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Estimating the number of sex workers in Malaysia

December 31, 2009 World Health Organization

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World Health Organisation Malaysia

Dr. Sabitha Marican 2 Dr. Mahmood Nazar Mohamed

Associate Professor, Public Administration and Social Policy, Faculty of Public Administration and Law, Universiti Utara Malaysia, 06010, Sintok, Kedah, Malaysia_ sabithaum@gmail_com

Professor of Psychology, Faculty of Human and Social Development, Universiti Utara Malaysia, 06010, Sintok, Kedah, Malaysia_ mahmoodnazar@yahoo_com

Estimating the number of Sex Workers in Malaysia By: Dr. Sabitha Marican Dr. Mahmood Nazar Mohamed

Publisher: Era Visi Sdn. Bhd. 2009 This publication is made possivle with technical and financial assistance from World Health Organization Representatives Office for Brunei Darussalam, Malaysia and Singapore.

Perpustakaan Negara Malaysia

Cataloguing-in-Publication Data

Marican, Sabitha Estimating the number of sex workers in Malaysia I Sabitha Marican, Mahmood Nazar Mohamed. ISBN 978-983-2576-93-8 1. Prostitution--Research--Malaysia. 2. Sex oriented business-Research--Malaysia. I. Mahmood Nazar Mohamed II. Title 363.440720595

Printers: Era Visi Sdn Bhd NO.4 - 6A, Jalan Jujur 2, Bandar Tun Razak 56000 Cheras, Kuala Lumpur. Tel: +60391731916, +60391737691 Fax: +6039173 3510 Email: eravisi@yahoo.~om.info@eravisi.com.my Website: www.eravisi.com.my

FOREWORD I am very pleased that this WHO-funded study "Estimation of Sex Workers in Malaysia" has been completed. Since 2004, it has been noted that there has been increasing trends in sexual transmission of HIV / AIDS in Malaysia. However. there were less data and information which could thoroughly explain the epidemiological changes. According to studies from other countries, there is strong evidence linking sex workers and HIV / AIDS epidemic. Therefore, it is very important to do more studies on sex workers, their risk behaviors, and what roles this high risk group may have been playing in the increasing trends of sexual transmission of HIV / AIDS in Malaysia. The purpose of this study is to estimate the number of sex workers, and identify the risk of HIV / AIDS among this subpopulation in Malaysia. Meanwhile the study will also provide some demographic information pertaining to the respondents, their knowledge towards HIV / AIDS, safe practices and their behaviours that put them at risk to contract HIV / AIDS. Estimating the numbers of sex workers is a difficult and tedious process. I highly appreciate the excellent work done by Dr Sabitha Marican, Dr Mahmood Nazar Mohamed and their team, for the support and coordination given by the Disease Control Division Ministry of Health, Malaysia. With the results of the study and the evidences to be produced by future researches in this area, effective intervention strategies and programmes could be developed to reduce the spread of disease among this most-at-rj,sk pOr:;lulation (MARPs), and stop and reverse the increasing tr.;;nd of sexual transmission of HIV / AIDS in Malaysia.

Dr Han Tieru WHO Representative for Brunei Darussalam, Malaysia and Singapore

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ACKNOWLEDGEMENTS

The research team wishes to express their gratitude and appreciation to the following organizations, personnel and individuals for their support, assistance, motivation and contribution towards the successful completion of this project: i. Westem Pacific Region Office of the World Health Organization for its technical and financial assistance, specifically Dr Han Tieru, Dr Venugopal, Puan Normah Mahmood and staffs of WHO office in Kuala Lumpur: The Malaysian Ministry of Health for the management of research funds; Dato' Dr Nordin Kardi. ViceChancellor, Universiti Utara Malaysia for his continuous encouragement and support; Dean, Faculty of Law and Public Management. Universiti Utara Malaysia; Dean, Faculty of Human and Social Development, Universiti Utara Malaysia: ASP Noraini Saad, Department. PDRM; Field enumerators: Anti-Vice

ii.

iii.

iv.

vi.

vii.

viii. ix. x.

Research assistants; Other support staffs; All key informants and govemment agencies involved in the study; All NGOs involved in the study; Respondents - FSW, MSW and TSW. All those directly or indirectly involved with this project.

xi. xii. xiii.

Thank you.

Sabitha Marican. Ph.D Mahmood Nazar Mohamed. Ph.D 20th December. 2006

ABSTRACT

There is strong evidence linking sex workers and HIV / AIDS epidemic, and effective intervention strategies and programs have been proven to reduce the spread of disease among this specific population. It is to this concern that countries should have an estimate of the number of sex workers so as to plan and execute proper prevention measures to address to the spread of the disease. Nevertheless, estimating sex workers is a difficult and tedious process because there are little information produced by the official statistics in any country. Often these statistics are cases which were prosecuted by the authorities and it only represent the tip of the iceberg of the actual number existing and operating in a specific country. For female sex workers, most estimates are either restricted to commercial sex establishments or guesstimates by the authorities or NGOs. Estimates for male and transsexuals are deemed to be more difficult. This is because prostitution and those involved in the sex industry is hard to measure for a variety of reasons, among which are methodological constraints such as restricted approaches to data collection, accessibility to the population especially when pimps protect their employees, territories and operational areas from unnecessary intrusions. Although the definition of sex workers is wide, for practical purposes, in this study it will be limited by scope and definition to male, female and transgender individuals, which include local and foreigners who actively choose to exchange sexual services for money or payment in kind within the geographical boundaries of Malaysia. The purpose of this study is to estimate the number of sex workers, thus identifying the risk of HIV / AIDS among this subpopulatioA in Malaysia. In addition, the study will also ascertain some demographic information pertaining to the respondents, their knowledge towards HIV/AIDS, safe practices and their behaviors that put them at risk to contract HIV / AIDS. For the estimation exercise, the multiplier method is used for female

sex workers and nomination and estimates for MSW and TSW sub-population. A total of 253 respondents were interviewed by trained field enumerators who have had prior experience with the industry, comprising of 32 male sex workers (MSW 12.6%), 63 transsexual sex workers (TSW 24.9%) and 156 female sex workers (FSW 62.5%). Most of them are married (n=102; 40.3%) as opposed to 40 (15.8%) single respondents. A total of 94 persons (37.2%) have children ranging from 1 (40.9%),2 (41.9%) to 5 (3.2%). Most of the respondents are Malay (n=137; 54.6%), followed by foreigners (n=75; 29.9%), Chinese (n=24; 9.6%) and Indians (n=11O; 5.9%). They started work at an early age of 15-20 years (n=80; 34%) and 21-25 years (n=110; 43.5%). The estimated numbers of FSW in Malaysia is between 9,754 and 19,674. with an average of 15,019. States with most significant numbers of FSW are Pulau Pinang (780 - 2,925), Selangor (1,827 -2,778), Perak (780- 1.776), Kuala Lumpur FT (1.556 - 2,778), Johor (1,394 - 2,875), Sabah (1,147 - 2,646) and Sarawak (816 - 1,200). The range of the multiplier for Malaysia is 1.53 - 3.00 and with a multiplier of 3.0, there is an estimated of about 20,000 female sex workers in Malaysia for 2005. For MSW and TSW sub-population, the highest estimates are from the states of Selangor (148-330), Perak (163-306), Kuala Lumpur (135-292) and Johor (142-258), while the lowest estimate is from Perlis (11-18). For Malaysia, the estimated for MSW and TSW is between 975 and 2033 with an average of 1,398. Total estimate of sex workers for 2005 is 22,000 or 0.83 per 1000 population. Several risk behaviors pertaining to safe sex and substance use were also discussed.

vii

CONTENTS

Acknowledgements Abstract Contents List of Tables Abbreviations

iv vi vii vi vii 1

1.0

Introduction Defining sex workers Economic significance The rational and objective of the study Sex industry and HIV / AIDS Estimating the numbers of sex workers Sex workers in Malaysia Laws pertaining to prostitution and sex workers in Malaysia Objective of Study Methodology Method of estimation Multiplier method Nomination method Results Estimation of female sex worker Estimation Of male and transsexual sex worker Profile of re~pondent Risk behavior and safe practices Discussions

