Kate Shannon
Biographic Data
| ID | 210074 |
|---|---|
| NAME | Kate Shannon |
| GIVEN NAMES | Kate |
| FAMILY NAME | Shannon |
| SIGNATURE | SHANNON K |
| AFFILIATIONS | University of British Columbia |
| ORCID | 0000-0002-6764-5212 |
| VERIFIED | Yes |
| TOTAL WORKS | 113 |
| TOTAL CITATIONS | 410 |
| AUTHOR COUNT | 113 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 2005 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 11 |
Navigating Barriers: The Intersectional Impact of Covid-19 on Routine Healthcare Access Among Marginalized Indigenous Women in Vancouver
This study investigates the intersectional barriers to routine healthcare access experienced by marginalized Indigenous women, including sex workers and women living with HIV, in Vancouver, Canada during the COVID-19 pandemic. Drawing on data from 142 Indigenous participants in the AESHA and SHAWNA cohorts collected between October 2020 and August 2021, the research employs bivariate and multivariable logistic regression with generalized estimati…
Prevalence and social-structural correlates of forced moves among women living with HIV in metro vancouver, Canada
Everyday discrimination and barriers to primary care, mental health, and substance use services: Findings from a community-based cohort of sex workers in Vancouver, Canada (2015–2024)
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…
Socio-structural barriers to mental health services among women living with HIV in Metro Vancouver, Canada
Women living with HIV experience high levels of mental health conditions and gendered social and systemic inequities to healthcare services access. This study therefore examined the prevalence and socio-structural factors associated with being unmet need for mental health services among women living with HIV. Data were drawn from Sexual Health & HIV/AIDS: Longitudinal Women's Needs Assessment (SHAWNA), an open longitudinal community-based study a…
Community-administered naloxone for overdose reversal: The role of sex worker-led programming and occupational violence in a community-based cohort (2018–2024)
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…
Higher Sexual Relationship Power Associated With Optimal HIV Treatment and Care Outcomes Among Women Living With HIV in Heterosexual Relationships in Metro Vancouver
In this study among a longitudinal cohort of women living with human immunodeficiency virus (HIV) in Metro Vancouver, Canada (2014-2019), we used bivariate and multivariable logistic regression with generalized estimating equations to investigate associations between low, medium, and high relationship power and two outcomes among women in heterosexual relationships: (1) being on antiretroviral therapy (ART); (2) optimal ART use. Multivariable ana…
Association between sex work occupational stigma and inconsistent condom use: Findings from a community-based cohort of women sex workers in Vancouver, Canada (2014–2022)
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…
Sex workers' engagement with mutual aid on-the-ground and online: Exploring access to grassroots support networks among a community-based cohort in Vancouver, Canada (2020-2024)
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…
Pandemic-related challenges accessing food and primary healthcare among sex workers during the Covid-19 pandemic: Findings from a community-based cohort in Vancouver, Canada
Findings provide insight about the potential role community-based healthcare delivery settings (e.g., community clinics) can play in ameliorating access to basic needs such as food among those who are highly marginalized. Future pandemic response efforts should also take the most marginalized populations' needs into consideration by establishing strategies to ensure continuity of essential services providing food and other basic needs. Lastly, po…
Stigma trajectories, disclosure, access to care, and peer-based supports among African, Caribbean, and Black im/migrant women living with HIV in Canada: Findings from a cohort of women living with HIV…
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…
Stigma, Discrimination and Other Social-Structural Factors Associated with Barriers to Counselling or Therapy among Women Living with HIV Who have Experienced Violence in Metro Vancouver, Canada
Gaps in health coverage for racialized im/migrant sex workers in metro Vancouver: Findings of a community-based cohort study (2014–2021)
Policy and program reforms are needed to decouple health insurance access from immigration status, remove mandatory waiting periods for health insurance coverage, and ensure that provincial insurance provides sufficient coverage for marginalized women's healthcare needs
Victims of religious hate crime: Victimisation of Muslims, Jews and Hindus compared
The surge in Hate Crime within the United Kingdom has disproportionately impacted religious communities, particularly Muslims, Jews and Hindus. This article provides a comprehensive exploration of hate crimes targeting these three religious groups in the United Kingdom. Through qualitative interviews with victims, the study aims to analyse their immediate response following the victimisation. Drawing insights from 30 individual interviews and thr…
