Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC International Health and Human Rights
Published in: BMC International Health and Human Rights 1/2018

Open Access 01-12-2018 | Research article

Influence of indoor work environments on health, safety, and human rights among migrant sex workers at the Guatemala-Mexico Border: a call for occupational health and safety interventions

Authors: Shira M. Goldenberg, Teresita Rocha Jiménez, Kimberly C. Brouwer, Sonia Morales Miranda, Jay G. Silverman

Published in: BMC International Health and Human Rights | Issue 1/2018

Login to get access

Abstract

Background

Migrant women are over-represented in the sex industry, and migrant sex workers experience disproportionate health inequities, including those related to health access, HIV and sexually transmitted infections (STIs), and violence. Despite calls for occupational sex work interventions situated in labour rights frameworks, there remains a paucity of evidence pertaining to migrant sex workers’ needs and realities, particularly within Mexico and Central America. This study investigated migrant sex workers’ narratives regarding the ways in which structural features of work environments shape vulnerability and agency related to HIV/STI prevention and violence at the Guatemala-Mexico border.

Methods

Drawing on theoretical perspectives on risk environments and structural determinants of HIV in sex work, we analyzed in-depth interviews, focus groups, and ethnographic fieldwork conducted with 39 migrant sex workers in indoor work environments between 2012 and 2015 in Tecún Umán, Guatemala.

Results

Participant narratives revealed the following intersecting themes to be most closely linked to safety and agency to engage in HIV/STI prevention: physical features of indoor work environments (e.g., physical layout of venue, proximity to peers and third parties); social norms and practices for alcohol use within the workplace; the existence and nature of management practices and policies on health and safety practices; and economic influences relating to control over earnings and clients. Across work environments, health and safety were greatly shaped by human rights concerns stemming from workplace interactions with police, immigration authorities, and health authorities.

