Andrea Krüsi
Dados Biográficos
| ID | 109476 |
|---|---|
| NOME | Andrea Krüsi |
| PRENOMES | Andrea |
| SOBRENOME | Krüsi |
| ASSINATURA | KRÜSI A |
| AFILIAÇÕES | University of British Columbia |
| ORCID | 0000-0002-2531-8192 |
| VERIFICADO | Sim |
| TOTAL DE OBRAS | 54 |
| TOTAL DE CITAÇÕES | 152 |
| TOTAL COMO AUTOR | 54 |
| TOTAL COMO EDITOR | 0 |
| PRIMEIRO ANO DE PUBLICAÇÃO | 2009 |
| ANO MAIS RECENTE DE PUBLICAÇÃO | 2026 |
| ÍNDICE H | 7 |
‘It's Primarily Around Their Viral Load’
In Ontario, Canada, public health authorities can issue and enforce orders to people living with HIV (PLWH). However, how public health practitioners determine when someone's behaviours constitute ‘significant’ risk remains underexplored. We drew on assemblage theory to examine how HIV risk is co‐constituted through the interplay among biomedical technologies, institutional practices, legal frameworks and social discourses. We conducted 18 semi‐s…
I Know So Many Women That Have the Same Story as Mine”
Background Benzodiazepines have become increasingly prevalent in the unregulated drug supply in Canada. Benzodiazepines are regularly prescribed as anxiety or sleep aids, and typically have strong sedative effects. Despite the influx of benzodiazepines in the unregulated drug supply, the gendered impacts of this change have not been evaluated. To address this gap, our aim was to explore how the increase of benzodiazepines in the unregulated drug …
Everyday discrimination and barriers to primary care, mental health, and substance use services
We evaluated the association between discrimination and access to primary, mental health, and substance use services among sex workers. Using baseline and semi-annual questionnaire data from a community-based cohort of sex workers in Vancouver, Canada (09/2015-02/2024), we used bivariate and multivariable logistic regression with generalized estimating equations to analyze the relationship between discrimination and access to primary care, mental…
Community-administered naloxone for overdose reversal
Over 5.5 years, over half of participants administered THN, which was associated with exposure to sex work-specific programs and occupational violence. Violence from clients, community members, and police independently increased the likelihood of THN administration. Findings suggest that marginalized sex workers, particularly those who use drugs in occupational settings, are uniquely positioned to respond to overdoses. This supports the feasibili…
Association between sex work occupational stigma and inconsistent condom use
BACKGROUND: Women sex workers face substantial health inequities due to structural barriers including criminalisation and stigma. Stigma has been associated with HIV-related inequities among marginalised populations, however, we know less about the impacts of sex work-specific occupational stigma on HIV/sexually transmitted infection (STI) risk among women sex workers. Given these research gaps and the disproportionate burden of stigma faced by s…
Navigating water, sanitation and hygiene (WaSH) access at the intersections of poverty, substance use, sex work and gender
Although substantial disparities in access to Water, Sanitation and Hygiene (WaSH) facilities persist in high-income countries (HICs), few studies have explored the WaSH experiences of marginalized and criminalized communities in HICs. Our study assessed how the Washroom Trailer Program (WTP), a municipal response to large-scale closures of public washrooms during the COVID-19 pandemic, shaped experiences of health (in)equity among unhoused/preca…
Sexual minority men’s experiences of, and strategies for emotional intimacy in intimate partner relationships
Emotional intimacy is key to intimate partner relationship quality and satisfaction. For sexual minority men, queer and feminist theorists consistently link emotional intimacy to diverse sexual practices and partnership dynamics formulated within the relationship. This Photovoice study adds to those insights by drawing on individual photovoice interviews with 16 sexual minority men to describe participant's experiences of, and strategies for emot…
Sex workers' engagement with mutual aid on-the-ground and online
HIV disclosure without consent linked to increased violence against women living with HIV in a Canadian setting
Our study examined the association between HIV disclosure without consent and verbal and/or physical violence due to HIV status among women living with HIV (WLWH). This study draws on baseline data of a sample (N = 316) from SHAWNA, a longitudinal community-based open cohort with WLWH in Metro Vancouver, Canada (2010-2019). Bivariate and multivariable logistic regression was used to investigate factors associated with physical and/or verbal viole…
