Sex workers, much like the rest of the population, face several health risks, including general health concerns, mental health issues and sexual health issues. For those living in poverty with addictions or mental illness, these concerns are exacerbated. Sex workers are at higher risk for sexually transmitted infections (STIs), including HIV and syphilis. Those who are injection drug users and share needles face greater health complications, including Hepatitis C. Most sex workers report using condoms, however it may be difficult for sex workers to negotiate condom use because of difficult customers or the demands of pimps. Many barriers prevent sex workers from accessing services, including stigmatization, discrimination, isolation and cultural factors.
The mental health of sex workers may also be affected by their work. The high levels of violence that sex workers experience produce not only physical, but also long-term mental and emotional harm. A 2005 study of Vancouver street-based sex workers found that 72 per cent met the criteria for post-traumatic stress disorder. (Farley & Cotton)
Street-based sex workers suffer extreme harm much more frequently than most workers do due to isolation, predators, robbery, bad dates, stigmas and Section 213 of the Criminal Code of Canada, which makes it illegal for sex workers to solicit in a public space and limits sex workers’ ability to screen out potentially violent and dangerous clients. Street-level sex workers are more vulnerable to exploitation by third parties such as owners and managers of sex-industry establishments, security guards, drug dealers, boyfriends or girlfriends, clients and pimps and madams.
Sex workers are at risk of violence and danger on a daily basis, although the levels of violence depend on the type of venue in which they work. Sex workers who work in the most dangerous environments experience, by far, the highest homicide rates of any occupational group. Much of the violence is perpetrated by customers.
Healthcare accessibility and health knowledge remain barriers for sex worker populations. In addition, sex workers fear disclosing the kind of work they are involved in for fear of stigmatization. Those who do disclose often face great discrimination. Historically, sex workers have not felt comfortable and supported when reporting violence to the police. The Vancouver Police Department’s response to bad date reporting has improved in recent years.