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Cambodia has an estimated population of 37,000 sex workers, 14.7 percent of whom are living with HIV and AIDs. Despite national initiatives to suppress sexual exploitation, policies criminalizing sex work have instead led to an inequitable access to healthcare services amongst other human rights violations.

At an international level, the Universal Declaration of Health Rights and other conventions prohibit discrimination against all people, including sex workers. Cambodia’s government has ratified numerous international human rights treaties and has recognized these international treaties in 1993 under Article 31 of the Cambodian constitution with provisions prohibiting exploitation of women adopted in Article 46 and equal employment rights in Article 36. However, the Cambodia government ratified numerous major international human rights treaties after the enactment of its civil laws, some of which remain noncompliant with Cambodia’s international human rights obligations.

In 2008, Cambodia’s Law on the Suppression of Human Trafficking and Sexual Exploitation (“Trafficking Law”) criminalized most areas of the sex work industry. Concurrently, the corresponding Police Guideline on the Implementation of the Law on Suppression of Human Trafficking and Sexual Exploitation specifically negated the criminalization of sex workers. Despite efforts to create a legal framework preventing sexual exploitation and human trafficking, the result of the Trafficking Law drove much of the sex industry further underground to less regulated environments. The legacy of the Trafficking Law has also been marred with human rights violations including reported police extortion, demands for bribes, arbitrary detention, violation of due process rights, physical violence, rape, sexual harassment, forced labor, extortion, confiscation of belongings, and ill treatment.

Foreshadowing the decrease in health access, Article 25 of the Trafficking Law equated the act of procuring prostitution to “hindering the act of prevention, assistance or re-education undertaken either by a public agency or by a competent private organization for the benefit of persons engaging in prostitution or being in danger of prostitution.”  Following the Trafficking Law, the number of sex workers seeking health services and communication with NGO outreach entities declined. This apprehension also affected sex workers’ access to health information, Antiretroviral Therapy (ARV), and condoms.

Other government initiatives have exacerbated healthcare access limitations for sex workers. The National HIV/ AIDS Strategic Plan 2011-2015 revised Prakas 006, the former 100 percent condom use policy, in hopes of increasing the condom use of sex workers in non-brothel establishments. Although a directive from the Ministry of Interior in 2011 prohibited utilization of condoms as evidence for arrest, police continued to use condoms as evidence of sex workers in entertainment establishments. The criminalization shifted the industry to unregulated environments, limiting sex workers’ negotiation power in condom use and increasing their exposure to violence.

Furthermore, forced detention of sex workers also can restrict access to health therapies. With the intention to clean-up the city, law enforcement has continued to unlawfully arrest and detain sex workers and other marginalized populations in social rehabilitation centers like Prey Speu. Most recently, law enforcement detained 440 sex workers in Phnom Penh in preparation for the 2012 ASEAN summit. During unlawful detention, sex workers can be restricted from accessing ARV therapies and healthcare services for sustained periods of time.

Efforts at the commune level have also challenged healthcare access for sex workers. In 2011, the Sangkat Commune Safety Policy intended to promote commune safety by targeting drug crimes, prostitution, child trafficking, and other crimes. As a result, the policy further limited the ability for health outreach agents to deliver HIV prevention services and needle programs to at-risk populations including syringe drug users, who were targeted by law enforcement. International agencies in collaboration with the local government have made efforts since to implement law enforcement education programs and other partnership initiatives.

While the intention of policies has been to reduce the sex work industry, laws and law enforcement practices have disrupted HIV prevention efforts and access to basic healthcare services. Policies in Cambodia have shown that the criminalization of sex work, condom policies, and law enforcement practices including rehabilitation or detention do not always have the intended effects in reducing the sex work industry but instead rob already vulnerable populations of access to health resources and protection. International agencies aim to provide legal support, medical care, and other outreach services.  However, the effects of the Trafficking Law and other policies underscore a need for further legal services for sex workers to specifically mitigate the threats of arbitrary detention and violence.