Stigma trajectories, disclosure, access to care, and peer-based supports among African, Caribbean, and Black im/migrant women living with HIV in Canada
Our findings indicate that im/migration trajectories of African, Caribbean, and Black women living with HIV are critically related to accessing HIV care and supports in Canada and compound HIV stigma and discrimination. HIV disclosure without consent complicates access to care and social/peer support, underscoring the need for privacy, confidentiality, and the importance of building trust in the context of clinical encounters. The results of this…
Impacts of Sex Work Criminalization and Censorship for Indoor Workers
Intersecting structural barriers to reporting violence among men and non-binary sex workers under end-demand criminalization in Canada
A growing body of evidence indicates that sex work criminalization is linked to increased risk of violence and undermines the occupational health and safety (OHS) of sex workers. However, less is known about men and non-binary sex workers’ (MNBSWs) experiences with workplace violence and police-based systems for reporting violence under end-demand criminalization. To address this gap, we conducted 21 semi-structured interviews with MNBSWs in Brit…
“When I came to Canada, I almost forgot myself
For young women, im/migration can impact education, employment, and family dynamics in ways that shape the courses of their lives and health. The purpose of this study is to deepen understandings of how im/migration shapes young women's experiences of pregnancy, motherhood, and marriage. Guided by intersectionality theory and the structural and social determinants of health, we analyzed qualitative interviews conducted with young im/migrants ages…
Staying Together No Matter What
Among young people who use drugs in the context of entrenched poverty and homelessness, pregnancy is often viewed as an event that can meaningfully change the trajectory of their lives. However, youth’s desires and decision-making do not always align with the perspectives of various professionals and systems regarding how best to intervene during pregnancies and early parenting. Drawing on longitudinal interviews and fieldwork with young people i…
An Evaluation of Indoor Sex Workers’ Sexual Health Access in Metro Vancouver
The criminalization of sex work has been consistently shown to undermine workers' Occupational Health and Safety (OHS), including sexual health. Drawing on the 'Guide to OHS in the New Zealand Sex Industry' (the Guide), we assessed barriers to sexual health best practices among indoor sex workers in Metro Vancouver, Canada, in the context of ongoing criminalization. Part of a longstanding community-based study, this analysis drew on 47 qualitativ…
Negative changes in illicit drug supply during Covid-19
Over two-thirds of participants experienced negative changes to illicit drug supply during the first year of the COVID-19 pandemic. The association between experiencing negative changes in the illicit drug supply and accessing overdose prevention services highlights the agency of women in taking measures to address overdose-related risks. Highly criminalized women who experience structural barriers to direct services are also vulnerable to fluctu…
They Give you a bus Ticket and They Kick you Loose”
To explore the transition from correctional facilities to community among women living with HIV in Vancouver, Canada, we interviewed 19 recently incarcerated women and 6 service providers. Findings highlighted heightened risk of violence at release, a lack of immediate supports, challenges accessing safe housing and addictions treatment, and interruptions in HIV treatment and care. In the face of structural barriers, women blamed themselves for n…
Housing Instability and Evictions Linked to Elevated Intimate Partner and Workplace Violence Among Women Sex Workers in Vancouver, Canada
Objectives. To model the relationship of unstable housing and evictions with physical and sexual violence perpetrated against women sex workers in intimate and workplace settings. Methods. We used bivariate and multivariable logistic regression with generalized estimating equations to model the association of unstable housing exposure and evictions with intimate partner violence (IPV) and workplace violence among a community-based longitudinal co…
Protection or police harassment? Impacts of punitive policing, discrimination, and racial profiling under end-demand laws among im/migrant sex workers in Metro Vancouver
In 2014, Canada implemented end-demand sex work legislation which leaves the sale of sex under some circumstances legal. However, immigration policies based on discourses positioning sex work as exploitation and migration as trafficking continue to criminalize many im/migrant sex workers. Despite community reports of punitive policing, limited research has explored how police interactions with im/migrant sex workers have impacted labour condition…