Conclusions

Physical isolation, establishment norms promoting alcohol use, restricted economic agency, and human rights violations related to sex work policies and immigration enforcement were found to exacerbate risks. However, some establishment policies and practices promoted ‘enabling environments’ for health and safety, supporting HIV/STI prevention, economic agency, and protection from violence and exploitation; these practices and policies were especially crucial for recent migrants. Policy reforms and structural workplace interventions tailored to migrant sex workers’ needs are recommended to promote improved working conditions and migrant sex workers’ health, safety, and human rights.
Literature
1.
United Nations Population Division. International migrant stock: the 2008 revision. Geneva: United Nations Population Division; 2009.
2.
3.
Fernández C, Ortega C. Labor market assimilation of immigrants in Spain: employment at the expense of bad job-matches? Span Econ Rev. 2008;10(2):83–107.CrossRef
4.
Sunmola AM. Sexual practices, barriers to condom use and its consistent use among long distance truck drivers in Nigeria. AIDS Care. 2005;17(2):208–21.CrossRefPubMed
5.
Magis-Rodriguez C, Lemp G, Hernandez MT, Sanchez MA, Estrada F, Bravo-Garcia E. Going north: Mexican migrants and their vulnerability to HIV. J Acquir Immune Defic Syndr. 2009;51(S1):S21–5.CrossRefPubMed
6.
Apostolopoulos Y, Sonmez S, Kronenfeld J, Castillo E, McLendon L, Smith D. STI/HIV risks for Mexican migrant laborers: exploratory ethnographies. J Immigr Minor Health. 2006;8(3):291–302.CrossRefPubMed
7.
Rocha-Jiménez T, Brouwer K, Paz-Bailey G, Silverman J, Morales-Miranda S, Goldenberg S. Migration, violence, & safety among migrant sex workers: A qualitative study in two Guatemalan communities. Cult. Health Sex. 2016;18:965–79.
8.
Goldenberg SM, Brouwer KC, Jimenez TR, Miranda SM, Mindt MR. Enhancing the ethical conduct of HIV research with migrant sex workers: human rights, policy, and social contextual influences. PLoS One. 2016;11(5):e0155048.CrossRefPubMedPubMedCentral
9.
Goldenberg SM. Trafficking, migration, and health: complexities and future directions. Lancet Glob Health. 2015;3(3):e118–e9.CrossRefPubMed
10.
Sou J, Shannon K, Li J, Nguyen P, Strathdee SA, Shoveller J, et al. Structural determinants of inconsistent condom use with clients among migrant sex workers: findings of longitudinal research in an urban Canadian setting. Sex Transm Dis. 2015;42(6):312–6.CrossRefPubMedPubMedCentral
11.
Goldenberg S, Chettiar J, Nguyen P, Montaner J, Dobrer S, Shannon K. Complexities of short-term mobility for sex work and migration among sex workers: violence and sexual risks, barriers to care, and enhanced social and economic opportunities. J Urban Health. 2014;91(4):736–51.CrossRefPubMedPubMedCentral
12.
Richter M, Chersich MF, Vearey J, Sartorius B, Temmerman M, Luchters S. Migration status, work conditions and health utilization of female sex workers in three south African cities. J Immigr Minor Health. 2014;16(1):7–17.CrossRefPubMed
13.
Platt L, Grenfell P, Fletcher A, Sorhaindo A, Jolley E, Rhodes T, et al. Systematic review examining differences in HIV, sexually transmitted infections and health-related harms between migrant and non-migrant female sex workers. Sex Transm Infect. 2013;89(4):311–9.CrossRefPubMed
14.
Platt L, Grenfell P, Bonell C, Creighton S, Wellings K, Parry J, et al. Risk of sexually transmitted infections and violence among indoor-working female sex workers in London: the effect of migration from Eastern Europe. Sex Transm Infect. 2011;87(5):377–84.CrossRefPubMed
15.
Goldenberg S, Liu V, Nguyen P, Chettiar J, Shannon K. International migration from non-endemic settings as a protective factor for HIV/STI risk among female sex workers in Vancouver, Canada. J Immigr Minor Health. 2015;17(1):21–8.CrossRefPubMedPubMedCentral
16.
Shannon K, Strathdee SA, Goldenberg SM, Duff P, Mwangi P, Rusakova M, et al. Global epidemiology of HIV among female sex workers: influence of structural determinants. Lancet. 2015;385(9962):55–71.CrossRefPubMed
17.
Chiao C, Morisky DE, Ksobiech K, Malow RM. Promoting HIV testing and condom use among Filipina commercial sex workers: findings from a quasi-experimental intervention study. AIDS Behav. 2009;13(5):892–901.CrossRefPubMed
18.
Deering KN, Rusch M, Amram O, Chettiar J, Nguyen P, Feng CX, et al. Piloting a ‘spatial isolation’ index: the built environment and sexual and drug use risks to sex workers. Int. J. Drug Policy. 2014;
19.
Mooney A, Kidanu A, Bradley H, Kumoji E, Kennedy C, Kerrigan D. Work-related violence and inconsistent condom use with non-paying partners among female sex workers in Adama City, Ethiopia. BMC Public Health. 2013;13(1):771.CrossRefPubMedPubMedCentral
20.
Yi HS, Mantell JE, Wu RR, Lu Z, Zeng J, Wan YH. A profile of HIV risk factors in the context of sex work environments among migrant female sex workers in Beijing, China. Psychol Health Med. 2010;15(2):172–87.CrossRefPubMedPubMedCentral
