Higher Traumatic Stress and Prevalence of Violence Among Sex Workers Identifying As Aboriginal: Findings from an Online Survey of Adult Sex Workers in Canada and the United States

This study examined differences between sex workers identifying as Aboriginal, sex workers identifying as White and sex workers identifying as Black on 9 different measures in a convenience sample of 339 sex workers in Canada and the United States (25 of which identified as male and 314 identified as female). The study’s variables were: prevalence of symptoms of PTSD, the prevalence of violence, sex work stigma, social cohesion among workers, clients’ motivations, workers’ control over working conditions, clients’ perceived adherence to hegemonic masculinity norms, clients’ sense of sexual entitlement and a scale measuring 8 non-violent negative behaviors and characteristics of clients - the “bad client” scale (for example: “bad personal hygiene”, “being rude or disrespectful”)  

Methods: An online Qualtrics survey was conducted among sex workers who advertise online in January 2018, resulting in a convenience sample of 339 respondents. 43.3% of the sample identified as having European ancestry (n=146) 18.7% identified as having African ancestry (black) (n=63) and 27.4% identified as aboriginal (n=93) (6.8% - 23 respondents identified as Middle Eastern and 3.5% - 12 respondents identified as Asian).The survey consisted of validated measures (PTSD, social cohesion, sex work stigma, prevalence of violence, burnout exhaustion) and measures that were especially developed for this study (clients’ perceived adherence to hegemonic masculinity norms, clients sense of sexual entitlement, the bad clients scale, clients motivations). 

Results: Respondents identifying as Aboriginal suffered from significantly higher levels of traumatic stress than respondents identifying as European (Cohen’s d =1.157) or respondents identifying as black (Cohen’s d = 0.663), respondents identifying as black has a significant higher level of traumatic stress than respondents identifying as European (Cohen’s d = 0.601). Respondents identifying as Aboriginal suffered from a significantly higher prevalence of violence than respondents identifying as European ( Cohen’s d=1.027) or black ( Cohen’s d = 1.014), prevalence of violence did not differ significantly among the other racial/ethnic identity groups. Respondents identifying as Aboriginal scored significantly higher than respondents identifying as European or black on the “bad client” scale, the clients’ hegemonic masculinity scale, the clients’ sexual entitlement scale and on both types of clients’ motivations. Respondents identifying as black. However, scores did not differ among the racial/ethnic identity groups on the burnout exhaustion scale and the social cohesion scale, and there was no significant difference between Europeans and Aboriginals on the control over working conditions scale and only a small (yet significant) difference on the sex work stigma scale.      

Conclusion: This study points out the increased vulnerability of people identifying as Aboriginal that are engaged in sex work in terms of prevalence of violence, having more “bad clients”, and experiencing PTSD symptoms. At the same time sex workers’ identifying as Aboriginal did not significantly differ from sex workers identifying as European in their control over their working conditions or the social cohesion they experience. This provides further evidence for the urgent need for effective and reliable interventions and services for Aboriginal sex workers as well as more research regarding the structural causes for this increased vulnerability.