Sex work community participation in criminalized environments
Sex workers who engaged in sex work community participation faced reduced odds of STI seropositivity. Building off reserach evaluating community interventions in low and middle income contexts, our study provides some of the first quantitative evidence on community participation among sex workers in Canada, and is the first to examine this in relation to sexual health outcomes. This research demonstrates the need to scale up community participati…
Seeing pre-screened, regular clients associated with lower odds of workplace sexual violence and condom refusal amidst sex work criminalization
Our findings highlight protective effects of seeing pre-screened regulars within a criminalized setting. Removal of 'end-demand' client criminalization is needed to enable sex workers to effectively screen clients, support HIV/STI prevention, and advance sex workers' human rights
It's not just about being here, but what brought you here”
This qualitative study aimed to understand how migration experiences shape im/migrant women's needs, desire for, and expectations of healthcare in the British Columbia (BC), Canada context. Interviews with 33 im/migrant women (December 2018-January 2020) highlighted that traumatic experiences across migration increased healthcare needs; insufficient prior health system information contributed to poor experiences; and comparative healthcare experi…
Digital Exclusion and the Structural Barriers to Safety Strategies among Men and Non-Binary Sex Workers Who Solicit Clients Online
Background: Evidence shows that online solicitation facilitates sex workers' ability to mitigate the risk of workplace violence. However, little is known about how end-demand sex work criminalization and the regulation of online sex work sites shape men and non-binary sex workers' ability to maintain their own safety while soliciting services online. Methods: We conducted 21 semi-structured interviews with men and non-binary sex workers in Britis…
Barriers to Governmental Income Supports for Sex Workers during Covid-19
The COVID-19 pandemic has brought into stark focus the economic inequities faced by precarious, criminalized and racialized workers. Sex workers have been historically excluded from structural supports due to criminalization and occupational stigma. Given emerging concerns regarding sex workers' inequitable access to COVID-19 income supports in Canada and elsewhere, our objective was to identify prevalence and correlates of accessing emergency in…
Indigenous Women Voicing Experiences of HIV Stigma and Criminalization Through Art
Indigenous women living with HIV are disproportionately affected by the criminalization of HIV nondisclosure. The purpose of this paper is to better understand how the criminalization of HIV nondisclosure shapes the lived experiences of HIV-related stigma, disclosure, and health service among cis and transgender Indigenous women living with HIV (IWLWH). This study was developed based on a community roundtable on HIV criminalization with engagemen…
They won't change it back in their heads that we're trash
In Vancouver, Canada, there has been a continuous shift in the policing of sex work away from arresting sex workers, which led to the implementation of a policing strategy that explicitly prioritised the safety of sex workers and continued to target sex workers' clients. We conducted semi-structured interviews with 26 cisgender and five transgender women street-based sex workers about their working conditions. Data were analysed thematically and …
Negotiating Safety and Sexual Risk Reduction With Clients in Unsanctioned Safer Indoor Sex Work Environments
Objectives. We examined how unique, low-barrier, supportive housing programs for women who are functioning as unsanctioned indoor sex work environments in a Canadian urban setting influence risk negotiation with clients in sex work transactions. Methods. We conducted 39 semistructured qualitative interviews and 6 focus groups with women who live in low-barrier, supportive housing for marginalized sex workers with substance use issues. All intervi…
Surviving the housing crisis
Negotiating Violence in the Context of Transphobia and Criminalization
A growing body of international evidence suggests that sex workers face a disproportionate burden of violence, with significant variations across social, cultural, and economic contexts. Research on trans sex workers has documented high incidents of violence; however, investigations into the relationships between violence and social-structural contexts are limited. Therefore, the objective of this study was to qualitatively examine how social-str…