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…
Precarious Housing Associated with Unsuppressed Viral load, sub-optimal Access to HIV Treatment and Unmet Health care Needs, Among Women Living with HIV in Metro Vancouver, Canada
Negative changes in illicit drug supply during Covid-19: Associations with use of overdose prevention and health services among women sex workers who use drugs (2020–2021)
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”: A Qualitative Analysis of Post-Release Experiences among Recently Incarcerated Women Living with HIV in Metro Vancouver, Canada
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: Findings of a Prospective, Community-Based Cohort, 2010–2019
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…
Violence against sex workers: Correlates and Changes under ‘End-Demand’ legislation in Canada: A five city study
Canada is among several countries to have implemented 'end-demand' criminalization frameworks for sex work. Drawing on interviews with sex workers (n = 200) in five cities, we employed multivariate logistic regression to identify associations with workplace violence. We also analysed descriptive data on trafficking and on workplace violence under end-demand legislation. In the past 12 months, being unable to call 911 in a safety emergency at work…
Sex work community participation in criminalized environments: A community-based cohort study of occupational health impacts in Vancouver, Canada: 2010–2019
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…
The prevalence and social-structural correlates of housing status among women living with HIV in Vancouver, Canada
Complex social-structural inequities are associated with housing instability among WLWH. In addition to meeting basic needs for living, to facilitate access to housing among WLWH, housing options that are gender-responsive and gender-inclusive and include trauma- and violence-informed principles, low-barrier requirements, and strong connections with supportive harm reduction services are critical
Seeing pre-screened, regular clients associated with lower odds of workplace sexual violence and condom refusal amidst sex work criminalization: Findings of a community-based cohort of sex workers in …
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
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…
Social and structural violence and power relations in mitigating HIV risk of drug-using women in survival sex work
They won't change it back in their heads that we're trash: The Intersection of Sex Work-Related Stigma and Evolving Policing Strategies
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 …
Risky health environments: Women sex workers' struggles to find safe, secure and non-exploitative housing in Canada's poorest postal code
Structural and Environmental Barriers to Condom Use Negotiation With Clients Among Female Sex Workers: Implications for HIV-Prevention Strategies and Policy
Objectives. We investigated the relationship between environmental–structural factors and condom-use negotiation with clients among female sex workers. Methods. We used baseline data from a 2006 Vancouver, British Columbia, community-based cohort of female sex workers, to map the clustering of “hot spots” for being pressured into unprotected sexual intercourse by a client and assess sexual HIV risk. We used multivariate logistic modeling to estim…
Associations between childhood maltreatment and sex work in a cohort of drug-using youth
Sex Workers' Access to Police Assistance in Safety Emergencies and Means of Escape from Situations of Violence and Confinement under an "End Demand" Criminalization Model: A Five City Study in Canada
There is limited available evidence on sex workers (SW) ability to access police protection or means of escaping situations of violence and confinement under an "end demand" criminalization model. Of 200 SW in five cities in Canada, 62 (31.0%) reported being unable to call 911 if they or another SW were in a safety emergency due to fear of police detection (of themselves, their colleagues or their management). In multivariate logistic regression,…
Negotiating Safety and Sexual Risk Reduction With Clients in Unsanctioned Safer Indoor Sex Work Environments: A Qualitative Study
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…
Safety and danger in downtown Vancouver: Understandings of place among young people entrenched in an urban drug scene
Negotiating Violence in the Context of Transphobia and Criminalization: The Experiences of Trans Sex Workers in Vancouver, Canada
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…
Seeking refuge from violence in street-based drug scenes: Women's experiences in North America's first supervised injection facility
Sexual and Drug-related Vulnerabilities for HIV Infection Among Women Engaged in Survival Sex Work in Vancouver, Canada
Sex workers’ experiences and occupational conditions post-implementation of end-demand criminalization in Metro Vancouver, Canada
A narrative analysis of the birth stories of early-age mothers
