR: 1.97, 95% CIs 1.11 to 3.48), as well as increaseddifficulty hooking up with clients due to road closures/construction (AOR: 7.68, 95% CIs2.46 to 23.98) and due to reduced availability of clients (AOR: 3.59, 95% CIs 1.79 to 7.19).DISCUSSIONDespite sensationalised media coverage leading up to the 2010 Winter Olympics inVancouver,12 this study found no statistically significant reports of increases in the supply ofSWs during the Olympics period nor reports of women being trafficked/sold into sex workin either time period. Instead, there was a statistically significant reduction in the availabilityof clients in the Olympics period. This may be explained by our results suggesting a scale-up of police harassment and enhanced difficulties meeting clients due to construction androad closures in the Olympics period. SWs working along a major artery (and main alternateto the TransCanada highway) running from outlying communities into the City ofVancouver also experienced significantly higher police harassment without arrest (resultsnot shown). While coordinated local enforcement efforts within the inner city core likelycurtailed enhanced police enforcement of marginalised, street-based populations during theOlympics period, these results suggest increased police harassment elsewhere. Policeharassment/crackdowns can displace outdoor sex work markets to more isolated spacesaway from health and support services and increase risks of violence and transmission ofHIV/STIs.389The study outcomes measured SWs’ perceived changes in the supply/demand of sex workand all changes may not have been captured. Since our study began in January 2010, wewere unable to compare our two time periods with one prior to January 2010 to assess trendsover a longer period. However, our method has been used successfully previously toexamine changes over two time periods.10 As previously,10 to address potential limitationsof comparing two samples in different time periods, we adjusted for factors that could havecaused bias (eg, type/geographic location of solicitation spaces). Our sample was notrandom or population-based, and may not be representative of all SWs in Vancouver. Time–location sampling is considered the best method of recruitment for mobile/hiddenpopulations.Given growing evidence of the adverse public health impacts of criminalisation andenforcement on the displacement of SWs to isolated spaces as well as heightened violenceand HIV/STI risks, these data provide important lessons for other cities planning to hostlarge-scale sporting events, such as the London 2012 Games.AcknowledgmentsWe thank Peter Vann, Calvin Lai and Ofer Amram for their research and administrative support, and ourcommunity partners and advisory board members for their ongoing feedback and expertise. We also thank theresearch staff at AESHA for their dedicated work, and in particular Lindsey Jer, Julia Homer, Jessica Xi Jia, AllisonHibbert and Alex Scott.Deering et al. Page 3Sex Transm Infect. Author manuscript; available in PMC 2013 June 01.NIH-PA Author ManuscriptNIH-PA Author ManuscriptNIH-PA Author ManuscriptFunding The funding agencies played no role in the analyses and the paper does not necessarily reflect the positionof the funding agencies. This research was funded by a CIHR (HHP-98835) and NIH operating grants(1R01DA028648-01A1). KND is supported by a Canadian Institutes of Health Research Postdoctoral ResearchAward (Bisby Award) and a Michael Smith Foundation for Health Research (MSFHR) Postdoctoral ResearchAward; JSGM is supported by the Ministry of Health, from the Province of British Columbia; through a KnowledgeTranslation Award from the Canadian Institutes of Health Research (CIHR); and through an Avant-Garde Award(No 1DP1DA026182-01) from the National Institute on Drug Abuse, at the US National Institutes of Health. KS issupported by NIH (1R01DA028648-01A1), a CIHR New Investigator Award and Peter Lougheed Award, and aMSFHR Scholar Award.References1. Vancouver Olympics get an ‘F’ for failing to curb sex trafficking. Ottawa Citizen; 2010.http://womenagainstslavery.blogspot.com/2010/02/vancouver-olympics-get-f-for-failing-to.html2. Vancouver sex trade expects to boom during Olympics. The Vancouver Sun; 2010.http://www.vancouversun.com/sports/2010wintergames/Vancouver+trade+expects+boom+during+Olympics/2504461/story.html3. Shannon K, Kerr T, Strathdee SA, et al. Structural and environmental barriers to condom usenegotiation with clients among female sex workers: implications for HIV prevention strategies andpolicy. Am J Pub Health. 2009; 99:659–65. [PubMed: 19197086]4. Delva W, Richter M, De Koker P, et al. Sex work during the 2010 FIFA World Cup: results from athree-wave cross-sectional survey. PLoS One. 2011; 6:e28363. [PubMed: 22163298]5. 