1 4

2.0

6 7 9

12 22 23 23 24 26 27 27 30 33 34 36 39 42 44

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4.0

5.0

References

Appendix I Appendix II

viii

LIST OF TABLE

Foreign sex workers prosecuted in Malaysia for 2005

Foreign, local and girls under the age of 18 years Identified os SW in 2005

List of key informants to the estimation of female sex worker

Multipliers and estimation of female sex worker by state in Malaysia for 2005

28/29

Estimates of MSW and TSW by state in Malaysia for 2005 31/32

ABBREVIATION

AIDS EUROPAP

Acquired Immunodeficiency Syndrome European network for prevention of HIV-STD in Prostitution

FSW HIV

Female Sex Workers Human Immunodeficiency Virus

IDU ILO

Injecting drug users International Labor Organization

MSW NGO PDRM RDU STI

- Male Sex Workers Non Governmental Organizations -

Royal Malaysian Police Recovering drug users Sexually Transmitted Infections

SW TSW

- Sex Workers -

Transsexual Sex Workers

1.0

Introduction

The sex industry, although a significant economic sector in many countries, is also generally illegal. Some countries provide a multitude of assistance and aid to sex workers mostly through civil societies and NGOs for the purpose of fulfilling their health, well-being and safety, and more importantly to curb the spread of communicable diseases such as STDs and AIDS. Some countries instituted laws against the industry and labeling it as a social or moral problem. Strict consequences and penalties are imposed to the sex workers, some provide rehabilitation whicr ;, usually social or spiritual- based. It is a known fact that sex workers have been among the most vulnerable groups to diseases and due to the nature of their profession, they have also been the most neglected. Stigma and discrimination, criminalization, limited access to health services and information, as well as exploitation and violence, exacerbate this vulnerability (Currier, 2003). It is to this concern that it has attracted many scientists to study and provide some solutions to the present predicament.

Defining Sex Workers Sexual transactions involving money happen in all forms and in a variety of settings i.e. in brothels, bars, beauty saloons, massage parlors, hotels, karaoke spots, restaurants, backstreets and even cinemas. The line between paid and unpaid sex can be very blur as there are many avenues for such transaction ranging from hard cash to expensive presents for partners. As_ such, in many countries that require a definitive transaction for sexual service rendered in order to charge sex workers under its legal system may prove to be difficult to implement. Therefore there exist a huge gap in numbers between sex workers who

were prosecuted by law and those who actually provide illicit services to customers in a given country. As a result, only a few countries have any real idea of the accurate number of sex workers within their boundaries. There are various terms and definitions used for sex workers. First, the term 'prostitute' is generally considered to refer to a woman over the age of consent who willingly exchanges sexual services for money. Also, all forms of engagement in the sex industry, like lap dancer, a pornographic actor(ess), or a 'call girl' equal prostitution (Barry 1995). 'Prostitute' is a term those who work within the sex industry are seeking to move away from, arguing it is associated with the concept of a dirty woman (whore, slut, etc.), whereas 'sex worker' identifies someone who is a member of a legitimate profession (McKegancy & Bemard, 1996). "The term 'sex worker' was coined by sex workers themselves to redefine commercial sex, not as the social or psychological characteristic of a class of women, but as an income-generating activity or form of employment for women and men (Lynne, 1998). Similarly, use of the term 'sex industry', was aimed at inclusion of exotic dancers, masseurs, telephone sex operators, receptionists (maids) and a whole host of people (including men) who sell sex (Alexander, 1996). Both ofthese terms, sex workers and sexi ndustry have gained increasing credence since the 1970s, better acknowledging the active, willful. moral, reflexive and insightful agency of sex workers and recognizing that the prostitute is socially situated in a culture that includes a range of other actors. Hence 'sex worker' refers to the group of people, female, transgender, male, under-age, immigrant, native, etc who actively choose to exchange sexual services for money or payment in kind (Lin, 1998a; 1998b; Ng, 2004). 'Pimp' is often used as synonym for anyone who lives off the earnings of prostitution. In some countries this extends to a prostitute's landlord, partner, cohabiter, or even parents though generally a pimp is someone who offers protection and business

to prostitutes in exchange for a sum of money or a proportion of her/his earnings. In cases of forced prostitution, pimp is also the name given the prostitute's exploiter. There is a confusion of terms as the owner/manager of a brothel fits the description of a pimp, whilst often receiving different treatment from law enforcers, particularly where prostitution is criminalized but tolerated. According to Barry (1995), 80 to 95 per cent of all prostitution is pimp-controlled. There is also forced prostitution which refers to the process of coercing women, men, children to exchange sexual services for money or other payment against their will. Individuals can be threatened with violence and/or sexual abuse, falsely imprisoned, held through debt-bondage, or in other ways coerced; The 'owner', exploiter or 'pimp' will sometimes split the revenue from the sexual act with the prostitute, sometimes simply offer the prostituted individual a minimum pay by which to live (Hoigard & Finstad, 1992). In this situation and many others, the individual often do not choose prostitution, but the choice is exerted on to them. The decision was impaired by social factors, poverty and history of violence or abuse. As such, one can also view that all sex work is forced prostitution to some degree, either by an individual (or group of individuals) or by personal or social circumstances (Barry, 1995; Bell, 1994; Harlan, Rodgers & Slattery, 1981; Hunter, 1994; Son, 1998; Silbert & Pine, 1982; 1983; 1984). Male prostitution, as female prostitution, is not necessarily voluntary, forced, underage or dominated by migrates. Male prostitutes and call boys, as transgender prostitutes, often face even more severe stigmatization than females, affecting quality of health services provided them and increasing the isolation of an already socially marginalized group (McKinnon, 1993). In this context. transgender prostitution are males who have had a sex change feel that selling themselves as females is a test on their credibility as a woman (Hoigard & Finstad, 1992; Jeffery, 1997; Harlan et al. 1981).

Child prostitutes are prostitute who is under the age of consent. although this can vary from country to country. Child prostitution and pedophilia is a very serious and extraditable offence, however has been a popular sector in the sex industry in many countries due to its increasing demands for such services (Hunter, 1994; Bagley & Young, 1987). In this study, sex workers will be limited by scope and definition to male, female and transgender individuals, which include local and foreigners who actively choose to exchange sexual services for money or payment in kind.

Economic Significance The existence of the sex industry in any state is very much fueled by economic reasons. It is also difficult for any state to legalize this industry because there are on-going debates on the pros and cons which is presented from a plethora of sources, of which much of it were fueled by moral and religious considerations. The ILO Report (1998) contends that govemment recognition of this economic sector would improve the lives of between 800,000 and one million people who are paid for sexual services in the four countries of the study: Indonesia, Malaysia, the Philippines and Thailand. This report estimates that 0.25- 1.5% of the total female population of the region is engaged in prostitution and, furthermore, that each sex job creates approximately seven other jobs. Among the millions of other workers implicated in the sex sector are business owners and managers, mamasans, pimps and procurers, cleaners, waiters, cashiers, parking valets, security guards, vendors of food, tobacco, liquor, cosmetics and clothing, stylists, property owners, travel agencies, taxi and hotel room services and even white-collar professionals such as lawyers and accountants. Earnings in the sex sector are higher relative to earnings in other types of unskilled employment. In manufacturing, for instance, average wages per annum in 1990 were US$2,852 for

skilled workers and US$l ,711 per annum for unskilled workers. In comparison. a part-time sex worker in the cheapest of hotels who received US$4 per client. seeing about ten clients daily and working only once a week for about 12 hours, earned US$2.080 per annum. As such. the sex business has assumed the dimensions of an industry and has directly or indirectly contributed in no small measure to employment. national income and economic growth. The ILO Report (1998) estimates that the sector accounts for 2-14% of the Gross Domestic Product in the Southeast Asia region. The sex sector experienced amazing increase during recent boom times. and is thus not the product of economic crisis. The volume of transfer payments alone. i.e. money sent to rural families by urban sex workers. sometimes exceeds government spending on development programs. Thai women sex workers in the cities remit nearly 300 million U.S. dollars annually to families in rural areas. In Thailand. prostitution produced between 22.5 and 27 billion dollars income from 1993 to 1995. In Indonesia. where there are brothel complexes tolerated by officials. the yearly income produced by the sex sector ranges from 1.2 to 3.3 billion dollars a year. This accounts for between 0.8 and 2.4 per cent of the country's GDP (ILO. 1998).

