Informing the general community about the diverse needs and issues of all types of Sex Workers in the Bay Area is a critical service that we provide at the St. James Infirmary. Our research practices are grounded in a participatory, peer-based process.
The data that we gather is not used to compromise the safety of our community nor are we required to gather this information for any government or private agencies. These assessments are about us learning what our diverse community has to say. Through our intake assessments we have learned several valuable things about our community.
For example, we have learned that:
• Before coming to St. James, 70% have never disclosed their sex work status to their medical provider for fear of discrimination or diminished healthcare
• Sex Workers who work collectively have lower rates of HIV and STIs than those working independently
• Sex Workers who have a history of arrest of more likely to test positive for HIV and STIs and experience work related violence
This tells us some really important things about what Sex Workers need. First, it is clear that Sex Workers are facing stigma and discrimination in the community in general, and at their doctor’s office specifically. How does this impact the healthcare of Sex Workers? In many ways. First, the level of trust and disclosure that is necessary for comprehensive care is missing in a setting where a Sex Worker is unable to be honest with his or her provider for fear of discrimination. Secondly, because of lack of communication, medical providers are misinformed about the needs of Sex Workers. Third, arresting Sex Workers is bad for our health and makes us vulnerable to infections and violence.
Sex Workers need either:
1) a less stigmatized world to function in; or
2) medical providers who won’t compromise their services because their patient is a Sex Worker; and/or
3) a clinic they can call their own.
This information is also critical to show that Sex Workers need collective organizing capacity for increased positive health outcomes. As documented by other workers in traditional labor fields, collective organizing improves health outcomes, improves negotiating power and improves employee relationships. As a criminalized community, Sex Workers can be more at risk for violence in the workplace and are legally excluded from organizing under Federal Law. For many reasons including health related ones, legal and social barriers to Sex Worker organizing and working collectively need to be dismantled.