Digital Exclusion and the Structural Barriers to Safety Strategies among Men and Non-Binary Sex Workers Who Solicit Clients Online
Background: Evidence shows that online solicitation facilitates sex workers' ability to mitigate the risk of workplace violence. However, little is known about how end-demand sex work criminalization and the regulation of online sex work sites shape men and non-binary sex workers' ability to maintain their own safety while soliciting services online. Methods: We conducted 21 semi-structured interviews with men and non-binary sex workers in Britis…
Health consequences of child removal among Indigenous and non-Indigenous sex workers
The child protection system can be a highly consequential institution for mothers who are sex workers, yet scant attention has been paid to the health consequences of its policies on this population. Drawing on 31 in-depth, semi-structured interviews with 19 Indigenous and 12 non-Indigenous sex workers in Vancouver, Canada, and using the stress process model and the concept of slow violence, this study proposes a typology of four trajectories thr…
Social and structural barriers to housing among street-involved youth who use illicit drugs
In Canada, approximately 150,000 youth live on the street. Street-involvement and homelessness have been associated with various health risks, including increased substance use, blood-borne infections and sexually transmitted diseases. We undertook a qualitative study to better understand the social and structural barriers street-involved youth who use illicit drugs encounter when seeking housing. We conducted 38 semi-structured interviews with s…
The Impacts of Intersecting Stigmas on Health and Housing Experiences of Queer Women Sex Workers in Vancouver, Canada
The objective of this study was to qualitatively explore how queer women sex workers' experiences of stigma impacted health and housing access in Vancouver, Canada. In-depth semi-structured interviews were conducted with 56 queer women sex workers in Vancouver, Canada between June 2012 and May 2013. Participants described sexual stigma in the form of discriminatory comments about their sexuality, and in the form of barriers to housing and complex…
Criminalizing Sex Work Clients and Rushed Negotiations among Sex Workers Who Use Drugs in a Canadian Setting
Barriers to Governmental Income Supports for Sex Workers during Covid-19
The COVID-19 pandemic has brought into stark focus the economic inequities faced by precarious, criminalized and racialized workers. Sex workers have been historically excluded from structural supports due to criminalization and occupational stigma. Given emerging concerns regarding sex workers' inequitable access to COVID-19 income supports in Canada and elsewhere, our objective was to identify prevalence and correlates of accessing emergency in…
Impacts of Sex Work Criminalization and Censorship for Indoor Workers
It's not just about being here, but what brought you here”
This qualitative study aimed to understand how migration experiences shape im/migrant women's needs, desire for, and expectations of healthcare in the British Columbia (BC), Canada context. Interviews with 33 im/migrant women (December 2018-January 2020) highlighted that traumatic experiences across migration increased healthcare needs; insufficient prior health system information contributed to poor experiences; and comparative healthcare experi…
Third Parties (Venue Owners, Managers, Security, etc.) and Access to Occupational Health and Safety Among Sex Workers in a Canadian Setting
Objective. To determine the impact of engagement with third parties (i.e., managers, receptionists, or owners of in-call venues; advertisers; security; spotters; and others) on sex workers’ occupational health access. Methods. We drew longitudinal data from An Evaluation of Sex Workers’ Health Access, a community-based cohort of more than 900 women sex workers. We used multivariable logistic regression and generalized estimating equations to (1) …
Association between sex work occupational stigma and inconsistent condom use
BACKGROUND: Women sex workers face substantial health inequities due to structural barriers including criminalisation and stigma. Stigma has been associated with HIV-related inequities among marginalised populations, however, we know less about the impacts of sex work-specific occupational stigma on HIV/sexually transmitted infection (STI) risk among women sex workers. Given these research gaps and the disproportionate burden of stigma faced by s…
They look at you like you’re contaminated”
An integrated supervised injecting program within a care facility for HIV-positive individuals