The telling of birth stories (i.e. stories that describe women's experiences of giving birth) is a common and important social practice. Whereas most research on birth narratives reflects the stories of middle-class, 'adult' women, we examine how the birth stories told by early-age mothers interconnect with broader narratives regarding social stigma and childbearing at 'too early' an age. Drawing on narrative theory, we analyse in-depth interview…
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…
I Walked into the Industry for Survival and Came Out of a Closet: How Gender and Sexual Identities Shape Sex Work Experiences among Men, Two Spirit, and Trans People in Vancouver
Background/Objectives:This article seeks to examine how gender and sexual identities shape sex work experiences among men, two spirit, and/or trans people in Vancouver.Methods:In-depth, semistructured interviews were conducted with men and trans people in Metro Vancouver from Community Health Assessment of Men Who Purchase and Sell Sex. An intersectional critical feminist perspective guided the thematic analysis of interview transcripts, and ATLA…
Complexities of Short-Term Mobility for Sex Work and Migration among Sex Workers: Violence and Sexual Risks, Barriers to Care, and Enhanced Social and Economic Opportunities
Health consequences of child removal among Indigenous and non-Indigenous sex workers: Examining trajectories, mechanisms and resiliencies
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…
Urban gentrification and declining access to HIV/STI, sexual health, and outreach services amongst women sex workers between 2010-2014: Results of a community-based longitudinal cohort
Access and Utilization of HIV Treatment and Services Among Women Sex Workers in Vancouver's Downtown Eastside
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
Social and Structural Factors Shaping High Rates of Incarceration among Sex Workers in a Canadian Setting
Prevalence and Correlates of Forced Sex Perpetration and Victimization in Botswana and Swaziland
Objectives. We sought to identify correlates of forced sex perpetration among men and victimization among women in Botswana and Swaziland. Methods. We surveyed a 2-stage probability sample of 2074 adults from the 5 districts of Botswana with the highest HIV prevalence rates and all 4 regions of Swaziland. We used multivariable logistic regression to identify correlates of forced sex victimization and perpetration. Results. Lifetime prevalence rat…
Barriers to Governmental Income Supports for Sex Workers during Covid-19: Results of a Community-Based Cohort in Metro Vancouver
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…
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
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 …
Access and Utilization of HIV Treatment and Services Among Women Sex Workers in Vancouver's Downtown Eastside
The impact of unregulated single room occupancy hotels on the health status of illicit drug users in Vancouver
Community-based HIV prevention research among substance-using women in survival sex work: The Maka Project Partnership
Substance-using women who exchange sex for money, drugs or shelter as a means of basic subsistence (ie. survival sex) have remained largely at the periphery of HIV and harm reduction policies and services across Canadian cities. This is notwithstanding global evidence of the multiple harms faced by this population, including high rates of violence and poverty, and enhanced vulnerabilities to HIV transmission among women who smoke or inject drugs.…
Income generating activities of people who inject drugs
Sex trade involvement is associated with elevated HIV incidence among injection drug users in Vancouver
Background: Canada's prostitution laws are under scrutiny, and there has been growing debate about the optimal strategies for reducing the harms associated with prostitution. Methods: We evaluated whether sex trade involvement was associated with elevated HIV incidence in a cohort of injection drug users. HIV incidence rates were calculated using Kaplan-Meier methods and Cox proportional hazards regression. Results: At 48 months after enrolment, …
Sexual and Drug-related Vulnerabilities for HIV Infection Among Women Engaged in Survival Sex Work in Vancouver, Canada
Associations between childhood maltreatment and sex work in a cohort of drug-using youth
Drug sharing with clients as a risk marker for increased violence and sexual and drug-related harms among survival sex workers
Previous studies have described links between violence, decreased condom use and drug sharing among intimate partners, though limited information exists about the predictors of drug sharing among female sex workers and their clients. The following analysis explored the association between sharing illicit drugs with clients and sexual and drug-related harms among survival sex workers. A total of 198 women participated in interview-administered que…
The Social and Environmental Factors Underlying Maternal Malnutrition in Rural Bangladesh: Implications for Reproductive Health and Nutrition Programs
Levels of low birth weight (LBW) and maternal malnutrition in rural Bangladesh are among the highest in the world. We surveyed dietary practices among pregnant mothers in a rural area served by a reproductive health and nutrition program. In total, 30 semi-structured interviews and five focus group discussions were carried out, supplemented by participant observations. Despite high levels of awareness of nutritional dietary requirements, half the…
