Programming Connection

Sex Workers Program 

RÉZO
Montreal, Quebec
2010

How Does the Program Work?

The Sex Workers Program has two distinct but connected services. Each service is instrumental to the success of the other:

  1. Afternoon street outreach service: used to engage, instruct and disseminate information on safer sex and drug use to male sex workers
  2. Evening drop-in program: used to provide a safe place for sex workers to meet, rest, access services and resources and build a sense of community

Service 1: Afternoon street outreach service

Location

Outreach workers conduct daily outreach in the gay village to connect with male sex workers. Outreach takes place during the mid- to late afternoon to meet with sex workers.

Outreach occurs on the street and in bars, hotels that rent by the hour, peep shows and strip clubs.

Engagement and Recruitment

RÉZO currently employs five full-time as well as one part-time and two on-call outreach workers who identify sex workers by visiting locations where sex work often takes place and particularly by working with men with whom they have already built relationships to identify other potential participants. The success of ongoing outreach—on the street and in bars, hotels that rent by the hour, peep shows and strip clubs—depends upon repeat visits to establish a trusted presence and discreetly observe people in each location to identify those who are involved in sex work. For this reason, each venue is visited at least once per week. Long-term relationships with the owners of many of these establishments have led to the creation of ongoing service agreements through which RÉZO outreach workers are welcomed for the services they provide. 

When visiting an establishment for the first time, outreach workers begin by offering condoms, safer-sex pamphlets and disposal bins for used needles to owners, employees and anyone who has already been identified as a sex worker. As an establishment gains access to such supplies, confidence is built, and outreach workers propose expanded services to respond more directly to the specific needs of sex workers and their customers, such as clinical vaccination against hepatitis A and B and access to information on sexual health, social and legal information, services and referrals. They are also encouraged to attend RÉZO’s evening drop-in program.

The way in which outreach is conducted is based (as much as possible) on the specific location where the outreach takes place, as well as on the specific skills of the outreach worker and the specific needs of the sex worker. In the peep shows, for example, sex occurs in private booths, sometimes accompanied by the use of illicit drugs, especially crack. In the dance bars, sexual services occur in private cubicles. In both places, outreach workers have their conversations with sex workers in the common areas of these establishments and never interrupt them while they are in a booth or cabin.

However, in all outreach encounters, outreach workers must respect the work dynamic of the sex workers and the intrinsic rules of their environment and remain discreet so as not to interfere with sex work or scare clients who are often present while outreach is taking place.

Outreach activities include:

  • Distribution of food, including juice, drinks and granola bars during outreach
  • Distribution of condoms, needles and other materials for safer substance use as well as information on HIV, STI and hepatitis A, B and C prevention at the drop-in centre and during outreach
  • Distribution of bags of groceries at the drop-in centre
  • Distribution of discreet information cards with location information for the drop-in centre during outreach
  • Discussions about the evening drop-in and what it has to offer during outreach
  • Support and referrals for sex workers with HIV and/or hepatitis C and STIs at the drop-in and during outreach

The juices and energy drinks are especially popular when it comes to initially drawing in sex workers, as many of them forget to hydrate while under the influence of drugs. After building trust by offering such supplies, outreach workers are able to speak with the men about their sexual relationships, their customers, their consumption of drugs, as well as their health and life in general.

Occasionally outreach will take place in sex workers’ homes, especially in situations where sex workers (with whom outreach workers have already developed a relationship) have been arrested and are restricted by police or a judge from entering some areas of the city where sex work takes place, such as the area where the drop-in centre is located. Outreach can also be conducted through Facebook.

Hepatitis A and B vaccination clinics are held backstage at bars where male dancers work in collaboration with Médecin du Monde.

Outreach workers also approach business owners and residents with brochures explaining the Sex Workers Program and the services offered by RÉZO, including information and resource distribution, mediation between sex workers and other members of the local community, and information on safe recuperation of used needles. RÉZO meets with any interested parties to explain the available services in greater detail. RÉZO also meets annually with the police to conduct sensitivity training on the realities of the lives of sex workers.