2.0

Rational and objective of the study

Sex industry and HIV / AIDS In 2005, a total of 38.6 million people (high-low estimates are 33.4 to 46.0 million) are estimated to be living with HIV / AIDS as compared to 36.2 million in 2003 (UNAIDS, 2006). The AIDS epidemic in Asia is also expanding rapidly. This is most evident with sharp increases in HIV infections in China, Indonesia and Viet Nam (UNAIDS, 2004). An estimated 7.4 million people are living with HIV in the region and 1.1 million people became newly infected last year alone - more than any year before. Home to 60% of the world's population, the fast-growing Asian epidemic has huge implications globally (UNAIDS 2004 Report on the Global AIDS Epidemic). In Asia, the AIDS epidemic remains largely concentrated among injecting drug users, men who have sex with men, sex workers, clients of sex workers and their immediate sexual partners. Effective prevention coverage in these groups is inadequate, partly because of stigma and discrimination. UNAIDS reported that some Asian countries such as Thailand and Cambodia, which have chosen to tackle openly highrisk behavior, such as sex work, have been more successful in fighting the spread of HIV as shown by the reduction in infection rates among sex workers (UNAIDS 2004). Commercial sex presents far higher risks than casual sex simply because the numbers involved are far higher (Lin, 1998a). A man who has several girlfriends a year is in a far lower risk bracket than a man who regularly visits a sex worker, who herself may have had 50 clients in just one week. Two factors are said to be very important in AIDS epidemics associated with sex workers are the numbers of clients per sex worker (in a day or week) and the frequency of men visiting sex workers. The first

determines how intense (if at all) the initial burst of new infections among sex workers and clients will be. The second determines how widely HIV will spread in the general population (Currier, 2003). In Thailand and Cambodia, before the AIDS epidemics, sex workers had several times more clients on average than in Indonesia and the Philippines. Similarly, more men were frequenting sex workers, Of course, other factors also influence the epidemic, such as condom use and treatment of Sexually Transmitted Infections (STls). However, the greatest risks come not from sex workers but from the unsafe conditions they work in. Undoubtedly, the most dangerous venues are the cheap brothels where the women work long hours and have little say about their partners or condom use. By contrast, part-time sex workers working in karaoke bars, night clubs and social lounges that have more freedom of choice will usually be more in control (Lin, 1998b). Sharing of needles among injecting drug users, given its high efficacy for HIV transmission, has also played a significant role early in the epidemics, particularly in the Golden Triangle region (from Thailand and Vietnam, across southern China, to Myanmar, to Manipur) and in Malaysia. As the epidemics mature, transmission from sex worker clients and IDUs to their wives or girlfriends becomes the most important route of female infection, although this transmission occurs at slower rates than that between sex worker and client (Lin, 1998b).

Estimating the numbers of sex workers Most estimates of the numbers of female sex workers are either restricted to licensed commercial sex establishments or ad hoc "guesstimates". Prostitution and those involved in the sex industry is hard to measure for a variety of reasons such as methods and approach to data collection and accessibility to the population. Pimps often protect their employees, territories and operational areas by employing violent methods to veer of unwanted intrusions to their businesses. As such gathering data

by survey and interviews instruments are often met with extreme difficulties In addition, the authorities will usually base their figures on arrests or prosecutions. This is very much dependent on law enforcement priorities and practices which vary from city to city and country to country. Whilst NGOs working with sex workers may provide completely different estimates, mostly based on field experiences and those estimates given by sex workers themselves. In some northern European countries, the ratio of prostitutes per 1,000 population is between 1 and 2, though in neighboring countries the level can be a tenth of that. This example shows that such variance can depend on population distribution (large cities typically have more prostitutes) and the local nature of demand and social acceptability of prostitution, though action being taken by law enforcers in any given moment in time also plays a role, particularly where the country in question is small and has land borders (as with luxembourg). In Holland and Sweden and Germany, it was estimated that 50% of prostitutes are local, the remainder being migrants, many of whom move between European countries. In Italy, the figure is reported to be substantially higher, whilst in the UK (outside of london) migrants allegedly make up a minority of sex industry workers. EUROPAP (European network for prevention of HIV-STI in prostitution) regional report compiled statistics showing current (and changing) estimates of numbers of prostitutes in the EU member states. For some countries like France, Ireland, Portugal and Spain, although sex industry is present, EUROPAP do not provide the numbers or the estimates. For others, it ranges from 300 in luxembourg with a population of 450,000 to 300,000 sex workers in Germany with a population of 80 million. In Asia, the International labor Organization (llO) estimates made in 1993-94 suggest that there were between 140,000 to 230,000 prostitutes in Indonesia. In Malaysia, the estimated

figures for working prostitutes range from 43,000 to 142,000. In the Philippines, estimates range from 100,000 to 600,000, but the likelihood is that there are nearly half a million prostitutes in the country. In Thailand, the Ministry of Public Health survey recorded 65,000 prostitutes in 1997, but unofficial sources put the figure between 200,000 and 300,000. There are also tens of thousands of Thai and Filipino prostitutes working in other countries. The prostitutes are mainly women, but there are also male, transvestite and child prostitutes (ILO, 1998).

Sex workers in Malaysia The Anti-Vice Department (07) of the Royal Malaysian Police (PDRM) is the agency which is responsible for the cumulative statistics on sex workers in the country, which includes data from Welfare and Social Services, Religious Department and Immigration Department. However, this statistic is limited to those prosecuted under the present legal system. According to Noraini Saad (2005) most of the sex workers detained and arrested by PDRM are of foreign nationalities, those who enter the country legally or by illegal means. Most of them are charged under the immigration Act such as overstay and do not possess a valid entry visa. Statistics for the past 5 years (2000 - July 2005) indicated that the most arrested are from Indonesia (11,932), China (6,985), Philippines (5,196), Vietnam (1,695), Uzbekistan (499), Kampuchea (459), India (186), Russia (33), Myanmar (52), Laos (10) and other states (63). In 2000, there are 3,607 arrested, 4,132 in 2001: 5,147 in 2002, 5,878 in 2003, 5,783 in 2004 and 3,347 arrested up to July 2005, making it a total of 27,896 arrests. However, in 2005, there were more Chinese nationals (2,824) who were detained and identified as involved in the sex industry, followed by Indonesian (1,606), Thailand (910), Philippines (742) Vietnam (204) and others as reflected in Table 1.

,;, '0''U-.;~,.,.;n""''''i.i",,'i :"Y"';'U"'b"'_/.i...,~·.,;.. al("I*;4lO.. ~iA,:',";;, • '.!.I.'.'.',/,; ' '" ' C" "'!"~"''':;;'''ll''~~,!::~,:~ ..'",~>"",< ,1"f ~- "'~~"~'''''''g:>,'~''I''''''''~:I!li'lf ,: ~sexW'ofMUl.:tDO$,,/, ',",' China 2824 Ii' Indonesia 1606 Thailand 910 Philippines 742 Vietnam 204 Uzbekistan 71 I' India 50 --~----------4---------------~------------~: Kampuchea 39 Myanmar 29 Russia 1 Laos ~ Others 5 """, Source: PDRM, 2006

Table 1: Foreign sex workers prosecuted in Malaysia for 2005 According to statistics provided by the Police statistics, local sex workers represent a small fraction of the total arrest cases, The relatively small numbers of local sex workers prosecuted in Malaysia is because it is difficult to charge them under any existing Act, In 2001, there are 495 arrests, 353 in 2002, 257 in 2003 and 150 in 2004. The drop in number of arrest is because in 2004, those under the age of 18 are charged under the Women and Girls Act. In 2004, the local sex workers were mostly from the states of Penang, Perak, Melaka and Sarawak, This number increased to 384 for 2005 and two states, Kuala Lumpur and Selangor which top the statistics with 128 and 104 consecutively (Table 2),