Mapping violence and policing as an environmental–structural barrier to health service and syringe availability among substance-using women in street-level sex work
Social and structural violence and power relations in mitigating HIV risk of drug-using women in survival sex work
Seeking refuge from violence in street-based drug scenes: Women's experiences in North America's first supervised injection facility
Injection drug use among street-involved youth in a Canadian setting
These findings highlight an alarmingly high prevalence of injection drug use among street-involved youth and demonstrate its association with an array of risks and harms, including sex work involvement, overdose, and HCV infection. These findings point to the need for a broad set of policies and interventions to prevent the initiation of injection drug use and address the risks faced by street-involved youth who are actively injecting
Safety and danger in downtown Vancouver: Understandings of place among young people entrenched in an urban drug scene
Structural and Environmental Barriers to Condom Use Negotiation With Clients Among Female Sex Workers: Implications for HIV-Prevention Strategies and Policy
Objectives. We investigated the relationship between environmental–structural factors and condom-use negotiation with clients among female sex workers. Methods. We used baseline data from a 2006 Vancouver, British Columbia, community-based cohort of female sex workers, to map the clustering of “hot spots” for being pressured into unprotected sexual intercourse by a client and assess sexual HIV risk. We used multivariate logistic modeling to estim…
Violence, Condom Negotiation, and HIV/STI Risk Among Sex Workers
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Association of highly active antiretroviral therapy coverage, population viral load, and yearly new HIV diagnoses in British Columbia, Canada: A population-based study
Gendered HIV risk patterns among polygynous sero-discordant couples in Uganda
Stable serodiscordant relationships and sexual concurrency are pathways that contribute to the HIV epidemic in sub-Saharan Africa. However whether polygyny imparts the same risks as informal concurrent relationships remains an open research question. Using data collected at enrollment from a cohort study of sero-discordant couples, this analysis investigates how polygynous relationships differ from those involving only a single female spouse and …
Homelessness among a cohort of women in street-based sex work: The need for safer environment interventions
These findings indicate a critical need for safer environment interventions that mitigate the social and physical risks faced by homeless FSWs and increase access to safe, secure housing for women
Condom use within non-commercial partnerships of female sex workers in southern India
This study revealed important patterns and interpersonal determinants of condom use within non-commercial partnerships of FSWs. Integrated structural and community-driven HIV/STI prevention programs that focus on gender and reduce sex work stigma should be investigated to increase condom use in non-commercial partnerships
Prevalence and Correlates of Forced Sex Perpetration and Victimization in Botswana and Swaziland
Objectives. We sought to identify correlates of forced sex perpetration among men and victimization among women in Botswana and Swaziland. Methods. We surveyed a 2-stage probability sample of 2074 adults from the 5 districts of Botswana with the highest HIV prevalence rates and all 4 regions of Swaziland. We used multivariable logistic regression to identify correlates of forced sex victimization and perpetration. Results. Lifetime prevalence rat…
Risky health environments: Women sex workers' struggles to find safe, secure and non-exploitative housing in Canada's poorest postal code
Structural Violence and Structural Vulnerability Within the Risk Environment: Theoretical and Methodological Perspectives for a Social Epidemiology of HIV Risk Among Injection Drug Users and Sex Worke…
Occupational stigma as a primary barrier to health care for street-based sex workers in Canada
Individuals working in the sex industry continue to experience many negative health outcomes. As such, disentangling the factors shaping poor health access remains a critical public health priority. Within a quasi-criminalised prostitution environment, this study aimed to evaluate the prevalence of occupational stigma associated with sex work and its relationship to barriers to accessing health services. Analyses draw on baseline questionnaire da…
Negotiating Safety and Sexual Risk Reduction With Clients in Unsanctioned Safer Indoor Sex Work Environments: A Qualitative Study
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…
Medicine (102 works) · Sex work and related issues (88 works) · HIV, Drug Use, Sexual Risk (82 works) · Sociology (69 works) · Environmental health (65 works) · Family medicine (58 works) · Demography (55 works) · Sex work (52 works) · Psychology (51 works) · Psychiatry (42 works)