Both Cambodian women engaging in sex work and their male clients engage in unhealthy alcohol use, according to the findings of a soon-to-be-published study.
Led by Dr Marie-Claude Couture of the University of San Francisco, a team of researchers administered a questionnaire to 100 women in Preah Sihanouk province who reported having had sex in the preceding three months in return for money, gifts or goods. Another questionnaire was administered to 100 self-identified clients.
Participants were asked to rate their alcohol intake, and the following morning they were invited to have their blood tested for HIV positivity as well as a biomarker called phosphatidylethanol (PEth). PEth is useful for detecting heavy drinking patterns because it stays in the blood for two to three weeks after a bout of heavy drinking, according to the report.
The results showed that 60 per cent of women and 42 per cent of men had a level of PEth in their blood that indicates “unhealthy alcohol consumption”. The study also found that men tended to under-report their alcohol use. The report defines unhealthy alcohol use as including “risky drinking and alcohol-use disorders”.
The majority of women (71 per cent) participating in the study reported that their sex work took place in the course of their jobs as entertainment workers, while the remainder’s took place on a freelance basis or in brothels. Nine per cent of all women surveyed tested HIV positive, nationwide HIV prevalence is currently 1.6 per cent.
Professor Ian Lubek, who has conducted extensive research on entertainment workers, alcohol and sex in Cambodia said that in his experience, workers and clients are far more likely to engage in risky behaviour when they have been drinking.
“We find that when entertainment workers drink alcohol, condom use goes down,” he said.
He attributes the high rates of HIV infections among Cambodia’s entertainment workers in part to the criminalisation of brothels in 2008.
“When brothels closed, the workers went underground and men still sought out sex, some of whom found it with beer sellers ... before 2008, beer sellers had paid sex 2.7 times a month when they had to make ends meet,” he said, adding that in the following years, those numbers increased significantly.
He also called for higher wages for entertainment workers, insisting that if their salaries were doubled to “living” wages, they would less frequently find themselves caught short at the end of the month.
However, the director of health NGO Khana, Choub Sok Chamreun, said that calling for higher salaries did not address an immediate need for education of entertainment workers.
“If the company who employs these people can increase their salary, we’re very happy. But in the meantime, we need to give them a proper message about how they can keep themselves safe,” Chamreun said.
One 32-year-old beer seller who asked not to be named said yesterday that while she refrains from engaging in sex with clients or becoming intoxicated on the job, she knew of colleagues that did both.
“I heard of some beer girls getting fully drunk with her customers ... I could not do that,” she said. “It’s high risk for her to have sex without protection.”