Table 2: Foreign, local and girls under the age of 18 years identified as SW in 2005 Ng (2004) argued that possibly the category of workers that has been most neglected by the local labor and women's movements are those involved in prostitution. As it stands local women in the sex sector are already poorly protected, with harassment and raids of brothels being a common occurrence. In the age of HIVjAIDS, they are unprotected from this pandemic unless they are aware of the repercussions and are, at the same time, able to convince their clients to practice safe sex. While current laws do little to protect local sex workers, Ng (2004) pointed that the plight of foreign women in prostitution is infinitely worse. Apart from suffering similar problems as their local counterparts, a number of women are victims of trafficking syndicates as news reports indicate. Many are tricked into coming

to Malaysia, where upon arrival, their chances of escape are slim because syndicate operators keep their passports and other personal documents and threaten them with police action, Ng also stated that the public perception of foreign sex workers is, however, very different to this reality, In Malaysia, there are recorded HIV infections among female sex workers, and the rates have gone from 0,3 per cent in 1989 to 1 per cent in 1994, A behavioral study conducted nationwide in 1992 found that almost one in three sexually active men and one in ten married men reported having had casual sexual contact in the previous month, Reported condom use in commercial sex is low, This implies serious potential for heterosexual transmission, The rapid growth in prevalence in IDUs and sex workers in Malaysia in the last three years is similar to that seen in Thailand and Myanmar in the early stages of their epidemics (www,who-sw\r-4vanasia,htm),

Laws pertaining to prostitution and sex workers in Malaysia To date no cases has been brought against sex workers or prostitutes in Malaysia, due to the simple reason that there is no proof. The cases that was charged in court are related to individuals who have been caught as what in lay men's term as pimp or using their premises for the purpose of prostitution, There are certain laws that are used to prosecute sex workers in Malaysia; the first one is ACT 574: PENAL CODE, speci~cally CHAPTER XVI, OFFENCES AFFECTING THE HUMAN BODY, There are cases of individuals who have been caught for exploiting any person for purposes of prostitution or normally called as pimps, The acts under the law are as follows, 372, Exploiting any person for purposes of prostitution

(1) Whoever(a) sells, lets for hire or otherwise disposes of, or procures, buys or hires or otherwise obtains possession of, any

person with such intention that the person is to be employed or used for the purpose of prostitution or of having sexual intercourse with any other person, either within or outside Malaysia, or knowing or having reason to believe that the person will be so employed or used; Ib) by or under any false pretence, false representation, or fraudulent or deceitful means made or used, either within or outside Malaysia, brings or assists in bringing into, or takes out or assists in taking out of, Malaysia, any person with such intention that the person is to be employed or used for the purpose of prostitution or of having sexual intercourse with any other person, either within or outside Malaysia, or knowing or having reason to believe that the person will be so employed or used; receives or harbors any person -

Ic)

Ii)

who has been sold, let for hire or otherwise disposed of, or who has been procured, purchased, hired or otherwise obtained possession of in the circumstances as set out in paragraph (a); or who has been brought into or taken out of Malaysia in the circumstances as set out in paragraph (b), knowing or having reason to believe that the person is to be employed or used for the purpose of prostitution or of having sexual intercourse with any other person, either within or outside Malaysia, and with intent to aid such purpose;

(ii)

(d)

wrongfully restrains any person in any place with such intention that the person will be used or employed for the purpose of prostitution or of having sexual intercourse with any other person;

(e)

by means of any advertisement or other notice published in any manner or displayed in any place for prostitution service or a service which a reasonable person would understand it to be a prostitution service, offers any person for the purpose of prostitution or seeks information for that purpose or accepts such advertisement or notice for publication or display; acts as an intermediary on behalf of another or exercises control or infiuence over the movements of another in such a manner as to show that the person is aiding or abetting or controlling the prostitution of that other, shall be punished with imprisonment for a term which may extend to fifteen years and with whipping, and shall also be liable to fine.

(f)

(2) For the purpose of paragraph (d) of subsection (1), it shall be presumed until the contrary is proved that a person wrongfully restrains a person if he (a) withholds from that person wearing apparel or any other property belonging to that person or wearing apparel commonly or last used by that person; threatens that person to whom wearing apparel or any other property has been let or hired out or supplied to with legal proceedings if he takes away such wearing apparel or property; threatens that person with legal proceedings for the recovery of any debt or alleged debt or uses any other threat whatsoever; or without any lawful authority, detains that person's identity card issued under the law relating to national registration or that person's passport.

(b)

(c)

(d)

(3) In this section and in sections 372A and 372B, "prostitution" means the act of a person offering that person's body for

sexual gratification for hire whether in money or in kind; and "prostitute" shall be construed accordingly. [s372 substituted by Act A 1131] 372A. Persons living on or trading in prostitution

( 1) Whoever knowingly lives wholly or in part on the earnings of the prostitution of another person sholl be punished with imprisonment for a term which may extend to fifteen years and with whipping, and sholl also be liable to a fine. (2) Where any person is proved to have exercised control, direction or influence over the movements of a prostitute in such a manner as to show that that person is aiding, abetting or compelling the prostitution of the prostitute with any other person or generally that person shall, in the absence of any proof to the contrary, be deemed to be knowingly living on the earnings of prostitution. [s372A inserted by Act A 1131] The following oct is soliciting for purpose of prostitution. Though there acts for this, to date is difficult to charge a person for soliciting because there of no evidence. As the person who is involved will not confess that he has solicited because both parties are involved with consent. 372B. Soliciting for purpose of prostitution

Whoever solicits or importunes for the purpose of prostitution or any immoral purpose in any place sholl be punished with imprisonment for a term not exceeding one year, or with fine, or with both. [s372B inserted by Act A 1131]

The following is act if for allowing prostitution in their premises, which are as follows: 373. Suppression of brothels (1) Whoever(a) keeps, manages or assists in the management of a brothel; being the owner of any place or the agent of such owner, or being the occupier of any place, lets the place or any part thereof with the knowledge that such place or part is to be used as a brothel or permits such place or part to be used as a brothel or is willfully a party to the continued use of such place or part as a brothel. shall be punished with imprisonment which may extend to fifteen years, and shall also be liable to fine.

(b)

(2) In this section, "brothel" means any place occupied or used by any two or more persons whether at the same time or at different times for purposes of prostitution. [s373 substituted by Act A 1131] Another act that are often used to charge sexual workers is ACT 336: MINOR OFFENCES ACT 1955. The specific section is on HOTELS AND PUBLIC HOUSES. It states: 18. Disorderly conduct in hotels, boarding-houses, etc. (1) The keeper of any hotel, boarding-house, public house, common lodging house, eating house, coffee shop or other place of public entertainment or resort who permits drunkenness or other disorderly behavior in such house or place, or permits prostitutes or persons of notoriously bad character to meet or remain for the purpose of soliciting or misbehaving therein, shall be liable to a fine not exceeding three hundred ringgit or in the case of a

second or subsequent offence to a fine not exceeding five hundred ringgit. (2) Whenever any person would be liable under the provisions of subsection (1) of this section to punishment for any ac!, omission, neglect or defaul!, he shall be liable to the same punishment for every similar act. omission, neglect or default of any agent or servant employed by him in the course of his business as keeper of such hotel, boardinghouse, public house, common lodging house, eating house, coffee shop or other place of public entertainment or resort; and every agent or servant employed by any person in the course of his business as aforesaid shall also be liable to the punishment prescribed by subsection (1) of this section for such acts, omissions, neglects or defaults as fully and effectually as if such agent or servant had been the keeper of such hotel, boarding-house. public house, common lodging house, eating house. coffee shop, or other place of public entertainment or resort. Till to date, what the authorities have used is individual laws on disorderly behavior or immoral conduct (for example, hugging and kissing in public places). 21. Drunkenness and disorderly behavior in public places Any person who is found drunk and incapable of taking care of himself. or is guilty of any riotous. disorderly or indecent behavior, or of persistently soliciting or importuning for immoral purposes in any public road or in any public place or place of public amusement or resort, or in the immediate vicinity of any Court or of any public office or police station or place of worship, shall be liable to a fine not exceeding twenty-five ringgit or to imprisonment for a term not exceeding fourteen days, and on a second or subsequent conviction to a fine not exceeding one hundred ringgit or to imprisonment for a term not exceeding three months, or to both.

27. Unlicensed hawkers (a) very hawker wandering abroad and trading without being duly licensed or otherwise authorized by law; Prostitutes (b) every prostitute behaving in a disorderly or indecent manner in or near any public road or in any place of public resort;

The following act is for the abduction of person for purpose of prostitution, i.e. ABDUCTION AND CRIMINAL INTIMIDATION OF WITNESSES ACT 1947 (Act 191), specifically: Section 3. Abduction with intent to commit extortion Whoever abducts any person (a) with the intent that such person shall be held to ransom or that extortion shall be committed from that person or any other person; or (b) knowing it to be likely that such person will be held to ransom or that extortion will be committed from that person or any other person; shall be punished with imprisonment for a term which may extend to fourteen years and shall also be liable to fine. 5. Criminal intimidation to impede the course of justice

Whoever commits criminal intimidation (a) with intent to impede the course of justice; or

(b)

so that the course of justice is thereby impeded; shall be punished with imprisonment which may extend to ten years and shall also be liable to fine.

