Impacts of im/migration experience on work stress among sex workers in Vancouver, Canada

  • Julie Sou
  • Kate Shannon
  • Jean Shoveller
  • Putu Duff
  • Melissa Braschel
  • Sabina Dobrer
  • Shira M. GoldenbergEmail author
Quantitative Research



Despite the precarious and unsafe working conditions frequently experienced by sex workers (SWs) and im/migrant workers, there remains a paucity of research on work-related stress and links to duration of im/migration residency among SWs. This study analyzes the relationship between duration of residency and two dimensions of work stress among SWs in Metro Vancouver.


Data were drawn from a longitudinal cohort of women SWs across Metro Vancouver (2010–2014). Multivariable confounder models with generalized estimating equations were developed to examine the independent effects of duration of residency on decision authority and job demands, after adjusting for confounders.


Of 545 SWs, 9.7% were recent im/migrants, 13.9% were long-term im/migrants, and 76.2% were non-migrants. In comparison to non-migrant SWs, recent (β coefficient − 1.02, 95% CI − 1.57 to − 0.47) and long-term im/migrants (β coefficient − 0.87, 95% CI − 1.36 to −0.38) faced decreased work stress related to job demands after adjustment for key confounders. Decision authority did not retain a significant independent association after adjusting for the same factors.


Job demands varied significantly by duration of residency. This may be explained by changing working conditions and experiences over the course of arrival and settlement among im/migrant SWs, as well as the role of formal work environments in supporting im/migrant SWs’ well-being. Given high rates of work stress related to job demands and low decision authority among all SWs, decriminalization of sex work, improved occupational standards, and culturally sensitive interventions to promote collectivization and improved access to working conditions remain needed.


Sex work Emigration and immigration Occupational health Occupational stress 



Malgré les conditions de travail souvent précaires et dangereuses des travailleuses et des travailleurs du sexe (TS) ainsi que des travailleuses et des travailleurs migrants ou immigrés, il n’y a toujours pas suffisamment de recherche sur le stress au travail et ses liens avec la durée de la période de résidence chez les TS migrants ou immigrés. Notre étude porte sur la relation entre la durée de résidence et deux aspects du stress au travail chez les TS du Grand Vancouver.


Nos données proviennent d’une cohorte longitudinale de travailleuses du sexe du Grand Vancouver (2010–2014). Nous avons créé des modèles d’analyse multivariée des facteurs confusionnels avec des équations d’estimation généralisées pour examiner les effets indépendants de la durée de résidence sur le pouvoir de décision et les exigences de l’emploi, après ajustement en fonction des facteurs confusionnels.


Sur 545 TS, 9,7 % avaient migré ou immigré récemment, 13,9 % étaient migrantes ou immigrées de longue date, et 76,2 % n’étaient ni migrantes, ni immigrées. Par comparaison avec les TS non migrantes, les TS ayant migré ou immigré récemment (coefficient β – 1,02, IC de 95 % − 1,57 à – 0,47) et celles ayant migré ou immigré depuis plus longtemps (coefficient β – 0,87, IC de 95 % − 1,36 à – 0,38) éprouvaient moins de stress au travail lié aux exigences de l’emploi compte tenu des principaux facteurs confusionnels. Le pouvoir de décision n’était plus indépendamment associé au stress après ajustement pour tenir compte des mêmes facteurs.


Les exigences de l’emploi variaient sensiblement selon la durée de résidence. Cela peut s’expliquer par l’évolution des conditions de travail et des expériences vécues par les TS migrantes ou immigrées à leur arrivée et au cours de leur établissement, ainsi que par le rôle des milieux de travail structurés pour favoriser le bien-être des TS migrantes ou immigrées. Étant donné les niveaux élevés de stress au travail liés aux exigences de l’emploi et au faible pouvoir de décision chez toutes les TS, il demeure nécessaire de décriminaliser le travail du sexe, d’améliorer les normes de travail et de mener des interventions culturellement appropriées pour favoriser la collectivisation et améliorer l’accès à de bonnes conditions de travail.


Prostitution Émigration et immigration Santé au travail Stress au travail 



We thank all those who contributed their time and expertise to this project, particularly participants, AESHA community advisory board members, and partner agencies. We wish to acknowledge Chrissy Taylor, Jill Chettiar, Jennifer Morris, Tina Ok, Avery Alder, Emily Groundwater, Jane Li, Sylvia Machat, Lauren Martin McCraw, Minshu Mo, Chris Rzepa, Brittany Udall, Rachel Nicoletti, Emily Sarah Leake, Rachel Croy, Zannie Biggs, Natalie Blair, Emily Sollows, Melissa Braschel, Sabina Dobrer, Krista Butler, Sarah Allan, and Peter Vann for their research and administrative support.

Funding information

This research was supported by operating grants from the US National Institutes of Health (R01DA028648) and Canadian Institutes of Health Research (HHP-98835), the Canadian Institutes of Health Research/Public Health Agency of Canada (HEB-330155), and MacAIDS. KS holds a Canada Research Chair in Global Sexual Health and HIV/AIDS and a Scholar Award from the Michael Smith Foundation for Health Research. SG is supported by a Canadian Institutes of Health Research New Investigator Award and the National Institutes of Health (R01DA028648).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Research involving human participants

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institution or practice at which the studies were conducted (Providence Health Care/University of British Columbia Ethics Board).

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© The Canadian Public Health Association 2018

Authors and Affiliations

  1. 1.Centre for Gender & Sexual Health EquitySt. Paul’s HospitalVancouverCanada
  2. 2.School of Population and Public HealthUniversity of British ColumbiaVancouverCanada
  3. 3.Department of Medicine, University of British ColumbiaSt. Paul’s HospitalVancouverCanada
  4. 4.Faculty of Health SciencesSimon Fraser UniversityBurnabyCanada

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