2012 Games sex trafficking fears. BBC News; 2007.http://news.bbc.co.uk/2/hi/uk_news/politics/6483407.stm6. The Impacts of the Sydney Olympic Games on Housing Rights: Background Paper. Geneva,Switzerland: Centre on Housing Rights and Evictions; 2007.http://www.cohre.org/store/attachments/Sydney_background_paper.pdf7. Human Trafficking, Sex Work Safety and the 2010 Games: Assessments and Recommendations.Vancouver, Canada: Sex Industry Worker Safety Action Group; 2009.8. Shannon K, Rusch M, Shoveller J, et al. Mapping violence and policing as an environmental-structural barrier to health service and syringe availability among substance-using women in street-level sex work. Int J Drug Policy. 2008; 19:140–7. [PubMed: 18207725]9. Blankenship KM, Koester S. Criminal law, policing policy, and HIV risk in female street sexworkers and injection drug users. J Law Med Ethics. 2002; 30:548–59. [PubMed: 12561263]10. Kerr T, Stoltz J-A, Tyndall M, et al. Impact of a medically supervised safer injection facility oncommunity drug use patterns: a before and after study. BMJ. 2006; 332:220–2. [PubMed:16439401]Deering et al. Page 4Sex Transm Infect. Author manuscript; available in PMC 2013 June 01.NIH-PA Author ManuscriptNIH-PA Author ManuscriptNIH-PA Author ManuscriptKey messages• There is a dearth of relevant scientific data examining the impact of large-scalesporting events on vulnerable populations such as sex workers.• There was no evidence in this study to support concerns of an influx of sexworkers or reports of trafficking of women and girls.• To reduce potential adverse impacts from displacement of local sex workmarkets, evidence-based public health strategies should be adopted for hostcities of future events.• The removal of criminal sanctions targeting sex work and the piloting andrigorous evaluation of safer indoor sex work spaces should be considered.Deering et al. Page 5Sex Transm Infect. Author manuscript; available in PMC 2013 June 01.NIH-PA Author ManuscriptNIH-PA Author ManuscriptNIH-PA Author ManuscriptNIH-PA Author ManuscriptNIH-PA Author ManuscriptNIH-PA Author ManuscriptDeering et al. Page 6Table 1The effect of the Olympics period on disruption of sex work environment in the context of HIV/STI risk*Valid nOverall (n=207), n(%)Period 1: Olympicsperiod (n=107), n(%)Period 2: post-Olympics period(n=100), n (%)Multivariable OR (95%CIs)p ValueHeightened police harassment without arresty†20285 (42.1%)55 (51.4%)30 (31.6%)3.95 (1.92 to 8.14)‡<0.001Heightened police arrests of clients20214 (6.9%)10 (9.3)4 (3.2)NSHeightened police arrest of sex workers20212 (5.9%)6 (5.6%)6 (6.3%)NSDecrease in the numbers of clients available20091 (45.5%)56 (53.8%)35 (36.5%)1.97 (1.11 to 3.48)‡0.020Difficulty hooking up with clients due to road closures/construction20026 (13.0%)22 (21.4%)4 (4.1%)7.68 (2.46 to 23.98)‡<0.001Difficulty hooking up with clients due to a decrease in clientsavailable20056 (28.0%)39 (37.9%)17 (17.5%)3.59 (1.79 to 7.19)‡<0.001Difficulty hooking up with clients due to increases in policesurveillance20056 (28.0%)36 (35.0%)20 (20.6%)NSDifficulty hooking up with clients due to increases in police raids/crackdowns/arrests20020 (10.0%)14 (13.6%)6 (6.2%)NSDifficulty hooking up with clients due to increases in the numbersof workers20038 (19.0%)22 (21.4%)16 (16.5%)NSInflux of sex workers Within this neighbourhood20215 (7.4%)5 (4.8%)10 (10.2%) From other Vancouver neighbourhoods20242 (20.8%)26 (25.0%)10 (10.2%) From outside Vancouver20225 (12.4%)15 (14.4%)16 (16.3%)NSIncrease in new sex work initiates Overall20268 (33.7%)35 (33.7%)33 (33.7%) Underage youth (<19 years old)20227 (13.4%)12 (11.5%)15 (15.3%) 20–25…years old20235 (17.3%)15 (14.4%)20 (20.4%) 25+ years old20236 (17.8%)16 (15.4%)20 (20.4%)NS*Reference period of the last month (30 days).† Police stopping/following sex workers (and their clients) without arrest.‡ Adjusted for the following variables, in multivariable logistic regression analysis: Heightened police harassment without arrest (sexual minority, number of shifts per week; work along the primarytransport route/commercial corridor; solicited in an indoor managed settings; solicited at home/in-call); Decrease in the numbers of clients available (work along the primary transport route/commercialcorridor); Difficulty hooking up with clients due to road closures/construction (sexual minority; work in the inner-city epicentre); and Difficulty hooking up with clients due to a decrease in clients available(work in the inner-city epicentre; solicit outdoors/in public spaces).Sex Transm Infect. Author manuscript; available in PMC 2013 June 01.NIH-PA Author ManuscriptNIH-PA Author ManuscriptNIH-PA Author ManuscriptDeering et al. Page 7NS, not significant, STI, sexually transmitted infection.Sex Transm Infect. Author manuscript; available in PMC 2013 June 01.


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