Too Soon to Tell Success of Nationwide Condom Program

sihanoukville – Tears roll down Chan Srey’s face and her voice chokes up as she recalls the parents and five brothers and sisters she left behind in Phnom Penh to become a prostitute here.

The 22-year-old is too ashamed to tell her parents what she does for a living. But what she earns as a prostitute helps feed her family in the capital.

Although Chan Srey never went to school and cannot read, she is educated about the dangers of her profession. She knows she needs to stay healthy so she can keep earning money for her family.

“I absolutely ask my partners to wear a condom,” she said last week. “Otherwise, they could not have sex with me.”

Chan Srey is one of 484 government-known prostitutes in Siha­noukville who are part of a pilot condom-use program that the National AIDS Authority implemented in cooperation with the police a year ago.

Earlier this month, the government hailed the Sihanoukville “100 percent condom use” program as a success in curbing the surge in HIV/AIDS cases in Cambodia, and announced that the campaign would be rolled out nationally.

But whether the government can take credit for the Sihanouk­ville program and call it a success remains questionable, as several brothel owners, prostitutes and clients said they started using condoms when the product hit local stores in 1992-93, years before the government began its campaign.

Experts also said it’s too soon to tell whether the Sihanoukville program is working in reducing HIV/AIDS. “It’s a little early to claim success, certainly in terms of the program’s impact on HIV,” said Geoff Manthey, UNAIDS’ country program adviser.

Seng Tam, a 29-year-old motorcycle taxi driver in Sihanoukville, said he started using condoms around 1993 when they became available in stores. “I don’t care about the government program,” said Seng Tam, who added that sometimes he uses two or three condoms at once.

Sok Vannak, a brothel owner who employs six prostitutes in the Phnom Khieu area of Siha­nouk­ville, said the girls also started requiring condoms long be­fore the campaign began.

“They have used condoms since 1993, when condoms hit the stores, particularly when I heard that AIDS is a dangerous disease,” Sok Vannak said.

Although men sometimes offer to pay more money if a prostitute allows them to not use a condom, Sok Vannak said his employees still refuse.

Ly Kosal, a 26-year-old photographer who visits prostitutes of­ten, also said he uses condoms be­cause he does not want to die.

“Even if a girl gave me $1 million, I would not have sex without a condom,” he said.

Francesca Stuer, coun­t­ry director of the Family Health Institute, said it’s too early to tell if the Siha­nouk­ville program is working, since one year does not give an accurate picture of whether HIV transmission has decreased.

Still, Manthey and Stuer said the program is a good idea be­cause it involves prostitutes and local authorities in the process.

“There is greater awareness about HIV and commitment from local authorities,” Manthey said. “Anything that improves STD services is positive.”

Kim Sitha, the AIDS provincial officer in Sihanoukville, estimated that condom use at 99 brothels has increased from 50 percent to 80 percent since the beginning of the $10,000 program. And he estimates that the percentage of pros­titutes with HIV will drop from 57 percent in 1998 to about 50 percent this year.

Said Nean Chhivun, secretary general of the National AIDS Authority: “Although the rate of condom use is not what we wish, it’s not at 100 percent, the campaign has shown good results.”

To check whether prostitutes are using condoms, Chhay Noun, a deputy AIDS Authority official in Sihanoukville, said he hires men to go undercover and ask prostitutes whether they will have sex without a condom for more money. “If they don’t follow [the rules], we will shut down their brothel,” Chhay Noun said.

No brothels have yet been shut down because of violations of the program. Several brothels found not to be using condoms have so far only been given warnings.

But he said October is the last month that warnings will be is­sued before non-complying broth­­­els are shut down.

Dy Savorn, a Sihanoukville po­lice officer, said that could affect a dozen brothels if they continue to not use condoms.

All Sihanoukville prostitutes

al­so get their blood tested monthly to check for sexually transmitted diseases, Kim Sitha said.

Despite what he calls the program’s success, Kim Sitha

admits there are loopholes.

Prostitutes who work in places that are not regulated by the program don’t use condoms regularly, he said. Old­er prostitutes who don’t have many customers also may not use condoms as a way to attract customers. Those who have no owners or have mental problems may also fall through the cracks, he said.

Whatever its shortcomings, the pilot program has had an impact on many prostitutes such as 19-year-old Sok Lang.

“[Before] sometimes I used a condom and sometimes not, ac­cording to my client’s demand,” she said. Now, though, she considers condoms a matter of life and death.

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