This study sought to identify factors associated with police violence experienced by FSW during the first year of the Covid-19 health crisis in Argentina. Almost half of the participants reported experiencing police violence in this period and most of them reported an increase in the frequency compared to before the crisis. These results confirm the warnings from researchers and sex workers’ organizations regarding an exacerbation of police violence and discrimination against this population during the Covid-19 health crisis [5, 16]. When governments worldwide increased policing to enforce Covid-19-related restrictions to circulation, this also involved greater attributions for the security forces to approach, interrogate and arrest citizens [5, 20]. As a result, these attributions may have provided security forces with greater agency to proceed against FSW, enhanced the preexisting criminalization of sex work activities in some areas and therefore increased the odds of police harassment and violence against this population, as results of this study show. Moreover, as streets and public places are the most frequent venues of sex work in Argentina [17] and considering that street-based sex work increases the odds of police violence [24], a reduction of people in the streets during lockdown may have left sex workers more unprotected when returning to the streets, as perpetrators of violence may have taken advantage of the lack of witnesses.
A considerable deterioration of the economic situation of FSW was independently associated with police violence. Participants that experienced police violence were also more likely to report a reduction of their weekly income since the beginning of the Covid-19 health crisis, which has also had a negative impact on their quality of life. In accordance with reports from international and local researchers and sex workers’ organizations [10, 16, 17], this study found a general worsening of the already precarious working conditions and socioeconomic situation among FSW in Argentina, probably owing to sex work not being recognized as a formal activity and still being criminalized in some areas of the country [1, 4]. This situation deteriorated even more after hotels, brothels, bars, massage parlors and other venues were forced to close during lockdown, as they were categorized as non-essential. This measure may have legitimized raids that frequently involved violence against FSW who tried to continue working indoors in these venues. Moreover, without these venues, some FSW may have been forced to provide their services in public places and/or rely on street-based sex work as the only option for livelihood. As circulation in streets was restricted unless a special permit was granted, security forces had additional latitude for raiding traditional sex work areas. The lack of special permits to circulate may have been used as a reason for detention, leading to greater exposure to harassment. This situation may also have contributed to a reduction in the number of clients, as they were subject to the same circulation restrictions and could be questioned and detained by the police. In sum, sex work was strongly limited or even impossible to practice without being exposed to police actions and retaliation.
Police violence was also independently associated with being a TW, and a person who uses non-injection drugs. These findings are consistent with reports that have shown that transgender and undocumented FSW present a greater vulnerability to punitive Covid-19 control measures [25, 26]. TW have a long history of violence and harassment from the police that is related to their gender identity [27]. In Argentina, several studies have also documented considerable levels of police violence and discrimination against this population [28,29,30]. Furthermore, TW from Buenos Aires have identified the streets and police stations as the most violent settings [29] for their community. Several researchers have warned that police violence against transgender people was exacerbated during the Covid-19 health crisis [18, 20].
The role of non-injection drugs use was highlighted in this study in relation to police violence. An association between substance use and police harassment among FSW has been already reported, especially in the context of street-based sex work [24, 31]. International evidence consistently shows high prevalence of substance use among FSW, even during the Covid-19 pandemic [24, 32, 33]. In Argentina, evidence is scarce, though elevated substance use was found in a sample of TW, most of whom were engaged in sex work [30]. In particular, during lockdown, FSW who use substances may have increased their exposure to police violence when going out to acquire them. It is also possible that some FSW may have been forced to engage in small-scale drug dealing as a source of income. Regardless, suspicion of drug possession for personal use or for commercialization is a reason commonly argued by the police to approach, interrogate and incriminate FSW, even in violent or abusive ways [1, 31].
Belonging to other stigmatized groups, such as being migrants or PLHIV, was also associated with police violence. Migrant FSW may experience several factors that contribute to a more precarious situation. They may possibly not be acquainted with the local laws (including their rights), they may lack local identity documents or may not have permanent residency in the country. Therefore, they are at a greater disadvantage to defend themselves against police harassment, violence and abuse. This has already been reported in other contexts [5, 6] and locally [17]. Additionally, they may not be aware of the available government resources for self-defense, where to turn to ask for help, or lack family networks that assist them. Similarly, FSW living with HIV, who had to leave their homes to attend medical appointments and pick up antiretroviral medicine, may have been more exposed to police interrogation. Even though circulation permits were granted for medical reasons, the police were authorized to request them at any time. Previous traumatic experiences with the police may have influenced the interactions between FSW and police officers even out of the context of sex work.
