Survey of Rape of Sex Workers in Cambodia

Submitted by: Alternate Visions, Bangkok, Thailand

Input for: Expert Group Meeting: "Violence Against Women: A statistical overview, challenges and gaps in data collection and methodology and approaches for overcoming them," 11-14 April 2005, Geneva, Switzerland

Topic: Sex Work and Violence Against Women

In 2004, Cambodian sex workers had the opportunity to select a topic and conduct research on it, in order to improve policy that affects their lives and working conditions. As the Principal Investigator, I never set the topic or methods in advance but first discussed the possibilities with the two best organized groups of sex workers in the country, Women's Network for Unity (WNU) and the Cambodian Prostitutes Union (CPU). In early 2004, we met in two separate groups and I presented them with the opportunity by simply stating that there were funds designated for research and advocacy among sex workers and if they were interested, I could help them design a piece of research, train them to do it and help them in disseminating the results. Each group was quite enthusiastic and without hesitation prioritized violence, including sexual violence, from various types of men as the single greatest bane in their lives. I remember saying to WNU folks, "You know, if we do a truly representative sample and the frequency is not high, there will be little to advocate with." They all gave me a strong look, and said essentially, don't worry, the frequency is very, very high. As a researcher, one is always concerned with ad hoc frequency estimates made by individuals, because, after all, any single person only has a narrow view of the whole social scenario. How could he or she really know? So be it for my own naiveté.

I decided we would try the relatively new method called respondent-driven sampling (RDS), also sometimes known as chain referral sampling. I had attended a workshop that did some training on this method and had watched as a friend tried it in Myanmar. It wasn't without difficulties, but had enormous potential for reaching people who ordinarily would hide from researchers. I felt that, since sex workers were themselves going to do this research, the respondents and the researchers were of the same social group and therefore this method was eminently suitable to research in which they were the primary participants at all levels. I also felt that, since the RDS statistical software only made single factor estimates of proportions (with 95 per cent confidence intervals) available, the results would be shallow without a deeper understanding of the context in which this violence took place. So we decided that every 5th person would be asked to give an in-depth interview about the violence they experienced that would be taped, translated and transcribed for analysis. As we discussed the methodology, the sex workers also agreed that it would be a good idea to interview policemen, as they were one of the major perpetrators of violence against them. We discussed the possibility of finding ex-policemen who they knew and trusted to understand the issues and before long three men emerged who were recruited by people from WNU.

My own experience working on the issue of violence against sex workers was limited and so it was hard for me to decide the sample size needed based on the only comparable data base available. I decided we would separate the brothel women from the freelancers (who worked from various entertainment venues, locations such as train stations, parks and streets, but without contracted obligations to another party as in the brothels) and aim for 500 from each group, and arbitrarily, 60 interviews of active policemen, 20 from each ex-policemen interviewer. The latter was a convenience sample. The sex workers decided that srey sraos or transgender sex workers who worked from the same locations as did the freelance women and were subject to the same exposure to violence, would be included. The seeds for the RDS sampling method were also to serve as the interviewers. However, some of them turned out to be illiterate, so we decided they would be the qualitative interviewers and we would devise an interview schedule that used pictures to remind them of the topic of the question.

A one-week training for each group covered the nature and value of sex worker empowerment, the RDS method, research ethics, the development and testing of the questionnaires, and qualitative interviewing. Needless to say, I learned a great deal from training them and tried to incorporate what I learned into the whole protocol. In the end the worst problems we had was with the translator, who failed to include an altered question (on drug use) in one questionnaire, and with the data entry process which had to be repeated by myself and another helper. The sex workers and the ex-policemen were extraordinary as recruiters and interviewers, given the little training they actually were given. We reached a sample of 1000 sex workers, plus 145 in-depth interviews and 60 of police (actually 58 of police and two of gangsters) in two months. There was a shortfall on brothel women's in-depth interviews due to their difficulties in staying away from the brothels for long periods of time. All interviews were done in totally private, air-conditioned rooms rented in a guesthouse and of course, anyone could stop if it got too hard for them, which happened several times. Violence, including sexual violence against the self, is hard to recall and discuss and some women simply cried too much to continue. In terms of the networks they had, a number of women said they had very small networks left as so many of their friends had already died of AIDS. However, the refusal rates (when offered coupons for recruitment) were low (about five per cent) and the majority of sex workers opened their souls to the sex worker interviewers and told just how horribly they had been treated by brothel owners, police, gangsters, clients and sweethearts.

The results were stunning. Most studies of violence claim that the results are probably under-reported. In this study 97 per cent of sex workers reported being raped by someone in the past year, somewhat more often by clients and gangsters than police, and more often among the brothel women when they left the brothel with a Œclient' than among others. The data from police completely corroborated what sex workers had to say and showed that, while HIV prevention programs may have helped them demand condom use, they are still unable to demand their legal and human rights.

Submitted by:

• Alternate Visions
  Bangkok, Thailand
  Tel: (662) 655-0732
  Email: hagahai@yahoo.com