Sex workers confront HIV

The photo above is Vong Street, next to my house. It has a nickname- "Wave Street" - since the street has bars, karaoke, massage... with women (actually sex workers) who waves at people to invite potential clients! This street is also one of the most notorious spots for fast set in Hanoi.

I have to say thank you because the issue is very close to me. As raised up in this area, I had to see offensive scenes as well as listen to the noisy sound all night at my very early age. In high school, whenever I came home late, I was often invited by those women; they waved at me every time I came close to their bars.

It is obvious that sex workers are severely affected by AIDS. In Vietnam particularly, the number of PLHIV is increasing, and the main reason is the unprotected sex. As we know, sex workers have a relatively high numbers of sexual partners. But it is not the main reason that increases their likelihood of getting infected with HIV. Having sex without condom is, in fact, the way that spreads the disease. So, why sex workers and their clients do not always use condom?

First, sex workers have little knowledge about the issue, or they have no access to condom. Many groups and organisations are trying to provide them with the necessary information, tools and skills to raise their awareness about the problems

Second, clients may offer more money to have sex without condom. Since money is importance, it is hard to resist the temptation to take the opportunity to gain a little more. This issue is well-illustrated by the clip "In Fosus Dominican Republic: Sex workers Confront HIV." The case is very much similar to the situation in Vietnam. The "supply" for paid sex is increasing; as a result, sex workers even have to compete against each other.

Third, sex workers are sometime powerless to negotiate safer sex, even if they try to do so. Clients may refuse to pay for sex if they have to use a condom.

My true story: I know a friend working in a NGO that focus on sex workers and HIV. When I asked her to tell something about the issue, she said that she knew a close friend, also a sex worker living with HIV. Before having sex, she (the sex worker) tells her client that she is HIV positive and asks him to use condom. The client, however, does not believe. He thinks that she is kidding and laugh: "You are beautiful! You do not look like HIV positive person." By the story, we understand that educating sex workers is definitely not enough!

There is also the issue about social factors. Sex workers around the world are generally stigmatised. In Vietnam, sex work is illegal, and there is a severe lack of legislation and policies to protect sex workers. The stigma is also a huge obstacle that sex workers need to overcome to access health services.

Now some stats from UNAIDS Vietnam website. Again, the 2009 information is in Vietnamese. The English one seems too outdated, or too hard for me to search for:

• In Vietnam, there are over 63,827 service companies, increase in 30% in less than two years. 
• Sex work is illegal in Vietnam. In 2009, the police discover 859 cases, arrest 3040 people.
• The number of sex workers is 15316, increase by 1.9% in 1 year. Many sex workers advertise themselves on the Internet, mobile phone,... so it is extremely difficult to identify.
• Currently, some 80% of prostitutes in Vietnam have primary and junior secondary degrees and those with senior secondary degree have been on the rise. 
• The Social Evils Prevention Department said that the country now has over 17,000 prostitution prevention clubs integrated into HIV/AIDS prevention programs.
• Annually, localities give treatment to some 5,000 prostitutes, of those, 70% are provided with the treatment at medical centers and 30% at the community. 

I just want to note that some programs by the government are very formalistic; they impress us by the money spent and the stats, number, not the result or impact on society. Besides, many programs and organizations are currently doing great to empower sex workers with knowledge - like Cactus Group, a group consists of over twenty sex workers in northern Vietnam. The peer education offered by the group helps reduce stigma and provide essential information for those sex workers.

Sex work is a highly controversial topic in every countries. The best solution is, perhaps, governments and organisations need to foster an environment where sex workers are able to protect themselves against HIV, and have widespread access to HIV prevention, testing and treatment services.