To protect child forced or forced prostitution of minors under the age of 18, or the involvement of minors in the industry, there is the Child Act 2001 (Act 61 1). It specifies: 43. Offences (1) Any person who (a) sells, lets for hire or otherwise disposes of, or buys or hires or otherwise obtains possession of, a child with intent that the child is to be employed or used for the purpose of prostitution, either within or outside Malaysia, or knowing or having reason to believe that the child will be so employed or used; procures a child for purposes of prostitution or for the purposes of having sexual intercourse with any other person, either within or outside Malaysia; by or under any false pretence, false representation, or fraudulent or deceitful means made or used, either within or outside Malaysia, brings or assists in bringing into, or takes out of or assists in taking out of, Malaysia, a child with intent that the child is to be employed or used for purposes of prostitution, either within or outside Malaysia, or knowing or having reason to believe that the child will be so employed or used; brings into Malaysia, receives or harbors a child knowing or having reason to believe that the child has been procured for purposes of prostitution or for the purposes of having sexual intercourse with any other person, either within or outside Malaysia, and with intent to aid such purpose;

(b)

(c)

(d)

(e)

knowing or having reason to believe that a child has been brought into Malaysia in the circumstances as set out in paragraph (c) or has been sold, let for hire, or hired or purchased in the circumstances as set out in paragraph (a), or in contravention of any other written law receives or harbors the child with intent that he is to be employed or used for purposes of prostitution either within or outside Malaysia; detains a child in a brothel against the child's will; detains a child in any place against the child's will with intent that the child is to be employed or used for purposes of prostitution or for any unlawful or immoral purpose; by means of any advertisement or other notice published in any manner or displayed in any place offers a child for purposes of prostitution or seeks information for that purpose or accepts such advertisement or notice for publication or display; acts as an intermediary on behalf of a child or exercises control or influence over the movements of a vv in such a manner as to show that the person is aiding or abetting or controlling the prostitution of that child; engages or hires, for any valuable consideration, a child to provide services for that person's sexual gratification; attempts to do any act in contravention of this section, commits an offence and shall on conviction(aa) in the case of offences under paragraphs (a) to (h) or paragraph (k): be liable to a fine not exceeding fifty thousand ringgit or to imprisonment for a term not exceeding fifteen years or to both; and

(f) (g)

(h)

(i)

(j)

(k)

(bb) in the case of an offence under paragraph (i) or (j), be liable to a fine not exceeding fifty thousand ringgit and to imprisonment for a term of not less than three years but not more than fifteen years and shall also be punished with whipping of not more than six strokes. (2) Any person who is cor.1Victed of a second or subsequent offence (a) under paragraphs (1 )(0) to (g) or paragraph (1) (k), shall be liable to whipping of not more than ten strokes; and under paragraphs (1 )(i) or (j), shall be punished with whipping of not less than six strokes but not more than ten strokes, in addition to any term of imprisonment imposed in relation to such offence.

(b)

(3) Sections 173A and 294 of the Criminal Procedure Code shall not apply in respect of offences under paragraphs (1 )(i) and (i). In Malaysia there is no law for prostitution in Islam. This is because prostitution is haram (forbidden). If a Muslim man and women were caught together, they will be charged under the syariah law. In the strictest sense, if an unwed couple were caught committing sexual intercourse and was proven by due process stated by the Islamic law, each will get 100 lashes each; however if the act I to be committed by 2 married consenting adults, then they will be stoned to death. However this is not practiced in the country. In Malaysia, if the couple committing sexual act is a Muslim and non-Muslim, then the non-Muslim will not be charged under the syariah law. He or she might be charged for immoral conduct. Furthermore, if they were the transsexuals and transvestites, then they too normally will be charged for immoral conduct. It is difficult to charge them as act is between two consenting parties and if there no witness to it, then there is no case. It

is also illegal to perform anal intercourse, and if the victim reported the act, legal action will be taken.

Objective of Study There are strong evidence linking sex workers and HIV / AIDS. However, effective intervention strategies and programs have been proven to reduce the incidence of HIV infections among this specific population. It is the purpose of this study is to estimate the number of sex workers in Malaysia, thus identifying the risk of HIV / AIDS among this population in Malaysia. This will include female, male and transsexual sex workers. In addition, the study will also ascertain some demographic information pertaining to the respondents, their knowledge towards HIV / AIDS, safe practices and their behaviors that put them at risk to HIV infections.

3.0 Method of estimation

Methodology

Estimating sex workers is a difficult and tedious exercise because there is little information produced by the official statistics at the states level. Often these statistics are mere cases which were apprehended by the police and the legal system and it only represent the tip of the iceberg of the actual number in a specific country. One promising direct estimation method being used in Thailand, Laos, Nepal and Taiwan developed by the Thai Red Cross and the East-West Center is the method of comprehensive geographic mapping of sex work sites and types. In Thailand, this method has now been adopted by the Ministry of Public Health for their annual survey of sex work. In several areas, the method has detected up to SO per cent more sites than estimates by using the conventional method of referral by STI patients. In other countries, population estimates have been generated through the application of capture-recapture techniques. In Dhaka, CARE/Bangladesh recruited and trained sex workers to assist in "capturing" street sex workers throughout the city by handing out the different colored cards for 24 hours on two different days within a fortnight. To estimate the number of sex workers in a country, Pisani (2002) suggested several methods of estimation such as census and enumeration, population survey, capture-recapture and multiplier methods. For this study, the multiplier method is used to estimate the number of female sex workers in the country and nomination method to estimate its sub-population, especially male and transsexual sex workers in specific area.

Multiplier method Multiplier methods generally rely on having information from two sources that overlap in a known way: the first is usually an institution or service with which the population to be estimated is in contact, and the second is the population at risk itself, The difficulty in using multiplier methods correctly is finding data for institutions and populations that correspond with one another. In order to use institutional and survey data together to estimate the size of a population, all members of the population have to have a chance of being included in both the survey and in the institutional data, In this study, data from Royal Malaysian Police (PDRM), Welfare and Social Services, Religious Department and Immigration Department will be the main reference data representing institutional statistics, There are four stages of general principles of multiplier method that will be used in the study. In Stage I, data of sex workers are recorded under the current system for the year 2005, These sources are available at the national and state level. ~.';::;#fiL: . . . i.i!< .•. ·•••· .• ·. . .•.• \\~fji~4ll~$ •.. Police, D7 (anti-vice) department 1 Welfare department 2 City, town / district council/officer 3 State religious department 4 Anti Drugs Agency 5 6 Immigration office Ministry of Health on district health office 7 3 relevant NGOs at the state, city or town level 8 '. .. .

Table 3: List of key informants to the estimation of female sex worker

Stage II is the estimation of the value of multiplier (m). This stage includes interviews with key informants and sex workers to ascertain the number of sex workers in specific towns and cities. Key informant is defined as individuals residing in the target community, town or city that have some information pertaining to the numbers of sex workers in that specified location. This information is usually derived from their occupations that have relevance to the sex industry. The list of key informants is as stated in Table 3. Stage III involves the derivation of multiplier. This stage involves three steps: i) Estimation of the percentage (p) of sex workers recorded from Stage I. The formula

where n is the number of sex workers recorded from Stage I and N is the total number of sex workers estimated in Stage II. ii) Multiplier (m) is estimated for each district by the inverse of percentages (Pisani, 2002) of the formula used.

The formula:

Total numbers of sex workers estimates for each state will obtained by multiplying the recorded number of sex workers in each state multiplied by the multiplier.

Stage IV involves the total national estimation of sexworkers. The total nationol estimation of sex workers is ascertained by the number of sex workers captured by the official sources multiply by the average multiplier of all the 14 states in the country.

