چکیده (انگلیسی):

Background:The prevalence of self-identified chronic pain in Canadian adults is approximately one in five people.
Marginalization and addictions have been shown to complicate chronic pain in vulnerable populations. This study
aimed to understand the experience of chronic pain among female Survival Sex Workers in Vancouver's downtown
eastside (DTES).
Methods:This study used an exploratory qualitative analysis with in-depth, semi-structured interviews. Members of
PACE Society who self-identified as a current or former Survival Sex Worker and who had a chronic pain experience
known to PACE support workers were invited to participate. Interviews were conducted, audio recorded and
transcribed. The investigators met to read the transcripts and discuss emerging themes. The process continued until
no new themes were observed.
Results:Participants ranged in age from 42 to 56 years old and all self- identified as females and Survival Sex
Workers. Eleven of thirteen interviews were analyzed for themes. Drug use for pain management, both prescribed
and illicit, was the most important theme. Poverty, the need to continue working and the lack of stable housing
were barriers to adequately addressing the source of chronic pain. Participants felt judged for living in the
downtown eastside, being a drug user and/or being Aboriginal and only two participants had been referred to a
pain specialist. All participants were involved in support networks made up of other Sex Workers and all spoke of a
sense of community and survival.
Conclusions:Our study emphasizes the complex nature of chronic pain and addictions among a uniquely
marginalized population. The study is unique in that it contributes the perspectives of a traditionally“hard-toreach” population and demonstrates that Sex Workers should not only participate in but should lead
development and implementation of research and programs for managing chronic pain in the setting of
addiction.