Peer Support using a Mobile Access Van Promotes Safety and Harm Reduction Strategies among Sex Trade Workers in Vancouver’s Downtown Eastside

• Published in: Journal of urban health 2009-09, Vol.86 (5), p.804-809
• Main Authors: Janssen, Patricia A., Gibson, Kate, Bowen, Raven, Spittal, Patricia M., Petersen, Karen L.
• Format: Article
• Language: English
• Subjects: British Columbia; Community health care; Community-Institutional Relations; Condoms; Condoms - supply & distribution; Disease prevention; Epidemiology; Female; Harm Reduction; Health Informatics; Humans; Hypodermic needles; Interviews as Topic; Medicine; Medicine & Public Health; Mobile Health Units - organization & administration; Mobile Health Units - utilization; Needle-Exchange Programs - statistics & numerical data; Peer Group; Prostitution; Public Health; Risk-Taking; Sex Work - statistics & numerical data; Sexual assault; Substance Abuse, Intravenous - complications; Substance Abuse, Intravenous - epidemiology; Urban areas; Urban Health; Violence - prevention & control; Womens health
• ISSN: 1099-3460; 1468-2869
• DOI: 10.1007/s11524-009-9376-1

Women in the sex trade whose economic and social base are urban streets face multiple dangers of predation, isolation, and illness. A Mobile Access Project (MAP) to provide emergency medical help, peer counseling, condoms and clean needles, resource information and referral, and a place of respite and safety was initiated for sex trade workers in Vancouver, British Columbia, Canada. We conducted surveys with 100 women sex workers who accessed MAP services and reviewed MAP logbooks to document use of services. We assessed the impact of MAP through review of data from a concurrent cohort study of injection drug users and a survey of 97 women at a drop-in center in the Downtown Eastside. Over 90% of MAP clients reported that the van made them feel safer on the street. Sixteen percent of surveyed MAP clients recalled a specific incident in which the van’s presence protected them from a physical assault and 10% recalled an incident when its presence had prevented a sexual assault. Distribution of needles and condoms has increased steadily since the implementation of MAP. Eighty percent of women surveyed at a drop-in center in the Downtown Eastside had received services from MAP. The peer-led Mobile Access Project has emerged as a viable harm reduction strategy for serving the immediate health and trauma-related needs of women engaged in street-level sex work.