title: Exploring the Context and Implementation of Public Health Regulations Governing Sex Work: A Qualitative Study with Migrant Sex Workers in Guatemala.
abstract: Public health regulations practices surrounding sex work and their enforcement can have unintended consequences for HIV and sexually transmitted infection (STI) prevention and care among sex workers. This analysis was based on qualitative in-depth (n = 33) and focus groups interviews (n = 20) conducted with migrant female sex workers in Tecún Umán and Quetzaltenango, Guatemala, and explored the implementation of sex work regulations and related consequences for HIV prevention and care among migrant sex workers. Sex work regulations were found to have health-related benefits (e.g., access to HIV/STI testing) as well as negative impacts, such as abuse by police and harassment, detention/deportation of migrant sex workers. Whereas public health regulations may improve access to HIV/STI testing, their implementation may inadvertently jeopardize sex workers' health through unintended negative consequences. Non-coercive, evidence-based public health and sex work policies and programs are needed to expand access to HIV/STI prevention and care among migrant sex workers, while protecting their dignity and human rights.
authors.affiliation: Division of Global Public Health, University of California, 9500 Gilman Drive, La Jolla, CA, 92093-0507, USA.
authors.forename: Teresita
authors.initials: T
authors.lastname: Rocha-Jiménez
authors.affiliation: Division of Global Public Health, University of California, 9500 Gilman Drive, La Jolla, CA, 92093-0507, USA.
authors.forename: Kimberly C
authors.initials: KC
authors.lastname: Brouwer
authors.affiliation: Division of Global Public Health, University of California, 9500 Gilman Drive, La Jolla, CA, 92093-0507, USA.
authors.forename: Jay G
authors.initials: JG
authors.lastname: Silverman
authors.affiliation: Unidad de VIH/SIDA, Universidad del Valle de Guatemala, 18 Avenida 11-42, Zona 15 Vista Hermosa III, Guatemala, Guatemala.
authors.forename: Sonia
authors.initials: S
authors.lastname: Morales-Miranda
authors.affiliation: Division of Global Public Health, University of California, 9500 Gilman Drive, La Jolla, CA, 92093-0507, USA. sgoldenberg@cfenet.ubc.ca.|Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada. sgoldenberg@cfenet.ubc.ca.|Gender and Sexual Health Initiative, British Columbia Centre for Excellence in HIV/AIDS, Department of Medicine, St. Paul's Hospital, University of British Columbia, 608-1081 Burrard St., Vancouver, BC, V6Z 1Y6, Canada. sgoldenberg@cfenet.ubc.ca.
authors.forename: Shira M
authors.initials: SM
authors.lastname: Goldenberg
mesh_terms: D000328:Adult; D005260:Female; D006166:Guatemala / Q000453:epidemiology; D015658:HIV Infections / Q000517:prevention & control*; D006801:Humans; D008875:Middle Aged; D036301:Qualitative Research; D011477:Sex Work / Q000331:legislation & jurisprudence*; D060386:Sex Workers / Q000523:psychology*; D012749:Sexually Transmitted Diseases / Q000517:prevention & control; D014171:Transients and Migrants / Q000523:psychology*; D055815:Young Adult
keywords: Guatemala; Migration; Public health regulations; Sex work