FSW who reported police violence during the Covid-19 health crisis were more likely to have declared an increase in the frequency of fear or experiences of discrimination by physicians or other healthcare workers since the beginning of the Covid-19 health crisis. Previous research has shown that stigma related to sex work and discrimination from physicians and healthcare workers have traditionally been a barrier to healthcare access in this population and a recurrent reason to avoid attending healthcare services, even before the Covid-19 health crisis [7,8,9, 34]. Moreover, experiences of physical and sexual violence have been found associated with fear of seeking healthcare services among FSW [31]. Although difficult to explain, the association between police violence and access to healthcare has been found at different levels [3]. Allam et al. [35] showed that having been arrested in the last year was related to non-adherence to HIV treatment among FSW. Similarly, local pre-pandemic evidence showed an association between gender identity-related police discrimination and low adherence to HIV care among TW from Buenos Aires, Argentina; many of whom were engaged in sex work [36].
There may be several explanations for this result. Firstly, the institutional violence involved in the abuse and harassment from the police may be generalized to other institutions. Therefore, FSW anticipate stigma and discrimination in different institutional settings, such as healthcare services, especially if there is a history of mistreatment from physicians and other healthcare workers. Secondly, FSW who experienced police violence may have developed chronic fear and anticipation of discrimination of uniformed personnel, including security staff and guards, which are frequently the first staff they would meet when attending clinics and hospitals.
In contrast, FSW who reported experience of police violence were more likely to have had a consultation with a community worker to access healthcare. As reported worldwide [37], these results highlight the role of community workers and CBOs in assisting FSW and facilitating access to healthcare during the Covid-19 health crisis. Community workers are frequently peers, have a better understanding and awareness of FSW’s adverse situations and thus may be more effective addressing their needs [13, 31]. They also grant a safe, accepting environment and a stigma-free interaction for FSW. In this sense, it is possible that FSW who experienced police violence also experienced higher vulnerability and were more likely to turn to CBOs and their peers for assistance and help. A local study has described how peer navigators facilitate access to healthcare and other kinds of assistance among the community of TW from Buenos Aires, who show high proportions of engagement in sex work. Peer navigators function as a bridge between the community and the healthcare services [38]. This role may have become even more fundamental during the Covid-19 health crisis, as barriers to access healthcare have been amplified for FSW for all the reasons stated above [18, 25]. Therefore, CBOs and community workers may have been the first option for assistance and protection in situations of violence and may have compensated for the barriers to access medical attention and treatment since the start of the pandemic.
Furthermore, several researchers and community leaders have highlighted how sex workers' organizations have developed rapid responses to meet the community’s needs and support their peers during the Covid-19 health crisis, showing high levels of resilience. This included strategies to support and protect sex workers experiencing violence and advocacy to end state-promoted policing [5, 17, 25]. In line with previous studies [31], these results highlight the need for intervention programs in violence prevention and risk reduction strategies among FSW. Additionally, considering the pivotal role of CBOs during the pandemic, the collaborative development of health interventions is necessary for greater impact.
Some limitations of this study can be mentioned. Firstly, a small non-probability sample was enrolled. As it may not be representative of the rest of the population of FSW from Argentina, generalizability of these results is limited. Sample size may also have limited statistical power analysis. Secondly, information was collected through an online survey, which may imply several biases. Self-report may involve social desirability bias, whereas the online procedures may be more easily available to some participants than to others, depending on access to electronic devices and familiarity with their use. Procedures were implemented to reduce this last bias (e.g., administration of the survey as an interview by peer navigators/promoters). However, these options were only limited to FSW that could be reached by peer navigators, and for some FSW groups or communities the only option available was online. Enrollment of participants and data collection were implemented in two phases that involved different strategies. This may have also introduced bias in the results and should be acknowledged. Thirdly, given the cross-sectional nature of the study, causality or direction of some of the observed associations with police violence cannot be inferred. Finally, due to the nature of the question or the distribution of the sample, the role of some variables, such as effective access to healthcare or the type of sex work venues, was not possible to be analyzed. Also, social class status, another possible reason for intersectional discrimination against FSW, could not be explored in this study and future research should consider including and analyzing the role of this variable.
Future studies would benefit from achieving a nation-wide sample, analyzing the role of different sex work venues in relation to violence and exploring the relationship between police violence and healthcare-seeking behaviors. This information is critical to accurately inform programs and public policies aiming to improve FSW’s quality of life and healthcare access, and to prevent police violence.
