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close this bookEffective Approaches for the Prevention of HIV/Aids in Woman (PAHO, WHO; 1995; 62 pages)
View the documentExecutive summary
View the document1. Introduction
View the document2. Opening of the meeting
Open this folder and view contents3. Women and HIV/AIDS
Open this folder and view contents4. Effective approaches to prevention of HIV/AIDS in women
Open this folder and view contents5. Experiences from other fields: implications for HIV/AIDS prevention
close this folder6. Future directions: national policies and large-scale programmes
View the documentNational programme for training urban and rural women on STD/HIV and health in Myanmar
View the documentIncome generation and reduction of women entering sex work in Thailand
View the documentMan/Hombre/Homme: meeting male reproductive health care needs in Colombia
View the documentFuture directions: policies and large-scale programmes - Conclusions
View the document7. Overall conclusions
View the documentAppendix 1 - Agenda
View the documentAppendix 2 - List of participants
View the documentAppendix 3 - List of background papers
View the documentAppendix 4 - Selected reading list

Income generation and reduction of women entering sex work in Thailand

Presented by Dr Chrunrurtai Kanchanachitra, Health Programmes and Project Sector, National Economic and Social Development Board

The first AIDS case was reported in 1984 in Thailand and since then the HIV epidemic has changed in a number of ways. The first AIDS cases were among homosexuals, and then spread rapidly among injecting drug users and commercial sex workers, and to their partners. Now the infection has extended to the general population. A sentinel seroprevalence survey in June 1994 showed that the HIV prevalence rate had increased steadily from 0.3% in 1989 to 1.8% in 1994. Between 1986 and 1990, the gender ratio of people with HIV increases from one woman for every 17 men, to one woman for every 5 men. In 1991, the ratio halved to 1:2.3.

The Government of Thailand has demonstrated a strong commitment to halting the spread of HIV and preventing discrimination against persons with AIDS - both in its policies and in the provision of resources to implement policies. The AIDS budget allocation was US$ 184,000 in 1988 - by 1991 it had risen to US$ 7.3 million, to US$ 25 million in 1992 and to US$ 44.9 million in 1993. This considerable investment reflects a national realization of the likely social and economic consequences of not taking action to prevent HIV transmission.

The government, the NAP, NGOs and others are also adapting to the changing dynamics of the epidemic. In the earlier years of the epidemic, HIV/AIDS education and information interventions were targeted towards people practising high-risk behaviour such as injecting drug users, commercial sex workers and their clients, and men attending STD clinics. While many of these prevention activities continue today, greater attention is now given to disseminating HIV/AIDS information to the general public. For commercial sex workers, the emphasis has also shifted from merely providing information and promoting condom use, to discouraging entry into the sex industry. Priority has been placed on reaching young girls in the northern part of Thailand, where for a variety of economic, social and other reasons, the risk of entering the sex market is high.

Under the auspices of the Operational Plan (1995-1996) for the implementation of the national HIV/AIDS strategy, a committee for the Prostitution Prevention Campaign was established in November 1993 to oversee the New Life Project for Women in Rural Areas. Approximately 70 projects in 6 different provinces across Thailand are being implemented by nongovernmental and governmental organizations.

Prostitution in Thailand is largely the result of poverty and lack of occupational skills and educational opportunities. In addition, high expectations are placed on daughters to provide financial support to their parents, and as a result, many young women enter the sex industry, where income is higher than in other occupations. In response to these and other factors, four main areas of concern were identified: provision of opportunities for girls in rural areas to enter secondary education after finishing primary school; increased vocational training to improve skills and provide occupational alternatives for women; financial support for revolving funds in villages; and information campaigns through various media to influence parental attitudes and discourage young girls from entering the sex industry.

For example, the “Better Education for Better Life Project” was launched in response to the finding that 95% of prostitutes only finish primary school. Families often have difficulties paying the tuition and other education-related expenses, forcing children to quit school soon after the six years of compulsory education is completed. To encourage and support girls to stay in school longer, this project aims to expand girls’ educational opportunities by providing three-year secondary school scholarships. Four thousand five hundred scholarships have so far been made available through the Ministry of Education and NGOs, and there have been very few drop-outs.

Another example of government activities to reduce the risk for young girls and women of entering sex work is a Vocational Training Scheme set up to provide occupational opportunities. This scheme also provides training for young women already engaged in the sexwork industry who wish to leave it but have no skills. Emphasizing marketable skills, the Department of Public Welfare provides women with training in dress-making, hairdressing, weaving, typing, cooking, bakery, and language training, as well as with information on HIV/AIDS. The women are also taught marketing and accounting to help them manage their own income generating activities. Six training centres have been opened throughout the country and between 1990 and 1992, nearly 9000 girls were trained. Eighty four percent completed their courses and a follow-up showed that almost all of them obtained employment - 54% through the centre’s placement services and 45% in their own home towns. They have also seen their average monthly incomes increase from 800 baht to 2000 baht, a sum sufficient for living and family expenses.

Lessons learned

• The widespread use of the commercial sex industry by men places women at considerable risk of HIV infection. In such settings, a priority of HIV prevention must be directed towards those at highest risk of transmitting the virus to their partners (e.g. males attending STD clinics, clients of commercial sex workers), and in promoting the use of condoms with sex workers and other partners. Long-term prevention however requires not just the promotion of condom use but discouragement of young girls from entry into the sex industry.

• Policies to eliminate child prostitution require various measures to reach young girls whose risk of entering the sex industry is high - for example, through increased educational opportunities (e.g. secondary school scholarships), vocational training and IEC campaigns targeted at parents of girls at risk.

• Because of the strong links between poverty and entry into commercial sex work, increased vocational training to improve skills and provide occupational opportunities for women may be an effective approach. A key factor in such programmes is the ability of the trained women to earn at least as much as they would have in the sex industry.

• Economic viability will require training designed for the future (e.g. computers, health work, textiles), and include management skills. Vocational schemes are strengthened by a close connection with the business sector (e.g. a scheme in which industry matches government funds for training).

• In addition to its link with poverty, prostitution is also linked to gender and family relations, and cultural beliefs and practices. Changing harmful ones (e.g. those that encourage children entering sex work) must be a long-term aim.

• Fundamental socioeconomic measures (e.g. prolonging compulsory education 1 or reallocating the industrial sector to rural areas), as well as explicit policy, can only enhance efforts to prevent children from entering sex work.

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