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The risk environment framework provides a valuable but under-utilised heuristic for understanding environmental vulnerability to HIV and other sexually transmitted infections among female sex workers. Brothels have been shown to be safer than street-based sex work, with higher rates of consistent condom use and lower HIV prevalence. While entertainment venues are also assumed to be safer than street-based sex work, few studies have examined environmental influences on vulnerability to HIV in this context.
Interviews were conducted in Khmer by trained interviewers, transcribed and translated into English and analysed for thematic content. The intensification of anti-prostitution and anti-trafficking efforts in Cambodia has increased the number of women working in entertainment venues and on the street. Our data also indicate that exposure to violence and interactions with the police are mediated by the settings in which sex is sold.
Entertainment venues may also provide a high risk environment for sex work. Our results indicate that strategies designed to address HIV prevention among brothel-based FSWs in Cambodia have not translated well to street and entertainment-based sex work venues in which increasing numbers of women are working. There is an urgent need for targeted interventions, supported by legal and policy reforms, designed to reduce the environmental risks of sex work in these settings.
Future research should seek to investigate sex work venues as risk environments, explore the role of different business models in mediating these environments, and identify and quantify exposure to risk in different occupational settings.
The literature suggests that brothel-based sex work may be safer than street-based sex work with lower HIV prevalence and higher consistent condom use documented among this group [ 1 , 2 ]. Concomitantly, several studies have shown that street-based female sex workers FSW may be more vulnerable to HIV and other sexually transmitted infections STI as they earn less from each customer, have sex with higher numbers of partners, and are more likely to use drugs [ 3 - 8 ].