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High risk of violence, STD: study No ‘easy’ money for sex workers

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Prostitution is legal in Macau but sex workers are marginalised and accused of spreading sexually transmitted diseases (STD). However, a study released on Wednesday shows that it’s the clients that refuse to practice safe sex.
The industry can be a profitable business but its workers can pay a high price, researcher Susanne Choi Yuk Ping said, starting with sexual violence. Chinese prostitutes also face a huge economic pressure, as most of them are divorced and the only financial support for their children.
The study commissioned by the local AIDS Prevention and Control Commission interviewed 491 sex workers from mainland China but also from Vietnam, Russia and Thailand.
Many Chinese prostitutes came because of family economic problems, Choi said, as they are mostly divorced (46 percent) or married (35.4 percent). In addition, the overwhelming majority (83.2 percent) sends remittances back to their family.
“They are very worried about STD but in practice they still have unprotected sex with clients,” the gender issues expert said. And in most cases (85 percent) it’s the clients who refuse to use a condom because they’re drunk or have a regular contact with the prostitute.
“Newcomers particular don’t have the knowledge or skill to negotiate or say no,” she said. Another at risk group were older women facing younger competition. “A 55 year-old woman interviewed openly admitted that she requested that her co-workers refer clients who wanted non-condom sex to her,” the report reveals.


Chinese prostitute
32 years old
little education
no English skills
rural background
divorced or married
has children

Russian prostitute
25 years old
secondary or university education
fluent in English
urban background
no children

Vietnamese or Thai prostitute
33 years old
secondary education
no English skills
rural background
no children

Unprotected job

“Some clients claim they don’t feel anything when using a condom. They even compare it to washing one’s feet with the socks still on,” Choi said. Some customers even offer extra money if the woman accepts unprotected sex.
“If they are under economic pressure, they usually take it,” the professor at the Chinese University of Hong Kong bemoaned. “Many have to support their parents’ medical expenses and with mainland China’s development it’s becoming more expensive to live in small villages,” Choi said.
“Society tends to blame sex workers for the spread of STD but our survey shows that they are the victims. It’s the clients that are to blame,” she stressed. Authorities should pay more attention to educating clients on the true danger of unprotected sex, the scholar added.
Even though most Chinese prostitutes have little knowledge of English, “the profile of their clientele was surprisingly international,” the survey shows, including Indian, Pakistani, Filipino, Caucasian and African.
Information on STD and safe sex is already distributed in several languages to the prostitutes, Vicky Lei Wai Kei, from the Health Bureau (SSM), said. More work must be done mainly with women from Vietnam and Thailand because they have little knowledge of AIDS (Acquired Immune Deficiency Syndrome), she acknowledged.
And most public health actions have “overlooked the issue of condom failure,” the report warns.
Since 2009 the workers have had access to free medical checks. “Thankfully no HIV [Human Immunodeficiency Virus] positive case was found among the women we spoke with,” Lei said.
If a test returns positive the prostitutes can go to public hospital Conde S. Januário or to the workers’ clinic of the Federation of Trade Unions to have a second test. “They are usually accompanied by people from our association [Hong Kong-based Action for Reach Out] and the whole process is anonymous,” Choi said.

Fear and pressure

A prostitute might earn MOP 20,000 a month but their expenses can also be as high as MOP 8,000. Most come to Macau using a two-week tourist visa but usually extend their stay for another week by travelling outside. Flight costs aside, the women must also pay agent fees, visa fees, rent and food.

In most cases (85 percent) it’s the clients who refuse to use a condom because they’re  drunk or had have a regular contact with the prostitute

Moreover, “there is a lot of competition” as many prostitutes charge as little as MOP 50 per transaction. “It means that these women needed to have at least (…) eight clients a day to make even,” the report stresses.
There is a clear double standard that makes it acceptable for men to buy sex but regards workers as “morally suspect,” the researchers wrote. “There is a very negative attitude from most people, who think these women just want to make easy money and don’t wish to find another job,” Choi said.
But the reality is very different, she stressed. “They live in very bad conditions, their services are sold for a low price, which forces them to have many customers in a risky environment and for long hours.”

Most sex workers tried to search for other jobs but were unable to find one that pays the same money, the researcher explained. Prostitutes from mainland China usually have little education, with nearly 10 percent having no formal schooling and another 25 percent only having attended primary school.

‘The play will try to discuss this phenomenon [compensated dating], as well as the social values that are behind it’ - Vicky Lei Wai Kei

The women also feel harassed by the police and are afraid of being deported. Most respondents don’t know what laws regulate the local sex industry and “complained most police officers have never explained to them the reasons for these raids and arrests”.
“They are under severe psychological pressure. Each and every one of the women we spoke with cried during the interview,” Choi revealed. Their biggest fear is for their family and children to find out what their job is. “In most cases the family doesn’t know they are prostitutes,” she underlined.

‘A 55 year-old woman interviewed openly admitted that she requested that her co-workers refer clients who wanted non-condom sex to her’

Widespread abuse

But the most dramatic finding of the survey was the widespread prevalence of sexual violence in the industry.
More than 40 percent of Chinese prostitutes said they were forced to have sex with clients. Almost half (46.4 percent) have experienced verbal violence and 17 percent suffered serious physical violence.
“Some are severely abused as the clients think there is no punishment,” Choi bemoaned. In most cases the cases of assault or rape are not reported because the women – all in Macau on two-week tourist visas – are aware that they are working illegally.


percentage of Chinese prostitutes who charge less than MOP 100 per sexual transaction

percentage of Vietnamese prostitutes who had unsafe sex in the previous three months

percentage of Thai prostitutes who are ‘very scared’ of HIV infection

percentage of Chinese prostitutes who have suffered sexual violence, including rape


“If reported, we think that the police would handle these cases appropriately,” the Hong Kong professor said. “All of the Chinese prostitutes we spoke with are self-employed but we do know there are also some who are controlled by pimps or criminal organised groups,” she conceded.
The situation is much better for non-Chinese workers, as all of them work in massage lounges or saunas under a legal visa and a work contract as ‘entertainers’. “There is more security and, as such, less violence,” she said.
About 16 percent of the Thai prostitutes admitted to having suffered sexual violence, while seven percent of the Russian women spoke about serious physical violence from clients.

‘Society tends to blame sex workers for the spread of STD but our survey shows that they are the victims. It’s the clients that are to blame’ - Susanne Choi Yuk Ping

Lack of staff

The survey of Chinese sex workers was carried out in December 2007 and the non-Chinese workers were interviewed between March and June 2008. However the results were only released on Wednesday.
Choi said that in fact the interviews continued well into 2009 which accounted for the delay in releasing the results. “This population is characterised by a big mobility. Every year we contact between 6,000 to 8,000 people,” Lei added.
“There was no plan to release this study,” Choi confessed. The decision to go public with it was only made in December, during the last meeting of the commission. “They thought some of its conclusions would be important for people to hear,” she said.
But the commission hasn’t been sitting on its hands since it completed the survey, Lei stressed. “We continue carrying out smaller questionnaires and the results are encouraging. For instance, the latest data shows that over 70 percent of the sex workers always use a condom,” she revealed.
However, the official said that more staff would be needed to carry out a similar wide-range survey. “We took more than two weeks to get the interviews with the Chinese [sex] workers. To do more we would need more human resources,” she emphasised.
Authorities expected to halve the number of new cases of HIV/AIDS among local residents by 2015. Another goal is to eliminate the cases in which the virus is transmitted from mother to child, as well as AIDS-linked deaths of pregnant women or women in labour.

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