Nomination method Among the sex workers in Malaysia, the male, transsexuals and transvestites are probably most hidden sub-population and most difficult to access. The nomination method starts at "the tip of the iceberg" of a specific target population usually not accessible by other methods. These individuals (MSW and TSW) are contacted and asked to provide the contacts of other individual male and transsexual sex workers in that area. Pisani (2002) reminded that this technique is highly risky, but the subpopulation is highly networked, and therefore, once gained their confidence, it will be quite easy to access them. Once accessed, respondents were asked to provide estimates of MSW or TSW in their area and other localities in the city known to them. They were also asked for other contacts. The process is then repeated (at least 3 layers) until the research team obtained a consistent estimate of MSW and TSW in the town or target city.

4.0

Results

Estimation of female sex workers The estimation of female sex workers was done by the use of multiplier method. Official statistics provided by Malaysian police is as refiected in Table 4, amounting to 6,876 cases which include foreign FSW, local FSW and girls under the age of 18 which is under the supervision of the Welfare Department. The percentages and multipliers for FSW are calculated and derived for each state. In Perlis, Kelantan and Terengganu, there were no prosecution of FSW in 2005, thus the official data is set at 1.0 case. Field estimates found a small number of FSW in Perlis because most of the sex services were provided at the Padang Besar border town of Thailand. However, for Kelantan, there are many visible presence of FSW and services were mainly provided at the Malaysian border towns of Rantau Panjang and Pengkalan Kubor. Consequently, this resulted in significantly large multipliers that are in between 8 to 25 for Perlis, 27 to 54 for Terengganu and 99 to 184 for Kelantan. These figures are considered as outliers and were taken out in the calculation of the average or national multiplier for FSW. The national multipliers for FSW are taken from the average of 11 states (excluding Perlis, Terengganu and Kelantan). It is calculated at 1.53 to 3.0 with an average of 2.3. The research team recommended a multiplier of 3.0 for FSW because of missing values for the above mentioned states, meaning that for every FSW prosecuted by PDRM, there are 3 more sex workers which are not prosecuted. For individual states. the high multipliers calculated for each state can be used to derive the estimates of FSW.

Official State Statistics (PDRM) Perlis

Major

~Estimate JiSW.El3timIIIl1 (Multipliet) (Multiplier)

AWl'B9'~

ofF'fN{

Town/City Kangar Kuala Perlis

(KI+FSW) low Ave. high low lAve. high

low high 0(1) 2 11 (;

PERLIS Kedah 12

4 (4} 7 4

17 (17)

low high 15 5 17 7 12·· 32 (12)

16.5 25

(32)

Alar Star Sungai Petani t=

12 8

Kulim

KEDAH

16 (l.4)

32 (2.7) 495 213 246

Pulau Pinang

650

Butterworth Georgetown Bukit Mertajam Penaga

205 185 175

Perak

609

143 177 PULAU PINANG 708 1131 (1.1) (1.7) Ipoh 324 797 Taiping 180 365 Setiawan 211 401 PERAK 715 1563

15 27 21 11 63 29 (2.4) (5.3) 522 145G 77 1321 104 1236 148 9Sfi 851 4969 (1.3) (7.2) 473 972 227 543 236 396 936 1911 6 12 385 416 319 355 441 705

1.9 3.0 4.0

1.2 2.9 4.5 780 1885 2925

1.4 2.2

2.9 780 1340 1766

(1.2 ) (2.6) (1.6) (3.2)

Slgr

1218

Petaling J aya ! Ampang Jaya

316

531 499 416 699 473

I I

Subang Jayal

325 311 298 333

773

Sunway Puchong Klang Kajang SELANGOR WP

659 716 666

1111 744

1583 2618 1916 (1.3) (2.2) (1.6) KUALA LUMPUR 1312 2275 1750 I (1.2) (2.0) (1.5) Seremban 385

3519 (2.9) 3319 (2.9) 936 265 103

1.5 2.1 1.4 2.0

2.6 2.5

827 2558 ~167 556 2222 ~778

Port Dickson Bahau N.SEMBlLAN

135 265

465 192 315

426 185 291

963 1902 1604 (1.1) (1.3) (1.2) (2.2)

776

1.2 1.5

1.8 893 1116 1339 , 1

Mka

Bandar Melaka Melaka Raya

75 57 132

124 144 268

128 140

204 232 2.1 2.9 3.7 206 21)5

L, !"

MELAKA Johor

(1.4) (2.7)

268 463 (2.7) (4.7)

363~

871

JohorBahru Kluang Segarnat Muar

572 88

1432 220

988 132 120 76 260 60

1592 236 244 280 568 124 1.6 2.5

104 I 196 108 I 240 -

II, '"

Batu Pahat Mersing JOHOR Phg

200 , 512 12 24

" 3.3 1394 2178 2875l'

1084 2624 1636 3044 (1.2) (3.0) (1.9) (3.5)

132

Kuantan

95 65 21

136 95 33

112 70

195 98 40 333 (2.5) 1.5 ,

Genting Highland Mentakab PAHANG Trg

30 181 264 212 (1.4) (2.0) (1.6) 12 11 23 (23)

!~! 1.9 2.3 198 251 304

0(1)

Kuala Terengganu Kemaman

20 18 38 (38)

15 15 30 (30)

31 38 69 (69) 27 41 54 27 41 54

TERENGGANU Ktn

!I ~,'.

0(1)

KotaBahru Rantau Panjang PengkaIan Kubur

25 32

48 62

29 36 41

52 71

KELANTAN Sabah

882

Kota Kinabalu T~wau

69 35 65 192 92 175 106 (92) (175) (106) (192) 460 864 660 1264 272 208 520 1440 300 604 484 924 1032 1676 1164 3628 (1.2) (1.9) (1.3) (4.1)

142 184

Sandakan SABAH Swk

1.3

2.2

3.0 114"' 1940 2646

480

Kuching f-

295 ~9 186

Miri

Sibu

439 296 296

396 235 261

619 366 251 1.7 2.1 2.5

I~; L.'

SARAWAK

680 1060 892 1236 (1.4) (2.3) (1.9) (2.6) " ,,~,

816 1008 1200 Is!

TOTAL H'

MALAYSIA c

1.58 2.30 3.00 9754 l5O11 1t967~; ...., L"

·';';n,!,

Table 4: Multipliers and estimation of female sex worker by state in Malaysia for 2005

states with most significant estimates of FSW are Pulau Pinang (780 - 2,925), Selangor (1,827 -2,778), Perak (780- 1,776), Kuala Lumpur FT (1,556 - 2,778), Johor (1,394 - 2,875), Sabah (1,147 -2,646) and Sarawak (816-1 ,200). For Malaysia, the range of numbers of FSW is between 9,754 - 19,674 with an average of 15,019. Thus, for 2005, there is an estimated of 20,000 sex workers in Malaysia.

Estimation of male and transsexual sex workers There is no official estimation or prosecuted cases on male sex worker or transsexual sex worker, however there are a lot of talks, visible activities and informal estimates made by NGOs from the ground. Because there were no official data to be used as a reference point, consequently the multiplier method could not apply to these sub-populations. This study used the nomination method combined with estimates given by MSW, TSW and key informants to estimate the number of MSW and TSW in the country. Fjeld enumerators meet with male sex worker and transsexual sex worker and asked them to nominate a few names of their acquaintances in their area. These nominees were then followed up by field enumerators and there were again asked to suggest another set of names of MSW and TSW in their area. As mentioned, at each stage the respondents were asked to provide estimates on the number of MSW and TSW in their area. The findings are as reflected in Table 5. The highest estimates for MSW and TSW are from the states of Selangor (148-330), Perak (163-306), Kuala Lumpur (135-292) and Johor (142-258), while the lowest estimate is from Perlis (1118). For Malaysia, the estimated for MSW and TSW is in between 975 to 2,033 with an average of 1,398. These estimates exclude transsexuals and transvestites who are not engaged in sexual work activities, thus not defined on sex worker as stated in the earlier part of this report.

