As the National Assembly debated the HIV/AIDS law last week, the Khmer HIV/AIDS NGO
Alliance (KHANA) kicked off a $2.7 million prevention program focused on educating
and mobilizing sex workers.
The four-year initiative covers target areas identified as high risk: Battambang,
Kampong Cham, Pailin and Sihanoukville.
It is funded by the Bill and Melinda Gates Foundation through the International HIV/AIDS
Alliance, whose senior program officer, Cheryl Overs, visited Cambodia at the end
of May to oversee the program.
"There's ample evidence that if HIV can be contained at low rates among sex
workers, that will have a major impact in slowing the epidemic, especially in Cambodia
where such a large percentage of the male population pays for sex," said Overs.
An estimated 168,000 or 2.8 percent of the country's adult population aged 15-49
are HIV- positive, the highest rate in Asia. Figures from the National Center for
HIV/AIDS in 2000 showed that 19.4 percent of men in urban areas and 10.9 percent
in rural areas had sex with a direct sex worker within the previous year.
The center's figures also revealed that HIV prevalence was 31 percent among direct
sex workers and 16 percent among indirect sex workers including beer girls, karaoke
and massage girls.
KHANA's program targets sex workers and other population groups key to the epidemic.
That includes people living with AIDS, homosexual men, and intravenous drug users.
The executive director of KHANA, Pok Panhavichetr, said her organization had just
begun a new collaborative approach.
"It is very exciting as for the first time there will be real integration through
targeting key populations simultaneously in each area and helping create and strengthen
sex worker collectives," she said.
The program will provide a range of services including home care, support for community
development, improved access to condoms and treatment for sexually transmitted infections.
It will also look at empowering sex workers by forming workers' collectives.
One organization involved in sex worker empowerment is Oxfam's Womyn's Agenda for
Change. Director Rosanna Barbero said much HIV/AIDS prevention was run on rigid medical
models that were not effective. Consequently the only way to minimize HIV infection
was to empower sex workers.
"Often HIV programs think that if they teach a sex worker how to put a condom
on to a wooden penis, then she has the power to negotiate condom use with clients,"
Barbero said. "This ignores the fact that sex workers are powerless and are
faced with exploitation and abuse every day. Only when that changes can women take
responsibility for safe sex practices."
KHANA's project is part of a $25 million 'frontier' initiative in four countries.
The others are Madagascar, India and Ecuador.