Do Sexually Oriented Massage Parlors Cluster in Specific Neighborhoods? A Spatial Analysis of Indoor Sex Work in Los Angeles and Orange Counties, California

Social determinants of health may be substantially affected by spatial factors, which together may explain the persistence of health inequities. Clustering of possible sources of negative health and social outcomes points to a spatial focus for future interventions. We analyzed the spatial clustering of sex work businesses in Southern California to examine where and why they cluster. We explored economic and legal factors as possible explanations of clustering.

A total of 889 venues were identified. Clusters of tracts having higher-than-expected numbers of sexually oriented massage parlors ("hot spots") were located outside downtowns. These hot spots were characterized by a higher proportion of adult males, a higher proportion of households below the federal poverty level, and a smaller average household size.

Sexually oriented massage parlors in Los Angeles and Orange counties cluster in particular neighborhoods. More research is needed to ascertain the causal factors of such clusters and how interventions can be designed to leverage these spatial factors.

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By: Chin JJ1, Kim AJ2, Takahashi L3, Wiebe DJ4.

• 1Hunter College, City University of New York, Urban Affairs and Planning, New York, NY.
• 2Georgia Institute of Technology, City and Regional Planning, Atlanta, GA.
• 3University of California, Los Angeles, Urban Planning, Los Angeles, CA.
• 4University of Pennsylvania, Department of Biostatistics and Epidemiology, Perelman School of Medicine, Philadelphia, PA.

Social and Structural Factors Shaping High Rates of Incarceration among Sex Workers in a Canadian Setting

In light of the emphasis on enforcement-based approaches towards sex work, and the well-known negative impacts of these approaches on women's health, safety and well-being, we conducted a study to investigate the prevalence and correlates of recent incarceration among a cohort of women sex workers in Vancouver, Canada. 

Data were obtained from an open prospective community cohort of female and transgender women sex workers, known as An Evaluation of Sex Workers' Health Access (AESHA). Bivariate and multivariable logistic regression analyses, using generalized estimating equations (GEE), were used to model the effect of social and structural factors on the likelihood of incarceration over the 44-month follow-up period (January 2010-August 2013). 

Among 720 sex workers, 62.5% (n = 450) reported being incarcerated in their lifetime and 23.9% (n = 172) being incarcerated at least once during the study period. Of the 172 participants, about one third (36.6%) reported multiple episodes of incarceration. In multivariable GEE analyses, younger age, being of a sexual/gender minority, heavy drinking, being born in Canada, living in unstable housing conditions, servicing clients in public spaces (versus formal sex work establishments) and experiencing police harassment without arrest remain independently correlated with incarceration. 

This prospective study found a very high prevalence and frequency of incarceration among women sex workers in Vancouver, Canada, with the most vulnerable and marginalized women at increased risk of incarceration. Given the well-known social and health harms associated with incarceration, and associations between police harassment and incarceration in this study, our findings further add to growing calls to move away from criminalized and enforcement-based approaches to sex work in Canada and globally.

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Understanding the Financial Lives of Female Sex Workers: Implications for Economic Strengthening Interventions for HIV Prevention

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Gendered Pathways: Violent Childhood Maltreatment, Sex Exchange, and Drug Use

Below:  Parameter Estimates for Direct-Indirect Effects Model in Women and Men

Note: Unstandardized regression weights (and standard errors) for women are left of the diagonal and in bold; estimates for men are right of the diagonal and in regular font. Correlations between the independent variables are not shown, but are similar to those reported in Table 1.

First, structural equation modeling revealed that childhood sexual and physical abuse were related to increased drug engagement in women and men, respectively, above the influence of early childhood contextual variables (e.g., neighborhood, family) and age. Second, sexual abuse was related to sex exchange, which in turn was related to drug use symptoms in women but not men.

These data provide empirical support for distinct trauma-related pathways to drug use problems in men and women, which has implications for gendered explanations and prevention approaches.

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