· "

State

Major1'ownl

KI estimates low high

TSiltfSW .' estimates

Estimates of

City Kangar

','

1'SfltfSW low 5

low···· high 8

Ave

high

Perlis

2 5

3 8

7 8

8 10

Kuala PerEs

pERLlS Kedah Alor Star Sungai Petani

7 19 3 3

11 32 7 9

6 11,4 25 15 12

2,. 45 36 21

·11 22 9

15 31 16 12

18 39 22 15

Kulim

8 39

nDAa Pulau Pinang Butterworth

25 15 20 9 5

48 25 33 23 12 93

52 4 35 5

102 113 112 14

57 40 51 13 15 131 86 18 37 57

75 69 73 19 22 156 123 27 48 74 69 77 63

10 28 7 7

Georgetown

Bukit Mertajam Penaga PULAU PINANG Perak Ipoh Taiping Setiawan PERAK Selangor Petaling J aya / AmpangJaya Subang Jaya/ Sunway Puchong Klang Kajang Wilayah Persekutuan

32 252 150 36

t 52 '. 271 177 52 12

51 106 49 9

17 ". 182

35 45 5

60 95 18

85 15 18 21 22 15

173 3D 35 43 42 32

241 35 60 49 25 36

438 65 112 95 112 93

163 25 39 35 24 26

235·· 306

52 51 45

SELANGOR KUAlA LUMPUR Seremban

91 112 18 10

182 259 38 35 12

205 158 5 15 12

477 325 13 42 25

148 135 22 13 9

239 214 28 26 14 71 35

330 292 34 39

N. Sembilan

Port Dickson

Bahau Melaka N.SEMBILAN Bandar Melaka Melaka Raya MELAKA ,ex

33 15 8

85 45 15

32 25 12 ,

80 55 27

43 20 10

98 50 21

Johor

Johor Bahru Kluang Segamat

low

high I

85 13 15 8 12

110 44 28 17 26

l~*igh 90 I

17-5 -88 35 28 20 28 15

IOi+ 116 ~43 Ave high

16 15 14 13 !

28 22 15 20 8 200 18 I 13 9 39 12 11

40 " 28 19 27 i'

Muar Balu Pahal --::-:--

15 11

Mersing Kuantan Genling Highland Menlakab PAHANG

13 6

JOHOR Pahang

1 134 7 6

5 230 15

10 150 II

15 286 26f-

10 258 22 17

r- -is f 18 -----

142 13 9 6

IS 15 59 17

3 16 8 I)

8 41 15

8 37 6 6

12 50 16

Terengganu

K. Terengganu

27 7 6

Kemaman TERENGGANU Kelantan Kola Bahru Rantau Panjang Pengkalan Kubur

12 27 21 --

18 35 29 18

15 31 25 17

13 -~

11 5

12 14 -

13 13 8

22 19 13

KELANTAN Sabah Kola Kinabalu -- Tawau -Sandakan

SABAH Sarawak Kuching Miri Sibu SARAWAK

TOTAL

MALAYSIA ,

6 22 42 22 15 79 29 9 5 43

12 48 68 43

12 37 53 31 I

21 68 78 56

9 30

13 I 44 61 39

17 58

48 27

73 50

35 146 65 !

31 115 35 15 8

48 182 68 25

23 97 32 --

33 131 17

42 164 22

-------5~ 67 -

19 9

12 105 i'r'

...." .•...

7 51 975 ,-

9 11 75 99 1,398 2,033 ,«'

Note: Average figures are obtaIned from the mean of hIgh are rounded to the next digit

estlmotes. All numbers

Table 5: Estimates of MSW and TSW by state in Malaysia for

2005

Profile of respondents A total of 253 respondents were interviewed by field enumerators comprising of 32 male sex workers (MSW 12.6%),63 transsexual sex workers (TSW 24.9%) and 156 female sex workers (FSW 62.5%). Mostofthem are married (n=102; 40.3%) as opposed to 40 (15.8%) single and 111 (43.9%) abstained from answering the question. A total of 94 persons (37.2%) have children ranging from 1 (40.9%),2 (41.9%) to 5 (3.2%) (Appendix P4). Only 18.6% said that their families are informed of their profession. Most of the respondents are Malay (n= 137; 54.6%), foreigners (n=75; 29.9%), Chinese (n=24; 9.6%) and Indians (n=llO; 5.9%). They started work as early as 15-20 years (n=80; 34%) and 21-25 years (n=110; 43.5%). Reasons for their involvement in the sex industry are as follows; they follow the actions of their peers (n = 138, 54.8%), they do it for economic reasons, a job, an occupation (n = 42, 16.6%) or they get involved just for fun (n = 54, 21.3%) and for more then 11 years (n = 66, 26.1 %). A total of 60.9% work by them self, where as 36.8% have pimps. Most of the sex workers work full time (55.6%) and 43.5% work part time. On services rendered, naturally FSW provided a combination of vaginal. oral and anal sex while TSW and MSW are only able to provide oral and anal sex. A total of 156 (all FSW) provided vaginal sex, 79 provide oral sex (31.2%) and 88 (34.8%) provide anal sex. On the average SW served between 6 - 15 clients per week (57.4%), mostly Malay clients (61.1%), followed by Chinese clients (30.6%). About 40.3% of their clients are from 31 - 40 years of age; 72.5%provide service to clients who are married. Comparatively 66.1 % provide service to local clients and about 33.9% provide sexual services to foreign clients.

Risk behaviors and safe practices Risk behaviors are defined as not adhering to safe sex practices (i.e. us·lng. condom), not attending regular health screening or medical check-up and AOD usage. A total of 231 sex workers (91.3%) said that in general. they practice condom use and 53% said they provide condoms to clients. However 13.4% still accept clients who do not use condoms. On health behavior and awareness, 65.2% go for regular STDs check up, mostly in 2005 (20.6%) and 2006 (32.4%): 67.6% went for HIV/AIDS screening and testing (29.6% in 2006 and 24.1% in 2005), all respondents know about HIV/AIDS, mostly from the media (81.8%). Respondents also know where to go for their health/HIV /STD check up. Other risk behaviors are pertaining to substance use. A total of 85.4% smoke: 65% drink alcohol: 20.6% use drugs: and 2.8% inject drugs. Out of those who used drugs, a significant number (44.9%) use heroin, 38.2% use ATS and 16.3% use marijuana. When comparing condom use and gender of respondents (P43) the lowest usage is among TSW (92.2%) as compared to MSW (96.7%) and FSW (97.4%), however the difference is not significant. The survey also observed more TSW tend to supply condoms to clients (74.1%) followed by FSW (53.7%) and MSW (16.7%). Also more TSW and FSW tend to reject clients without condoms (81.8% and 80.8% respectively) as compared to MSW (65%). On substance use and abuse, the survey observed more TSW (70.5%) and MSW (70%) consumed alcohol as compareq to FSW (61.9%): more MSW smoke (93.8): more FSW do drugs (25.9%) as compared to other categories. For those using drugs, more MSW (6.3%) and FSW (6%) use needles to inject drugs. The survey also looks at protective and risk behaviors among full time and part time sex workers. Both categories are aware

of condom use (96.3% and 96% respectively) More full time sex workers (61.2%) supply condoms to clients as opposed to part time sex workers (52%), however more of them also accepted clients who do not use condoms (23.3%) as compared to part time sex workers (18.2%) On substance use, more full time sex workers (26.6%) as compared to part time sex workers (16%). Other variables on substance use remain almost the same for both categories of sex workers. On the selection of clients, the survey concluded that more Malay sex workers (72.1 %) attend to Malay clients, more Chinese sex workers serving Chinese clients and also Indian sex workers serving more Indian clients (P61-64). In addition, it is also interesting to note that more Malay sex workers started with the profession because they follow their friends (60.4%), Indians sex workers do it because of economic reason (33.3%) and more Chinese sex workers (29.2%) do it just for fun as compared to the other groups respectively (P65)

5.0

Discussion

Among the greatest concem at present is the AIDS epidemic, which will soon become the greatest health catastrophe of all time. In just two decades, UNAIDS noted that HIV / AIDS has become the world fourth ranking cause of death. Hence, to address such urgent health issues that have direct consequences to human security and well being, it is essential to implement effective policies, formulate pragmatic strategies, mobilize social action and provide access to information to remove the root causes of the epidemic. Such intentions are also among the aims of the UN Millennium Development Goals (MDG). For developing countries like Malaysia, the provision and access to affordable drugs and medications, effective intervention programs, efficacious preventive measures are some of the critical factors that need to be focused. The Ministry of Health stated that more then 75% of all HIV cases in Malaysia are among the IDUs, while sex workers accounted for about 20 per cent of the statistics. As such, the incidence of HIV infections among sex workers in Malaysia can be considered as a hidden population because there is no mandatory testing for sex workers. However, the Ministry of Health encourages any person, especially those who are at risk, to come for confidential, voluntary HIV counseling and testing which is further followed by counseling upon confirmation of the infection. Unlike drug users who are mandated by law to undergo drug treatment and rehabilitation in govemment rehabilitation centers, they are all subjected to mandatory HIV testing. Upon confirmation of the infection, counseling, medication (depending on the CD4 count) and monitoring is provided as part of their drug rehabilitation. The International Labor Organization (ILO) estimates made in 1993-94 suggest that there were between 43,000 to

