Mobility and Migration: Female Commercial Sex Work and the HIV Epidemic in Northern Thailand
KATHERINE C. BOND, DAVID D. CELENTANO, SUNKANYA PHONSOPHAKUL, and CHAYAN VADDHANAPHUTI
The commercial sex industry in Thailand is of singular importance in the dynamics of HIV transmission. Ford and Koetsawang ( 1991) suggest that the sex industry developed significantly during the Vietnam war, and has been amplified recently by international tourism. The majority of female commercial sex worker (CSW) clients, especially outside of the tourist centres and Bangkok, are Thai men ( DaGrossa, 1989). Female CSWs in northern Thailand are predominately young women from agrarian backgrounds, recruited by agents, brothel owners, or friends, and generally have a short (under three years) duration of work in brothels, characterized by high mobility between establishments ( Ministry of Public Health, 1993). The rapid rise in HIV infection rates among brothel CSWs, and the common use of CSWs by ethnic Thai, northern Thai, Shan, and highland (Hmong, Lahu, Lisu, Akha, and Karen) men suggests that commercial sex exposure is a particularly high risk behaviour for the acquisition of HIV in Thailand. In Chiang Mai, a provincial capital in northern Thailand, an HIV infection rate of 44 per cent was detected in the first sentinel surveillance of brothel-based CSWs in June 1989. Subsequently, high incidence (over 10 per cent per month) was noted among female CSWs who were HIV-negative on the initial survey ( Siraprapasiriet al., 1991).
This chapter aims to provide recent evidence of social and economic factors underlying the spread and continuation of commercial sex work in northern Thailand, with an emphasis on social and spatial mobility. First, we review the epidemiology of HIV/AIDS in Thailand before discussing mobility and migration issues in the context of socioeconomic changes that are occurring in South- East Asia. Next, we address commercial sex as a pathway to economic mobility and the individual decisions and structural factors underlying entry into commercial sex work. Recruitment and procurement processes are presented. Finally, we trace the migratory paths of a small group of female sex workers in northern Thailand.