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Cambodia's Female Beer Promoters are HIV Health Risk

Cambodia's drinking culture sees groups of men head to beer gardens after work. Once there, women in uniforms advertising global brands try to persuade the men to drink their brand, but risks to the health of these women have some worried.

Across Cambodia about 4,000 women work as beer promoters in hundreds of beer halls. Their job is to persuade men to drink their brand of beer.

But a new report by Professor Ian Lubek of Canada's University of Guelph says the low wages beer promoters receive force many into sex work.

The beer promoters are paid between $80 and $110 a month by local distributors. A family in Cambodia needs about $200 a month to get by.

The report says 57 percent of beer promoters interviewed last year in the town of Siem Reap engaged in sex work.

Lubek says the sex work leads to a high HIV risk. He believes HIV-related infections are behind a death rate of nearly 10 percent among 900 beer promoters in Siem Reap during the past seven years.

Speaking on Skype, Lubek says the women's average age at death was just 25.

"We feel that it is an economically driven activity. It is quite shameful to them - they lose respect in their home villages. They cannot get married because they agree to sell sex. But they have no other way."

The government's National AIDS Authority says an ongoing challenge is responding to sex work that now takes place outside brothels, after a 2008 law outlawed prostitution. It says one-in-five beer promoters reported not using condoms in a three-month survey period.

The National Aids Authority says the HIV rate among the general population is 0.9 percent. No one knows the actual rate among beer promoters, but figures as high as 20 percent have been cited.

The country head of non-governmental aid organization CARE International, Sharon Wilkinson, says her group found less than one-third of beer promoters interviewed in Phnom Penh had sold sex - about half the rate Professor Lubek reported. But she says beer-gardens are a tough workplace.

"It is an environment in which sexual harassment, including physical abuse, is high."

Wilkinson says the best way to improve the women's position is to change the way Cambodian men view them.

"Women generally who are working in the entertainment industry in Cambodia - whether it is karaoke, massage parlors, in the beer promotion work - they are stigmatized by society. They are considered to be bad women."

In response to criticisms, the major brewers in 2006 established the Beer Selling Industry of Cambodia. The association's stated objective is to improve the working conditions of beer promoters.

Among other things, that includes making sure the women have clear work contracts, are provided with transport to and from work, have clear grievance procedures, receive suitable training, and are provided with culturally-appropriate uniforms.

The association also bans women drinking alcohol at work, but Lubek found that prohibition was ignored by 99 percent of the women in the Siem Reap study. Most of them said they were pressured by customers to drink.

Lubek says the big four brewers; Holland's Heineken, Danish brewer Carlsberg, Belgium's AB-InBev, and London-based SAB-Miller whose beer the women represent, must take more responsibility for the promoters - starting with doubling their salaries.

Lubek also wants the brewers to improve training on sexual health issues and provide anti-retroviral drugs to women who need them.

But the brewers say the women do not work for them, they are employed by local distributors. All four brewers contacted for this story insist their beer promoters receive adequate wages and get good training.

The brewers say anti-retroviral drugs should be provided by health clinics - a stance with which Wilkinson at CARE agrees.