The use of condoms is far from standard practice among the city’s sex workers, research says

Prostitutes working at the low end of the market in Macau are more likely to have sex without insisting their customers wear condoms, research shows. They are often ignorant of the risks posed to their health.

A study by the Chinese University of Hong Kong in cooperation with the Macau Health Bureau found female sex workers in Macau were “very vulnerable” in the face of the refusal of customers to use condoms. When clients offer to pay a higher price for sex without a condom, they are more likely to accept, the study found.

The investigation focused on the health problems faced by non-resident female prostitutes in Macau in 2007 and 2008. Although already three years old, this research remains one of the few available studies about the city’s sex workers.

Researcher Susanne Choi Yuk Ping says the study used data from a survey of 491 female sex workers from Russia, Vietnam, Thailand and the mainland, all self-employed and working for the least return.

The survey found that sex workers from the mainland and Thailand were the most disadvantaged. On average, they were older, less educated, most likely to be from rural areas and more likely to be divorced.

Russian sex workers were mostly from urban areas, the youngest and best educated. Sex workers from Vietnam had the lowest levels of knowledge about sexual health in general and the need for condoms.

Among the most concerning findings, the study said customers that were unwilling to use condoms may use force to get their way. “Especially among Chinese female sex workers, there is an alarmingly high rate of violence perpetuated by clients,” Ms Choi says. “There is neither enough protection [for workers] nor health education [for customers].”

Mainland prostitutes typically enter Macau on two-week tourist visas, which do not allow them to work. They are afraid of reporting problems with customers to the police. In contrast, some of the sex workers – especially non-Chinese – employed by clubs or saunas have valid work permits.

“By having this dual system, the government, inadvertently, is putting the female sex workers from the mainland at a disadvantage,” Ms Choi says. “Russians, Thais and Vietnamese usually work in casinos, saunas and nightclubs, while the mainlanders work in small hostels, hotels and on the street.”

Dangerous delusion

Although sex workers in Macau have various cultural backgrounds, most maintain regular contact with their relatives, sending remittances frequently, the study found.

This year, the Association of Rehabilitation of Drug Abusers of Macau, in cooperation with the University of Macau, conducted another survey, on the health knowledge and behaviour of sex workers in the city.

Female prostitutes that work the streets and those that work in brothels were approached. All 85 respondents, ranging in age from 18 to 35, were from the mainland.

“We were not able to include in this study sex workers from other territories other than the mainland because they are in big hotel-casinos and we cannot reach them,” says assistant professor Joanne Chan Sow Hup.

One of the main findings of the survey is that mainland sex workers have little understanding of HIV or AIDS and that they revealed some misconceptions about how the virus is transmitted. For instance, they are unwilling to have a meal with a person with HIV and believe kissing and hugging will infect them. And 70 percent of the survey respondents believed AIDS could be cured with medicine.

The use of condoms was far from standard practice among the respondents.

“They have difficulties in using condoms, because the customers don’t want to,” assistant professor Chan says. Some may warn their colleagues about an uncooperative customer but others may accept money to have sex without a condom.

Considering that the respondents had, on average, 222 partners a month, and that more than half admitted they did not use condoms consistently, there are reasons for concern, assistant professor Chan stresses.

By Luciana Leitão