Conducting HIV/AIDS research with indoor commercial sex workers: reaching a hidden population.

Background: Although comprising up to 80% of the commercial sex industry in Canada, indoor female sex workers (FSW) are generally not represented in research because they are a hidden population and difficult to access.

Objectives: This paper describes a community-academic partnership model that was established to gain access to, deliver outreach services to, and conduct community-based research with the indoor commercial sex industry in four cities in British Columbia.

Methods: The project employed an ongoing community consultation, peer-delivered approach to reaching this overlooked segment of the commercial sex industry. Peers (former and current FSW) were hired, trained, and supported as outreach workers and participated in the development, implementation, and evaluation of the project. Outreach teams visited sex establishments to deliver harm reduction materials and provide education, support, and referrals. The teams developed rapport with establishment managers and staff to facilitate research recruitment and data collection. The community team leader met with managers in targeted business to describe the study and elicit permission to recruit workers. The team leader conducted in-person interviews with consenting FSW.

Observations: During the first 2 years of the project, more than 50 sex establishments were visited by outreach teams and 37 allowed repeat visits. Research interviews have been conducted with 49 FSW in seven establishments from four cities.

Conclusions: Although the high cost in terms of time and resources must be recognized, this project represents a successful research and outreach model that permits access to the hidden commercial sex industry.