title: Enhancing the Ethical Conduct of HIV Research with Migrant Sex Workers: Human Rights, Policy, and Social Contextual Influences.
abstract: Migrant sex workers are often highly marginalized and disproportionately experience health and social inequities, including high prevalence of HIV, sexually transmitted infections, and human rights violations. In recent years, research involving migrant sex workers has increased, yet many knowledge gaps remain regarding how best to protect research participant rights and welfare. Our objective was to identify key challenges and opportunities related to the responsible conduct of HIV research with migrant sex workers.
  
  
  
  Focus groups and interviews conducted with 33 female sex workers ≥18 years old at the Guatemala-Mexico border from June 2013-February 2014 were analyzed. Participants were recruited through community outreach by a local HIV prevention organization to sex work establishments such as bars, hotels, street corners, and truck stops.
  
  
  
  Key themes influencing research engagement for migrant sex workers included researcher mistrust and fear related to research participation, rooted in the social isolation frequently faced by recent migrants; intersecting concerns related to immigration status, fear of criminalization, and compliance with sex work regulations; and perceived benefits and risks of HIV/STI testing for migrants (e.g., immigration implications, stigma) represent potential barriers and opportunities for the responsible conduct of research involving migrant sex workers.
  
  
  
  Results highlight the intersection between the human rights vulnerabilities of migrant sex workers and barriers to research participation, including social isolation of migrants and policy/legal barriers related to immigration and sex work. Findings illustrate the need for researchers to develop population-tailored procedures to address fears related to immigration and criminalization, and to reinforce positive and non-stigmatizing relationships with migrant sex workers. Community-led efforts to reduce stigma and foster community organization and supports for migrant sex workers are recommended, as are broader policy shifts that move away from punitive legal approaches towards approaches that safeguard and prioritize the human rights of migrant sex workers.
authors.affiliation: Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada.|Gender and Sexual Health Initiative, British Columbia Centre for Excellence in HIV/AIDS, Department of Medicine, University of British Columbia, 608-1081 Burrard Street (St. Paul's Hospital), Vancouver, BC, V6Z 1Y6, Canada.|HIV Prevention Research Ethics Institute, Fordham University, 441 E. Fordham Road, Bronx, NY, 10458, United States of America.
authors.forename: Shira M
authors.identifier: 0000-0003-1633-9749
authors.initials: SM
authors.lastname: Goldenberg
authors.affiliation: Division of Global Public Health, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093-0507, United States of America.
authors.forename: Kimberly C
authors.initials: KC
authors.lastname: Brouwer
authors.affiliation: Division of Global Public Health, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093-0507, United States of America.
authors.forename: Teresita Rocha
authors.initials: TR
authors.lastname: Jimenez
authors.affiliation: HIV Unit, Universidad del Valle, Guatemala City, Guatemala.
authors.forename: Sonia Morales
authors.initials: SM
authors.lastname: Miranda
authors.affiliation: HIV Prevention Research Ethics Institute, Fordham University, 441 E. Fordham Road, Bronx, NY, 10458, United States of America.|Department of Psychology, Fordham University, 441 E. Fordham Road, Bronx, NY, 10458, United States of America.
authors.forename: Monica Rivera
authors.initials: MR
authors.lastname: Mindt
mesh_terms: D000328:Adult; D017144:Focus Groups; D015658:HIV Infections / Q000503:physiopathology*; D006291:Health Policy; D006806:Human Rights; D006801:Humans; D008875:Middle Aged; D011477:Sex Work; D012919:Social Behavior; D014171:Transients and Migrants; D055815:Young Adult