While there has been growing interest in comprehensive models of treatment and care for individuals living with HIV/AIDS, little attention has been given to the potential role that supervised injecting programs could play in increasing access to prevention and care services for HIV-positive injection drug users (IDU). We conducted 22 semi-structured interviews with HIV-positive IDU regarding a supervised injection program integrated in an HIV foc…
I guess my own fancy screwed me over
Importantly, as young people become increasingly entrenched in the local drug scene, drug use transitions seem to constitute increasingly relevant (and even 'inevitable') choices congruent with everyday lived experience. The implications of these findings for the development of meaningful interventions for youth are discussed
Social and structural determinants of Haart access and adherence among injection drug users
Social and structural barriers to housing among street-involved youth who use illicit drugs
In Canada, approximately 150,000 youth live on the street. Street-involvement and homelessness have been associated with various health risks, including increased substance use, blood-borne infections and sexually transmitted diseases. We undertook a qualitative study to better understand the social and structural barriers street-involved youth who use illicit drugs encounter when seeking housing. We conducted 38 semi-structured interviews with s…
Street-level policing in the Downtown Eastside of Vancouver, Canada, during the 2010 winter Olympics
Negotiating Safety and Sexual Risk Reduction With Clients in Unsanctioned Safer Indoor Sex Work Environments
Objectives. We examined how unique, low-barrier, supportive housing programs for women who are functioning as unsanctioned indoor sex work environments in a Canadian urban setting influence risk negotiation with clients in sex work transactions. Methods. We conducted 39 semistructured qualitative interviews and 6 focus groups with women who live in low-barrier, supportive housing for marginalized sex workers with substance use issues. All intervi…
Criminalisation of clients
OBJECTIVES: To explore how criminalisation and policing of sex buyers (clients) rather than sex workers shapes sex workers' working conditions and sexual transactions including risk of violence and HIV/sexually transmitted infections (STIs). DESIGN: Qualitative and ethnographic study triangulated with sex work-related violence prevalence data and publicly available police statistics. SETTING: Vancouver, Canada, provides a unique opportunity to ev…
Violence prevention and municipal licensing of indoor sex work venues in the Greater Vancouver Area
Using a socio-ecological, structural determinants framework, this study assesses the impact of municipal licensing policies and related policing practices across the Greater Vancouver Area (Canada) on the risk of violence within indoor sex work venues. Qualitative interviews were conducted with 46 migrant/immigrant sex workers, managers and owners of licensed indoor sex work establishments and micro-brothels. Findings indicate that policing pract…
Condoms and sexual health education as evidence
BACKGROUND: Despite a large body of evidence globally demonstrating that the criminalization of sex workers increases HIV/STI risks, we know far less about the impact of criminalization and policing of managers and in-call establishments on HIV/STI prevention among sex workers, and even less so among migrant sex workers. METHODS: Analysis draws on ethnographic fieldwork and 46 qualitative interviews with migrant sex workers, managers and business…
They won't change it back in their heads that we're trash
In Vancouver, Canada, there has been a continuous shift in the policing of sex work away from arresting sex workers, which led to the implementation of a policing strategy that explicitly prioritised the safety of sex workers and continued to target sex workers' clients. We conducted semi-structured interviews with 26 cisgender and five transgender women street-based sex workers about their working conditions. Data were analysed thematically and …
‘Because I’ve been extremely careful’
In this article, we examine how injection drug users who do not attribute their HIV infection to engaging in HIV risk behaviours take up and critique discourses of individual responsibility and citizenship relating to HIV risk and HIV prevention. We draw on data from a study in Vancouver, Canada (2006–2009) in which we interviewed individuals living with HIV who had a history of injection drug use. In this paper, we focus on six cases studies of …
The impact of construction and gentrification on an outdoor trans sex work environment
