An Evaluation of Sex Workers Health Access (AESHA)

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AESHA is a community-based research project that includes a quantitative cohort and qualitative/ethnographic arm. As part of the quantitative arm, AESHA operates a community-based prospective cohort that involves semi-annual questionnaires and sexual health research visits with our community-based staff. The qualitative arm is focused on documenting the lived-experiences of sex workers of all genders, and third parties who provide services for sex workers, like receptionists, venue managers, owners and security personnel.

The research study operates out of our community-based research site as well as through weekly outreach across Metro Vancouver. On outreach, our multi-lingual team (English, Mandarin, Cantonese, French) conducts research and provides support to indoor- and outdoor-based sex workers across diverse work environments. Since the project’s inception, current and former sex workers are engaged and employed through all stages of the project including as interviewer/outreach workers, sexual health nurses, coordinators, researchers, and co-authors.

Research Objectives

From 2015 – 2020, the AESHA project focused on evaluating the impact of evolving legislative approaches to the regulation of sex work including the Canadian ‘end-demand’ laws (The Protection of Exploited Persons and Communities Act, PCEPA) on sex workers’ health, safety and human rights. This research has been shared in 38 peer-reviewed articles and a recent report on the harms of end-demand legislation, which our team submitted to the federal Department of Justice and all MPs and Senators. Our team also leveraged AESHA findings in a submission to the Committee on the Elimination of Discrimination Against Women (CEDAW) of the United Nations Office of the High Commissioner on Human Rights calling for an end of the conflation between sex work and sex trafficking.

From 2020 – 2025, the AESHA cohort focused on evaluating the impacts of ‘naturally occurring’ community empowerment (CE) and policing interventions on HIV/STIs, overdose (OD), and engagement with health and social services among diverse sex workers across Metro Vancouver. During this funding cycle, AESHA research findings were shared widely with participants, community partners, health and policy stakeholders, as well as via 32 peer-reviewed articles. AESHA project findings were also used to advocate for sex workers’ occupational health and safety via numerous policy processes. For example, in 2022 our team provided expert testimony based on AESHA findings at the Superior Court of Ontario in the context of a Charter Challenge regarding the constitutionality of Canada’s sex work laws brought forward by the Canadian Alliance for Sex Work Law Reform. We were also invited to present AESHA findings as expert witnesses by the Canadian House of Commons Standing Committee on Justice and Human Rights to assist with the Committee’s review of the Protection of Communities and Exploited Persons Act in Spring 2022.

Principal Investigators