title: The relationship between social, policy and physical venue features and social cohesion on condom use for pregnancy prevention among sex workers: a safer indoor work environment scale.
abstract: BACKGROUND
  This study aims to report on a newly developed Safer Indoor Work Environmental Scale that characterises the social, policy and physical features of indoor venues and social cohesion; and using this scale, longitudinally evaluate the association between these features on sex workers' (SWs') condom use for pregnancy prevention.
  
  
  METHODS
  Drawing on a prospective open cohort of female SWs working in indoor venues, a newly developed Safer Indoor Work Environment Scale was used to build six multivariable models with generalised estimating equations (GEE), to determine the independent effects of social, policy and physical venue-based features and social cohesion on condom use.
  
  
  RESULTS
  Of 588 indoor SWs, 63.6% used condoms for pregnancy prevention in the last month. In multivariable GEE analysis, the following venue-based features were significantly correlated with barrier contraceptive use for pregnancy prevention: managerial practices and venue safety policies (adjusted OR (AOR)=1.09; 95% CI 1.01 to 1.17), access to sexual and reproductive health services/supplies (AOR=1.10; 95% CI 1.00 to 1.20), access to drug harm reduction (AOR=1.13; 95% CI 1.01 to 1.28) and social cohesion among workers (AOR=1.05; 95% CI 1.03 to 1.07). Access to security features was marginally associated with condom use (AOR=1.13; 95% CI 0.99 to 1.29).
  
  
  CONCLUSIONS
  The findings of the current study highlight how work environment and social cohesion among SWs are related to improved condom use. Given global calls for the decriminalisation of sex work, and potential legislative reforms in Canada, this study points to the critical need for new institutional arrangements (eg, legal and regulatory frameworks; labour standards) to support safer sex workplaces.
authors: Gender and Sexual Health Initiative, British Columbia Centre for Excellence in HIV/AIDS, St Paul's Hospital, Vancouver, British Columbia, Canada School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.
authors: Putu
authors: P
authors: Duff
authors: School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.
authors: Jean
authors: J
authors: Shoveller
authors: Gender and Sexual Health Initiative, British Columbia Centre for Excellence in HIV/AIDS, St Paul's Hospital, Vancouver, British Columbia, Canada.
authors: Sabina
authors: S
authors: Dobrer
authors: British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada.
authors: Gina
authors: G
authors: Ogilvie
authors: Department of Medicine, University of British Columbia, St Paul's Hospital, Vancouver, British Columbia, Canada.
authors: Julio
authors: J
authors: Montaner
authors: Gender and Sexual Health Initiative, British Columbia Centre for Excellence in HIV/AIDS, St Paul's Hospital, Vancouver, British Columbia, Canada.
authors: Jill
authors: J
authors: Chettiar
authors: Gender and Sexual Health Initiative, British Columbia Centre for Excellence in HIV/AIDS, St Paul's Hospital, Vancouver, British Columbia, Canada Department of Medicine, University of British Columbia, St Paul's Hospital, Vancouver, British Columbia, Canada.
authors: Kate
authors: K
authors: Shannon
mesh_terms: D000328:Adult; D001955:British Columbia; D017280:Condoms / Q000706:statistics & numerical data*; D003268:Contraception Behavior; D005260:Female; D006297:Health Services Accessibility / Q000592:standards / Q000639:trends; D006801:Humans; D007407:Interviews as Topic; D008137:Longitudinal Studies; D015999:Multivariate Analysis; D016272:Occupational Health / Q000639:trends; D011247:Pregnancy; D011446:Prospective Studies; D011640:Public Policy; D034121:Reproductive Health Services / Q000592:standards / Q000639:trends*; D021841:Safe Sex; D060386:Sex Workers; D012944:Social Support; D017132:Workplace / Q000592:standards*
keywords: Cohort studies; LONGITUDINAL STUDIES; Measurement tool Development; POLICY; SOCIAL FACTORS IN