Tools for Sex Workers

Mental and Physical Health

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 and HIV due to the demand for unprotected sex by clients. 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. The ongoing experience of society stigma and discrimination can have serious negative impacts on sex workers’ self-esteem and perceived quality of life.


Street-based sex workers suffer extreme harm much more frequently than most workers do due to isolation, predators, robbery, bad dates, stigmas and the criminalization of public communication for the purposes of prostitution 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, 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 predators posing as clients.


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.


These groups provide mental health drop-in support and information about the provincial health care system. You can call 811 (HealthLink BC) anytime to find health services.

Here to Help
This group provides excellent mental health and substance abuse information for those who are at risk or may be experiencing mental health issues. They have excellent fact sheets about different mental health issues and toolkits for managing mental health issues such as anxiety (including post-traumatic stress disorder) and addictions.


BC Mental Health & Addiction Services
This agency of the Provincial Health Services Authority provides a diverse range of mental health services to people across BC.


Canadian Mental Health Association
This national organization promotes mental health and supports the resilience and recovery of people experiencing mental illness.


Mood Disorders Association of BC
This nonprofit organization provides treatment, support, education, and hope of recovery for people living with a mood disorder.


Vancouver Coastal Health
This BC government agency delivers multi-faceted health services to BC residents. The Adult Mental Health Program serves clients over the age of 19 who are diagnosed with a major mental illness and experiencing significant problems that interfere with their functioning in the community. The Children and Youth Mental Health Program serves children and youth with serious mental health difficulties and social, emotional or behavioural disturbances and also supports their families.


ARA (Mental Health Action Research and Advocacy)
This group advocates for people with mental illness who require help with income assistance, tenancy issues, employment, education, medical and dental care, appeals and tribunals and substance abuse. It provides outreach to consumers in the Downtown Eastside and Metro Vancouver.


Kettle Friendship Society

Phone: 604-251-2801

The society serves individuals with mental health disabilities by providing advocacy, a drop-in centre, employment preparation, housing services, outreach and referrals.


Coast Foundation Society

Phone: 604-872-3502, ext. 293

The society offers individual support, housing, showers, laundry and affordable lunches. Coast provides many other services as well.