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 and/or mental illness, these concerns can be much worse. Sex workers are at higher risk for sexually transmitted infections (STIs), including HIV and syphilis. Those who are injection drug users face greater health complications, including Hepatitis C, if they share needles. 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 impacted by their work, due to its particular conditions. The high levels of violence that sex workers experience produce not only physical, but also long-term mental and emotional harm. A 1998 study of street-based sex workers found that 68 percent met the full criteria for post-traumatic stress disorder. (Farley, M. & Barkan, H., Prostitution, Violence and Post-Traumatic Stress Disorder)
Street-based sex workers suffer extreme harm much more frequently than people working indoors do, due to isolation, predators, robbery, bad dates, stigmas and section 213 under the Criminal Code of Canada, which makes it illegal for sex workers to solicit in a public space and limits the sex worker’s ability to screen out potentially violent and dangerous clients. Street level sex workers are more vulnerable than most indoor workers to exploitation by third parties such as owners/managers of sex industry establishments, security guards, drug dealers, boyfriends/girlfriends, clients, or pimps/madams.
Sex workers are at risk of violence and danger on a daily basis, though the levels of violence are dependent on the type of venue in which they work, among other factors. 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 at the hands of sex work 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. In some cases, the VPD’s response to bad-date reporting has improved in recent years.
The Evergreen Community Health Centre is a member of the SAFE Steering Committee. They are located at 3425 Crowley Drive (at Joyce St) and are open Monday to Friday 8:30am to 4:30pm. You will be treated with respect and can feel safe in accessing medical care at Evergreen.
Understanding Mental Health
Some sex workers may be at risk for developing mental health issues, such as complex Post Traumatic Stress Disorder because of their exposure to trauma and violence. The following websites provide information about health issues and the provincial health care system, such as primary health care, the Medical Services Plan and Pharmacare.
For more information about mental health, see the links below:
Vancouver Community Mental Health Services
Serves people 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. E.g. schizophrenia or other psychotic disorders, mood disorders like bipolar or major depressive disorders. Multidisciplinary services are provided through 8 mental health teams and a variety of specialized programs. Mental Health Teams are designated agencies that are responsible for looking into reports of suspected abuse and neglect of adults who cannot seek help for themselves.
Phone: (604) 675-3997
Mental Health Action Research and Advocacy (ARA) – Advocates for people with mental illness, addressing issues including income assistance, tenancy, employment, education, medical/dental, appeals and tribunals, and substance abuse. Provides outreach to consumers living in the Downtown Eastside and other points in Greater Vancouver.
Kettle Friendship Society – Serves individuals with a mental health disability. Provides advocacy, drop-in, employment prep, housing services, outreach and referrals.
Address: 1725 Venables St., Vancouver, BC
Coast Foundation Society – The society offers a number of different services for people living with mental health issues such as individual support, housing, showers, laundry and affordable lunches. There are many other services that Coast provides for further information, check out their website.
Address: East 11th Ave, Vancouver, BC
Phone: 604-872-3502 Ext. 293
Self Care for Sex Workers
Many of us have so many responsibilities in life that we forget to take care of ourselves. When working in an industry where you are constantly tending to the needs of others it is easy to become unbalanced. It’s hard to prioritize something like taking a bath when we have many other priorities in life, however balancing our mind, body, spirit, and our soul is an important aspect of living a healthy life. In many Indigenous cultures, the body is divided into four equal parts; mental, physical, spiritual and emotional and when one is out of whack, the others are soon to follow. Doing something for yourself once a week seems like a small task but can make a big difference in how you feel about yourself and others. Try one or two of the suggestions below and start to feel good inside and out.
- Pick up a good book and read it
- Put on some of your favorite tunes (sing/dance)
- Take a class on a topic that interests you
- Take a night off, your needs come first
- Take a long bath with candles
- Give yourself a pedicure
- Get a massage
- Take a yoga class
- Go for a walk and enjoy Mother Nature
- Buy self-care cards and make it daily ritual to read a card and follow the message
- Take some quite time and meditate
- Always remember that you are a child of the universe, no less than anyone else and that you have the right to be here and are loved.
- Record your thoughts, goals and dreams into a journal (there is much comfort in being able to reflect back on where you were and where you are today, in moments of personal weakness)
- Stick up affirmations and positive thoughts around your home where they are visible to you
- If life overwhelms you and you feel like isolating, reach out and call a friend (get what’s in-out!)
Check out this interesting website that speaks to healing and taking care of all aspects of our mind body and soul: www.heartofhealing.net.
If you find that you have lost control over your drug use and it has taken on a destructive force of its own, you will need help. Although many people drink alcohol and use drugs without developing an addiction problem, it is important to be aware of the possible risks so that you can avoid problems or make changes in your life.
There is a lot of support out there and you do not have to go through this alone. Know that recovery is possible and with a little willingness, you are well on your way. The following website has lots of great information and resources.
Vancouver Coastal Health Addictions Services – This is an excellent web page where you will find a lot of valuable information; such as Aboriginal Health Services, Detox services, Day treatment, Residential support recovery, Residential treatment, Self-help groups and Crisis interventions. www.vch.ca/community/addictions.htm
Safe Needle Disposal
What to do if you accidentally prick yourself with a dirty needle
- If possible, put the pricked area below your heart to promote bleeding. Do not squeeze.
- Wash the area well with soap and water.
- Do not soak the wound in bleach.
- Go to the nearest local health unit or hospital emergency department immediately for care.
All blood and body fluids from any person are potentially infectious.
For more BC HealthFile topics visit www.bchealthguide.org/healthfiles/index.stm, or visit your local public health unit.
Call the BC NurseLine to speak to a registered nurse, available 24-hours every day:
- In Greater Vancouver, call 604-215-4700
- In BC, call toll-free 1-866-215-4700
- Deaf and hearing-impaired, call 1-866-889-4700
- Pharmacist available 5pm to 9am every day
- Translation services in over 130 languages upon request