Sex Workers: Access & Barriers to Health Care & Social Services

By Natalie, February 10th, 2016 in

Sex workers comprise part of the Canadian population who have very different health care needs and risks. Access to services is important but may be prevented by various barriers such as stigma, fear of judgement, and criminalization.

In Peel, sex work exists in both indoor markets and outdoor “street” markets. Indoor sex work can be working for an agency, massage parlour or independently as an in-call service (where clients come to a location to meet with a sex worker often from a posting online) and out-call (where the sex worker goes to the clients location) services. Statistically in Canada, 80% of women in the sex trade work in the commercial market; whereas street-level prostitution is estimated to account for 5-20% of the sex trade (Indoor article, Subcomittee on Solicitation Laws, 2006). When looking at these statistics we must consider the poverty and demographics in each city.

Multiple needs assessments have been done to address the needs of sex workers, often looking at the relationship between sex workers access to and barriers to health and social services.

Sexual and Reproductive Health Awareness Week’s focus, “what is your relationship status” aims to highlight the importance of the relationship between service user and service provider.  Canada wide sex worker needs assessments have shown us that sex workers are often the most difficult and most vulnerable population to reach. Sex workers have addressed similar barriers to accessing care throughout Canada, often stating that avoiding or omitting information to health care providers is regular practice because of fear of judgement, shame, being mistreated or dismissed entirely by health care professionals. Needs assessments have documented and proven that sex workers fear of criminalization and judgement keeps sex work at high risk and victims of sexual and physical violence as a result of these fears.


For Sex Work Needs Assessments & Articles:,%20Catherine%2020135.pdf


  • When we look at how to build relationships with sex workers and promote better health practises and lower risks we must address the issues from their lens. “For us, by us” (Peer) models like Maggie’s Sex Workers Action Project, Sistering Toronto, Regent Park Community Health Center, Street Health and Parkdale Community Health Center have had great success in providing support, health care and promoting harm reduction practices to sex workers through Peer Programming.


Resources for sex workers in the GTA and surrounding areas: (Big Susie’s article page has a great resource for other sex work organizations)


  • A Unique Approach to reaching sex workers:

The PAR (Person at Risk) program in London Ontario takes a very different approach by using Police Services as a connection point for street involved women to get connected to essential services like; shelters, addiction supports and health care through a collaborative with a health care professional who goes on outreach to provide services to women and build the relationships needed to get sex workers comfortable enough to attend their community health center and treatment programs.


For more information on the London PAR Program:


  • Currently the Region of Peel has one Safe Space Sex Workers Drop In for self identified women located at 156 Main St N, Brampton Ontario which runs weekly Mondays from 10am – Noon and is hosted by a Peel HIV/AIDS Network Peer in collaboration with John Howard Society. The drop in provides women with harm reduction supplies, referrals to case management (through the PATCH Network), workshops on sexual health, point of care testing (1st Monday of the month with a Public Health Nurse), bad date reporting and provides women with a safe space to network and build relationships with each other.


For more information about PHAN’s Safe Space Sex Workers Drop In or Harm Reduction Program please contact:


  • Natalie Kaminski

Women’s Health Promotion Community Development Coordinator 


Phone: 905 361 0523 ext 222



  • Adam Chalcraft

Harm Reduction Coordinator


phone: 905 781 0223