21.
Chen NE, Strathdee SA, Rangel G, Patterson TL, Uribe-Salas FJ, Rosen P, et al. HIV risk behaviours differ by workplace stability among Mexican female sex workers with truck driver clientele. J Public Health. 2012;1:e32.
22.
Gaines TL, Rusch MLA, Brouwer KC, Goldenberg SM, Lozada R, Robertson AM, et al. Venue-level correlates of female sex worker registration status: a multilevel analysis of bars in Tijuana, Mexico. Glob Public Health. 2013;8(4):405–16.CrossRefPubMedPubMedCentral
23.
Wang HB, Chen RY, Ding GW, Ma YL, Ma JG, Jiao JH, et al. Prevalence and predictors of HIV infection among female sex workers in Kaiyuan City, Yunnan Province, China. Int J Infect Dis. 2009;13(2):162–9.CrossRefPubMed
24.
Chen Y, Li X, Zhou Y, Wen X, Wu D. Perceived peer engagement in HIV-related sexual risk behaviors and self-reported risk-taking among female sex workers in Guangxi. AIDS Care: China; 2013.
25.
Mai TTT, Linh LC, Long NT. Factors associated with inconsistent condom use among female sex workers in Nha Trang, Vietnam. Asia Pac J Public Health. 2008;20(4):370–8.CrossRef
26.
Li Y, Detels R, Lin P, Fu XB, Deng ZM, Liu YY, et al. Difference in risk behaviors and STD prevalence between street-based and establishment-based FSWs in Guangdong Province, China. AIDS Behav. 2012;16(4):943–51.CrossRefPubMedPubMedCentral
27.
Zhang C, Li X, Hong Y, Zhou Y, Liu W, Stanton B. Unprotected sex with their clients among low-paying female sex workers in southwest China. AIDS Care. 2012;25:503–6.
28.
Urada LA, Morisky DE, Hernandez LI, Strathdee SA. Social and structural factors associated with consistent condom use among female entertainment workers trading sex in the Philippines. AIDS Behav. 2013;17(2):523–35.CrossRefPubMedPubMedCentral
29.
Liao M, Bi Z, Liu X, Kang D, Fu J, Song Q, et al. Condom use, intervention service utilization and HIV knowledge among female sex workers in China: results of three consecutive cross-sectional surveys in Shandong Province with historically low HIV prevalence. Int J STD AIDS. 2012;23(3):e23–9.CrossRefPubMed
30.
Shi Y, Guo S, Bo F, Zhang X, Cao W, Wang P. Impact evaluation of a sexually transmitted disease preventive intervention among female sex workers in Hohhot, China. Int J Infect Dis. 2013;17(1):e59–64.CrossRefPubMed
31.
Larios SE, Lozada R, Strathdee SA, Semple SJ, Roesch S, Staines H, et al. An exploration of contextual factors that influence HIV risk in female sex workers in Mexico: the social ecological model applied to HIV risk behaviors. AIDS Care. 2009;21(10):1335–42.CrossRefPubMedPubMedCentral
32.
Hong Y, Li X, Yang H, Fang X, Zhao R. HIV/AIDS-related sexual risks and migratory status among female sex workers in a rural Chinese county. AIDS Care. 2009;21(2):212–20.CrossRefPubMed
33.
Goldenberg SM, Duff P, Krusi A. Work environments and HIV prevention: a qualitative review and meta-synthesis of sex worker narratives. BMC Public Health. 2015;15(1):1.CrossRef
34.
Leyva R, Dreser A, Magali S, Hernández Rosete D, Bronfman M. Guatemala, Tecun Uman. In: Bronfman M, Leyva R, Negroni M, editors. Movilidad poblacional y VIH/SIDA. Contextos de vulnerabilidad en México y Centroamérica. Cuernavaca, Morelos, México: INS; 2004. p. 175-212.
35.
Morales-Miranda S Á-RB, Arambú N, et al. Encuesta Centroamericana de Vigilancia de Comportamiento Sexual y Prevalencia del VIH e ITS, en poblaciones vulnerables y poblaciones clave (ECVC). Guatemala: Universidad del Valle de Guatemala, MSPAS, HIVOS 2013.
36.
Vogt WA. Crossing Mexico: structural violence and the commodification of undocumented central American migrants. Am Ethnol. 2013;40(4):764–80.CrossRef
37.
Shannon K, Goldenberg S, Deering K, Strathdee S. HIV infection among female sex Workers in Concentrated and High Prevalence Epidemics: why a structural determinants framework is needed. Curr Opin HIV AIDS. 2014;9(2):174–82.CrossRefPubMedPubMedCentral
38.
Rhodes T, Wagner K, Strathdee SA, Shannon K, Davidson P, Bourgois P. Structural Violence and Structural Vulnerability Within the Risk Environment: Theoretical and Methodological Perspectives for a Social Epidemiology of HIV Risk Among Injection Drug Users and Sex Workers. In: O’Campo P, Dunn J, editors. Rethinking Social Epidemiology. Dordrecht: Springer; 2012. p. 205–30.
39.
Shannon K, Kerr T, Allinott S, Chettiar J, Shoveller J, Tyndall MW. Social and structural violence and power relations in mitigating HIV risk of drug-using women in survival sex work. Soc Sci Med. 2008;66(4):911–21.CrossRefPubMed
40.
Simic M, Rhodes T. Violence, dignity and HIV vulnerability: street sex work in Serbia. Sociol Health Illn. 2009;31(1):1–16.CrossRefPubMed
41.
Galtung J, Höivik T. Structural and direct violence: a note on operationalization. J Peace Res. 1971;8(1):73–6.CrossRef
42.
Infante C, Aggleton P, Pridmore P. Forms and determinants of migration and HIV/AIDS-related stigma on the Mexican—Guatemalan border. Qual Health Res. 2009;19(12):1656–8.CrossRefPubMed
43.