The objective of this study was to investigate how environmental and structural changes to a trans outdoor work environment impacted sex workers in Vancouver, Canada. The issue of changes to the work area arose during qualitative interviews with 33 trans sex workers. In response, ethnographic walks that incorporated photography were undertaken with trans sex workers. Changes to the work environment were found to increase vulnerabilities to client…
Criminalizing Sex Work Clients and Rushed Negotiations among Sex Workers Who Use Drugs in a Canadian Setting
Negotiating Violence in the Context of Transphobia and Criminalization
A growing body of international evidence suggests that sex workers face a disproportionate burden of violence, with significant variations across social, cultural, and economic contexts. Research on trans sex workers has documented high incidents of violence; however, investigations into the relationships between violence and social-structural contexts are limited. Therefore, the objective of this study was to qualitatively examine how social-str…
Through our eyes
Realizing Women Living with HIV’s Reproductive Rights in the Era of ART
Surviving the housing crisis
Street-involved youth engaged in sex work at increased risk of syringe sharing
Syringe sharing places street-involved young people at risk of acquiring HIV and hepatitis C. While markers of economic marginalization, such as homelessness, have been linked with syringe sharing and have led to targeted interventions, the relationship between syringe sharing and other markers of economic vulnerability, such as sex work, are not well documented among young people. This study examines whether those engaged in sex work are at incr…
Recent Incarceration as a Primary Barrier to Virologic Suppression Among Women Living with HIV
Third Parties (Venue Owners, Managers, Security, etc.) and Access to Occupational Health and Safety Among Sex Workers in a Canadian Setting
Objective. To determine the impact of engagement with third parties (i.e., managers, receptionists, or owners of in-call venues; advertisers; security; spotters; and others) on sex workers’ occupational health access. Methods. We drew longitudinal data from An Evaluation of Sex Workers’ Health Access, a community-based cohort of more than 900 women sex workers. We used multivariable logistic regression and generalized estimating equations to (1) …
Violence and other social structural factors linked to incarceration for women living with HIV in Metro Vancouver
Despite women living with HIV (WLWH) being disproportionately criminalized and overrepresented within correctional facilities, there remains limited longitudinal research with WLWH examining factors that make WLWH vulnerable to incarceration. Data are drawn from SHAWNA (Sexual health and HIV/AIDS: Women's Longitudinal Needs Assessment), a community-based research cohort with cisgender and transgender WLWH in Metro Vancouver, Canada. Multivariable…
Perspectives of HIV-positive and -negative people who use drugs regarding the criminalization of HIV non-disclosure in Canada
The paper concludes by discussing the challenges and opportunities for resisting HIV stigma and misconceptions about HIV within the context of personal accounts that, at times, support criminalization of non-disclosure
Indigenous Women Voicing Experiences of HIV Stigma and Criminalization Through Art
Indigenous women living with HIV are disproportionately affected by the criminalization of HIV nondisclosure. The purpose of this paper is to better understand how the criminalization of HIV nondisclosure shapes the lived experiences of HIV-related stigma, disclosure, and health service among cis and transgender Indigenous women living with HIV (IWLWH). This study was developed based on a community roundtable on HIV criminalization with engagemen…
Prevalence and Correlates of HIV Stigma Among Women Living with HIV in Metro Vancouver, Canada
Negotiating sex work and client interactions in the context of a fentanyl-related overdose epidemic
Despite awareness of the role of drug use in shaping sex worker/client interactions, these dynamics remain poorly understood in the context of illicit fentanyl-driven overdose epidemics. This study examined sex workers' experiences negotiating client interactions amidst a toxic drug supply in Vancouver, Canada. Findings draw from two ethnographic studies. The first, conducted between December 2016 and May 2017, examined the rapid implementation o…
Medicine (44 obras) · HIV, Drug Use, Sexual Risk (38 obras) · Psychology (38 obras) · Sex work and related issues (37 obras) · Sociology (32 obras) · Environmental health (27 obras) · Family medicine (26 obras) · Sexuality, Behavior, and Technology (25 obras) · Criminology (23 obras) · Psychiatry (22 obras)