Research reaches out to street-based sex workers
Mark Tyndall of the MAKA project.
Vancouver may be known as the most beautiful city in Canada but it also ranks first with a less-publicized statistic: it has the highest rate of HIV infection among drug users.

"Montreal also reports high HIV rates in some studies but no other city in Canada has the same rate of HIV infection among drug users," said Mark Tyndall, a researcher with the BC Centre for Excellence in HIV/AIDS.

Tyndall explained that, in Vancouver, the rate of HIV infection is higher among drug-using women than men. In order to target help to the female group, The BC Centre for Excellence and the Women's Information and Safe House (WISH) formed a partnership, to carry out a research study called the MAKA Project.

The project works with, "street-based women, as opposed to women working in brothels or more organized places," Tyndall said. The women in this study, who work in the Downtown Eastside, rely on selling sex to fund their drug use or just to survive.

Through interviews with about 200 street-based female sex workers, the study has found that most of the women are inconsistent in using condoms with clients and tend to have little trust in healthcare programs. Tests showed that 26 percent of the women are HIV positive. The average age of their initiation into sex work was 18.

One of the key elements of the study is "community engagement and capacity building" Tyndall said. Tyndall said the study has sought to engage sex workers in the research process so that they are fully involved in the development and dissemination of innovative and sustainable HIV/AIDS prevention, care and treatment programs.

Through MAKA, eight peers have been trained to assist with the research process: they help form appropriate questions for MAKA questionnaires, run focus groups and are involved in the dissemination of information throughout the Downtown Eastside. Women are also trained to support one another in accessing healthcare and taking medications (especially antiretroviral programs for HIV), to help others gain access to detox services and to promote condom use.

The project is run out of a Hastings Street storefront, open Monday to Friday, and includes a full-time nurse and a full-time project coordinator, as well as some part-time staff.

WISH Executive Director Kate Gibson said the program has already made a difference in the lives of women. "It gives women access to healthcare in a safe environment."

Gibson said many of the women she sees at WISH are reluctant to disclose their HIV status, but involving women in this project has brought the issue of HIV into the open. "Making it more open and accessible to be discussed makes people safer."

Now, Gibson said, "Women are talking about prevention and harm reduction in discussing HIV openly." Unlike other research projects that, Gibson said, "count heads," MAKA has a direct, immediate benefit for women. "Not only does it make it more mainstream to talk about being HIV positive, it gives people access to antiretroviral drugs in a safe sphere, in the neighbourhood."