Being open: exploring primary health care services for women who sell sex and do high risk drugs in Vancouver

Women who sell sex and do high risk drugs in Vancouver’s Downtown Eastside have comprehensive primary health care needs. There is evidence that primary health care agencies can also be loci of social capital building in communities with a large multiply-marginalized population. This research identifies how agency-level determinants act as barriers and facilitators to the uptake of care as well as to identify how these can enable or impede the development of social capital among women clients who sell sex and do high risk drugs. Fifteen interviews were conducted with primary health care providers and key informants. Data were analyzed using a modified warranted assertion method. Eleven agency-level determinants were identified. The study offers valuable insights into how sex workers who do high risk drugs can become agents in their own care and community experience, and how agencies can be reconfigured to facilitate uptake of primary care by these women.