Sex workers’ experiences and occupational conditions post-implementation of end-demand criminalization in Metro Vancouver, Canada

Objectives In 2014, Canada introduced end-demand criminalization (the Protection of Communities and Exploited Persons Act (PCEPA)), criminalizing purchase of sexual services while leaving the sale of sex legal. We assessed factors correlated with self-reported changes in working conditions post-PCEPA among sex workers (SWs) in Metro Vancouver. Methods Post-PCEPA data for one year were drawn from a community-based cohort of SWs. We analyzed self-reported changes in working conditions among 299 participants who worked prior to PCEPA and were asked about working conditions post-PCEPA. Multivariate GEE analysis evaluated factors correlated with negative changes post-PCEPA, including reduced capacity to screen clients and reduced access to workspaces/clients. Results Most (72.2%) experienced no change in working conditions, and 26.4% reported negative changes (e.g., reduced ability to screen clients or reduced access to workspaces/clients). Reporting negative changes was correlated with being an im/migrant to Canada (adjusted odds ratio (AOR) 2.79, 95% CI 1.59–4.92) and recent physical workplace violence (AOR 4.01, 95% CI 1.12–14.40). In sub-analysis, physical/sexual workplace violence (AOR 3.77, 95% CI 1.17–12.16) and living in the suburbs of Richmond/Burnaby (AOR 2.81, 95% CI 1.15–6.84) correlated with reduced screening capacity; incarceration (AOR 2.98, 95% CI 1.04–8.57) and being an im/migrant (AOR 2.39, 95% CI 1.14–4.99) correlated with reduced access to workspaces/clients. Conclusions Most SWs reported no change in working conditions and one quarter reported negative changes, suggesting that PCEPA may be failing to advance sex workers’ safety. Im/migrants, women experiencing workplace violence, and those facing criminalization were most likely to report negative impacts. Decriminalization of all aspects of sex work is needed to support well-being, health, and safety.