Service 2: Evening drop-in centre

Location

The drop-in centre is designed to be a safe place for male sex workers to hang out, meet one another and access services. A part of the centre’s success is due to its confidential location: It is not advertised and is largely unknown to their clients (“Johns”) or neighbouring businesses/residents. Men can come and go as they wish without fear of violence, harassment or stigma. Men learn of its location through the program’s ongoing outreach activities (street work).

The centre is open four evenings a week, from 6:00 to 10:00 p.m. Sex workers are welcome to visit the centre at any time during open hours to access various forms of assistance. Approximately 25 men frequent the centre per night, which adds up to approximately 3,790 visits per year.

Services Provided

When a sex worker visits the drop-in centre for the first time, a staff member orients him to the centre’s services and works with him to assess his immediate and longer-term needs with the help of an intake form.

The centre offers many formal and informal services, each of which helps meet the goal of increasing the quality of life for men involved in the sex trade. These services include:

A comfortable environment for informal conversations: The drop-in centre offers a relaxed environment to sex workers and allows them to discuss their work in an informal way, among themselves and with staff, both individually and in groups. Armchairs are provided and a television with DVDs is available for use.

Food preparation services: The centre has a kitchen and is often stocked with food donated from local organizations; sex workers can also bring their own food to cook in the centre’s facilities. These activities encourage and facilitate interaction by fostering a sense of accomplishment among those who learn to cook and can cook for peers at the drop-in centre.

Clothing bank and hygiene products: To promote good hygiene, sex workers can obtain clothes, including new underwear and socks. Other personal hygiene products (such as deodorant, soap, shaving cream, razors and toothbrushes) are also provided. Showers are not provided at the centre.

Safer-sex and harm reduction tools and information: HIV, STI and hepatitis C testing and information, as well as prevention support and resources (such as literature, condoms, lube, clean needles, containers to safely collect used needles and safer-crack kits) are offered by staff along with support for starting and staying on treatment. 

Workshops: RÉZO invites educators from a variety of organizations to the drop-in centre to provide workshops on issues of concern to the sex workers. Past speakers include homelessness advocates and those knowledgeable about interacting with police. Workshops use role-playing and feedback sessions to teach and practice skills related to coping with stress, health concerns and other problems confronted by sex workers.

Case management: Because many sex workers have difficulty or are reluctant to access other services, the staff provides case management support on an ad hoc basis according to their needs. Referrals and support are often related to addiction, housing, physical health, mental health, employment services and legal issues. Sex workers can also be accompanied by staff when accessing such services.

Health and vaccine clinic: RÉZO has partnered with Quebec Health care and social services centres to offer on-site HIV testing, STI testing, vaccinations (for hepatitis A and B, seasonal flu, H1N1, etc.), medical consultation for minor injuries and health concerns and medical referrals through a mobile health unit that visits one evening per week. RÉZO also partners with the University of Montreal to offer on-site dental services to sex workers once a week. Hepatitis C and dental problems among crack and injection drug users, and HIV and STIs among sex workers are the major health problems encountered by the mobile health unit. Sex workers also tend to have problems with their feet from spending long hours standing and walking every day.

Exit services: If a sex worker wishes to exit the sex trade, the program will support the sex worker to do so, offering employment services (such as help with writing résumés and preparing for job interviews) on an ad hoc basis. A computer is available to sex workers for use in searching for employment and writing résumés, and telephones are available for calling prospective employers.

Volunteer opportunities: Sex workers are encouraged to become involved with the centre on a volunteer basis, which provides an opportunity for them to develop a sense of ownership over the program and personal accomplishment. Volunteer activities include making meals for other sex workers accessing the drop-in centre, cleaning the centre, participating in street “clean ups” to collect discarded drug use paraphernalia, and organizing social events for other sex workers. A volunteer committee of sex workers meets regularly to assess sex workers needs and suggest improvements to the program.

Off-site services: Some sex workers have their own residences and tend to be less dependent on drugs than those reached through peep shows and strip clubs and on the street. They tend to remain as inconspicuous as possible and are reluctant to access the services of the drop-in centre. After being introduced to these sex workers—usually through the referral of another sex workers using the program services—RÉZO staff will meet them in their homes or via the Internet, as necessary.