Infante C, Leyva R, Caballero M, Guerrero C, Cuadra S, Bronfman M. VIH/SIDA y rechazo a migrantes en contextos fronterizos. Migración y Desarrollo. 2004;3:45–53.
44.
Ogren C. Migration and human rights on the Mexico-Guatemala border. Int Migr. 2007;45(4):203–43.CrossRef
45.
Uribe-Salas F, Conde-Glez CJ, Juarez-Figueroa L, Hernandez-Castellanos A. Sociodemographic dynamics and sexually transmitted infections in female sex workers at the Mexican-Guatemalan border. Sex Transm Dis. 2003;30(3):266–71.CrossRefPubMed
46.
Fernández Casanueva C. Building migratory trajectories: Guatemalans, Salvadorians and Hondurans at the southern mexican border. Doctoral Dissertation, University of Essex, Department of Sociology. 2006.
47.
United Nations Office of Drugs and Crime. Global study on homicide 2013. Vienna: United Nations Office of Drugs and Crime 2013.
48.
Goldenberg S, Rivera-Mindt M, Rocha Jimenez T, Brouwer K, Morales Miranda S, Fisher C. Structural and Interpersonal Benefits and Risks of Participation in HIV Research: Perspectives of Female Sex Workers in Guatemala. Ethics & Behavior. 2014;Epub 14 Aug.
49.
Morgan D. Focus groups as qualitative research. Newbury Park,CA: Sage; 1988.
50.
Angen M. Evaluating interpretive inquiry: reviewing the validity debate and opening dialogue. Qual Health Res. 2000;10(3):378–95.CrossRefPubMed
51.
52.
Crabtree BF, Miller WL. Doing qualitative research. Thousand Oaks, California: Sage Publications; 1999.
53.
Rocha-Jiménez T, Brouwer K, Morales-Miranda S, Silverman J, Goldenberg S. Exploring the context and implementation of public health regulations governing sex work: A qualitative study with migrant sex workers in Guatemala. J. Immigr. Minor. Health. 2016;19:1235–44.
54.
Bambra C, Gibson M, Amanda S, Wright K, Whitehead M, Petticrew M. Tackling the wider social determinants of health and health inequalities: evidence from systematic reviews. J. Epidemiol. Community Health. 2009:jech. 2008.082743.
55.
Ghose T, Swendeman DT, George SM. The role of brothels in reducing HIV risk in Sonagachi, India. Qual Health Res. 2011;21(5):587–600.CrossRefPubMed
56.
Chen YY, Latkin C, Celentano DD, Yang XS, Li XM, Xia GM, et al. Delineating interpersonal communication networks: a study of the diffusion of an intervention among female entertainment Workers in Shanghai, China. AIDS Behav. 2012;16(7):2004–14.CrossRefPubMedPubMedCentral
57.
Buzdugan R, Halli SS, Hiremath JM, Jayanna K, Raghavendra T, Moses S, et al. The female sex work industry in a district of India in the context of HIV prevention. AIDS Res Treat. 2012;2012:371482.PubMedPubMedCentral
58.
Maher L, Mooney-Somers J, Phlong P, Couture M-C, Stein E, Evans J et al. Selling sex in unsafe spaces: Sex work risk environments in Phnom Penh, Cambodia. Harm Reduct J. 2011;8:30.
59.
Krüsi A, Chettiar J, Ridgway A, Abbott J, Strathdee SA, Shannon K. Negotiating safety and sexual risk reduction with clients in unsanctioned safer indoor sex work environments: a qualitative study. Am J Public Health 2012;102(6):1154-9.
60.
Goldenberg SM, Strathdee SA, Gallardo M, Nguyen L, Lozada R, Semple SJ, et al. How important are venue-based HIV risks among male clients of female sex workers? A mixed methods analysis of the risk environment in nightlife venues in Tijuana, Mexico. Health Place. 2011;17(3):748–56.CrossRefPubMedPubMedCentral
61.
Shannon K, Rusch M, Shoveller J, Alexson D, Gibson K, Tyndall MW. Mapping violence and policing as an environmental-structural barrier to health service and syringe availability among substance-using women in street-level sex work. Int J Drug Policy. 2008;19(2):140–7.CrossRefPubMed
Metadata
Title
Influence of indoor work environments on health, safety, and human rights among migrant sex workers at the Guatemala-Mexico Border: a call for occupational health and safety interventions
Authors
Shira M. Goldenberg
Teresita Rocha Jiménez
Kimberly C. Brouwer
Sonia Morales Miranda
Jay G. Silverman
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC International Health and Human Rights / Issue 1/2018
Electronic ISSN: 1472-698X
DOI
https://doi.org/10.1186/s12914-018-0149-3

Other articles of this Issue 1/2018

BMC International Health and Human Rights 1/2018 Go to the issue

Research article

Does exposure to interparental violence increase women’s risk of intimate partner violence? Evidence from Nigeria demographic and health survey

Debate

The HIV self-testing debate: where do we stand?

Research article

Realization of the right to adequate food and the nutritional status of land evictees: a case for mothers/caregivers and their children in rural Central Uganda

Research article

Causes of death among street-connected children and youth in Eldoret, Kenya

Research article

Determinants and perceptions of the utilization of tetanus toxoid immunization among reproductive-age women in Dukem Town, Eastern Ethiopia: a community-based cross-sectional study

Debate

Children with albinism in African regions: their rights to ‘being’ and ‘doing’