Commercial Sex Workers: Victims, Vectors or Fighters of the HIV Epidemic in Cambodia?

In this 14-page paper, author Lisa Marten contends that the Cambodian government's 100% Condom Use Policy (CUP) narrowly targets the ‘risky behaviour’ group and that the "punitive nature" of the policy makes it difficult for non-government organisations (NGOs) to participate. Using an NGO programme as a case study, this paper explores the extent to which changes in behaviour can be achieved with a voluntary approach that does not infringe on the rights of commercial sex workers (CSWs) and seeks to empower rather than stigmatise them. This paper looks at the knowledge, attitudes and behaviour of CSWs regarding HIV/AIDS and condom use.

The findings are described as being based on semistructured interviews as well as focus groups with brothel-based and self-employed CSWs. The respondents are described as living in two towns near the Thai border where Medecins Sans Frontiers has clinics set up to reduce the transmission of HIV. Many CSWs are described as having attended the clinics and are knowledgeable about HIV and condom use. They are described as "active and skilful" in negotiating condom use with clients.

According to Marten, a lack of condom use is often "due to disparate power relationship with brothel owners and clients, and economic desperation." Marten further describes the current 100% Condom Use Policy in Cambodia as "not compatible with voluntary programmes such as the successful Medecins Sans Frontiers clinics." She further states "the government policy also fails to address the broader social and economic factors that make CSWs unable to enforce condom use when a client does not desire to do so."

In conclusion the paper suggests that the highest rates of HIV infection coupled with inability to afford treatment and isolation from social networks to provide care for AIDS, make CSWs "unfortunate victims" of the HIV/AIDS epidemic in Cambodia. Marten describes that in spite of their efforts to protect themselves from HIV, they have been stigmatised by government policy and education campaigns as vectors - and that ironically, government policy also depends on them to break the chain of infection.

Click here to access the article in PDF format.