100% condom use among sex-workers is possible
Developing countries like Cambodia are following the Thai example and implementing successful 100% condom use programmes for commercial sex workers. But some argue that the approach discriminates against commercial sex workers. Jo Stein reports
Developing countries like Cambodia are following the Thai example and starting to implement a countrywide 100% condom use policy for commercial sex workers.
The Cambodian Prime Minister Mr Hun Sen, has called on all Provincial Governors to endorse the national 100% condom use policy for commercial sex workers.
Local authorities, politicians, municipalities, police, and health departments throughout the country are all responsible for implementing the policy despite the fact that commercial sex is still legally a criminal offence.
In the Cambodian port city of Sihanoukville, a decree making condom use mandatory for sexual encounters in sex establishments must be affixed in a visible place at every sex establishment in town. After repeated infractions, non-compliant establishments are closed down by local authorities.
Sex establishment managers must also send their staff on a monthly basis to local clinics for sexually transmitted disease check-ups.
After 18 months, reported condom use in Sihanoukville had increased by up to 80% and all the evidence indicates that sexually transmitted diseases had been dramatically reduced.
Dr Tia Phalla, secretary general of the National AIDS Authority of Cambodia, says that such social controls are necessary.
“We cannot achieve behaviour change by knowledge alone; we need to create an enabling environment to support people who want to protect themselves from HIV, and to create obstacles for those who don’t want to make that choice.”
SWEAT, the Sex Worker Education and Advocacy Taskforce in Cape Town, does not support the authoritarian approach of the Cambodian programme.
Jill Sloan, director of SWEAT, argues that the approach discriminates against sex workers as a group. It makes regular condom-use and sexually transmitted disease testing for commercial sex workers mandatory, without imposing similar restrictions on clients or anyone else. It also penalizes sex establishments which don’t comply with the 100% condom-use rule.
“We don’t support enforced testing. The key issue is access to sexual health services which are suited to commercial sex worker’s needs. Sex workers want the services. It is not necessary to force them to use these services.”
“And management [of sex establishments] must be encouraged, in their own interests, to make it a safer sex premises. But more than this, you can’t do,” says Sloan. ‘ Health-e news service