142,000 sex workers in Malaysia. These figures has not validated by any studies or by official government statistics. PDRM statistics resulted from prosecutions rarely exceed 7,000 cases per year. Therefore the actual number of sex workers can be anywhere in between 7,000 to 43,000. What is of interest is to have an estimate of sex workers in a particular year so as to identify the possible threat of HIV infection to this group. Estimating the number of the population at risk is important for planning of future programs. This study has come up with an estimation of sex workers in Malaysia, which comprise of male, female, and transgender individuals. local and foreigners who actively choose to exchange sexual services for money or payment in kind. By identifying the numbers, it is possible to identify the risk of HIV / AIDS infections among this sub-population in Malaysia. In addition. it can be used as a guide to perform advocacy, response planning and possibly resource allocation in accordance to the specified areas identified. This is important in order to obtain estimates the numbers infected with HIV and to forecast the projection of the burden of the d'isease. The areas of future programming for the sex workers population should encompass intervention planning, measurement of coverage and monitoring and evaluation of the intervention program. Thus, in conclusion, the range of numbers of FSW in Malaysia is from 9,754 to 19,674 with an average of 15,019 persons. States with most significant numbers of FSW are Pulau Pinang (780 2,925), Selangor (1,827 -2,778), Perak (780- 1,776), Kuala Lumpur FT (1,556 - 2,778), Johor (1,394 - 2,875), Sabah (1,147 - 2,646) and Sarawak (816 - 1,200). Hence, using the upper estimates for 2005, it is then concluded that there is an estimated of 20,000 female sex workers in Malaysia. For TSW and MSW, there are no official or institutional statistics or estimates in Malaysia. Field estimates for MSW and TSW mostly comes from the states of Selangor (148-330), Perak (163-306), Kuala Lumpur (135-292) and Johor (142-258), while the lowest estimate is from Perlis (11-18). For Malaysia, the estimated number of MSW and TSW is in between 975 to 2,033 with an average of 1,398.

It is then concluded that the number of sex workers (FSW, TSW and MSW) in Malaysia can be estimated at 22,000 for the year of 2005 that is about 0.83 per 1,000 population. A multiplier of three (3) can be applied for coming years based on the official statistics provided by relevant authorities.

REFERENCES

Alexander, P. (1996). Forward. In N. McKeganey & M. Barnard Sex Work on the Streets: Prostitutes and Their Ciients. Milton Keynes: Open University Press. Bagley, C. & Young, L. (1987). Juvenile Prostitution and Child Sexual Abuse: A Controlled Study, CQ'cv.!. ·r OJ

Baldwin, M.A. (1992). Split at the Root: Prostitution and Feminist Discourses of Law Reform, Yale Journal of Law and Feminism 5: 47-) 20. Barry, K. (1995). The Prostitution of Sexuality. New York: New York University Press. Bell. S. (1994). Reading. Writing, and r;;ewrlting the Prostitute Body. Bloomington: Indiana University Press. Currier, N. R. (2003). New Partnerships Emerging in AIDS Education: The United Nations, Governments and Sex Workers Join Hands to Confront HIV/AIDS, United Notions Chronicle. Dworkin, A. (1997). Prostitution and Male Supremacy. In Life and Death, pp. 139-151. New York: Free Press. Graham. D. L., Rawlings, E. & Rigsby, R. (1994). Loving to Survive: Sexual Terror, Men's Violence and Women's Lives. New York: New York University Press. Harlan, S., Rodgers, L. L. & Slattery, B. (1981). Male and Female Adolescent Prostitution: Huckleberry House Sexual Minority Youth Services Project, Washington, DC: Department of Health and Human Services, Youth Development Bureau.

Hoigard, C, & Finstad, L. (1992). Backstreets: Prostitution. MonE-y ana Love. University Park: Pennsylvania State University Press, Hunter, S.K. (1994). Prostitution is Cruelty and Abuse to Women and Children', lVichigan Journal of Gender and Low ! 1-14. ILO Press Release (1998). Sex industry assuming massive proportions in Southeast Asia Economic incentives and hardships fuel the growth of the sex sector Migrant women. children are particularly vulnerable to commercial sexual exploitation, Wednesday 19 August. James, J. & Meyerding, J, (1977), Early Sexual Experience and Prostitution, American Journal of Psychiatry, i34.' 1381-5, Jeffreys, S. (1997). The Ideo at Proslihtlon. Melbourne: Spinifex Press. Leidholdt, D. (1993). Prostitution: A Violation of Women's Human Rights, Cardozo Women's Law Journoll (lJ: 133-47. Lin, L. L. (19980). The Sex Sector: The economic and social bases of prostitution in Southeast Asia, Geneva: International Labor Office. Lin, L, L. (1998b). The economics of sex - Sex os a sector: Economic incentives and hardships fuel growth, World of Work, No, 26, September / October. Lynne, J.A,M. (1998). Street Prostitution as Sexual Exploitation in First Nations Women's Lives, Thesis submitted in partial fulfillment of Master of Social Work, University of British Columbia, MacKinnon, CA (1993). Prostitution and Civil Rights, Michigan Journal of Gender and Law, I: 13-31,

McKeganey, N. & Barnard, M. (1996). Sex Work on the Streets: Prostitutes and Their Clients. Milton Keynes: Open University Press. Muecke, MA (1992). Mother Sold Food, Daughter Sells her Body: The Cultural Continuity of Prostitution', Social Science and Medicine 35(7): 89 i -90. ]. Noraini Saad. (2005). Amon, Kuala Lumpur. Personal Interview, PDRM, Bukit

Ng, C. (2004). Women workers in Malaysia (1980-2004) (Part II): Emerging issues: Migrant workers and sex workers, Aliran Monthlv, 2004:5. Silbert, M. H. & Pines, A. M. (1982). Victimization of Street Prostitutes, Victimology: An International Journal, 7: 122-33. Silbert, M. H. & Pines, A. M. (1983). Early sexual exploitation as an influence in Prostitution, Social Work, 28: 285-9. Silbert, M. H. & Pines, A.M, (1984). Pornography and Sexual Abuse of Women, Sex Roles 10: 857-68. Sharful Islam Khan, Abbas Bhuiya & Jamal Uddin A. S, M, (2004). Application of the capture-recapture method for estimating the number of Mobile Male Sex Workers in the Port of Bangladesh, Journal of Health and Population Nutrition, Mar: 22 (1),19-26. Son, J. (1998). South-east Asia: Sex Industry Thrives, But States Look Away, InterPress News Service (IPS) - August 19. UNAIDS. (2004). Report on the Global AIDS Epidemic. Vanwesenbeeck, I. (1994). Prostitutes' Weil-Being and Risk. Amsterdam: VU University Press. http://wwvv.ex.ac.uk/-watupman/undergrad/aac/scale.htm

APPENDIX I

Soalselidik Sex Workers (SW Survey Questionnaire)

1. Jantina

c:::=J Male c:::=J Female c:::=J Transexual/transvestite

Status kahwin; _ _~ Ada anak: Ya _ _~ (berapa orang: _ _~) Tidak _ _~ Keluarga tahu mengenai pekerjaan ini: Ya Tidak _ _~

Umur sekarang _ _~Tahun; Bangsa/agama _ _~ 2. Bila mula pekerjaan ini, pada umur _ _~ tahun Bagaimana anda mula pekerjaan ini: _ _~ Berapa lama dah jadi pekerja seks: _ _~ bulan, 3. Cara bekerja; c:::=J sendirian Anda bekerja setiap hari: _ _~ days/week Perkhidmatan anda (boleh tanda lebih dari satu):

c:::=J Ada pimp

Lokasi tempat kerja: _ _ _ _ _ _ _ _ _ _ _ _ __

c:::=J Ya c:::=J Hanya part time c:::=J oral

C:.:J vaginal c:::=J anal 4. Anggaran bilangan klien seminggu _ _~ orang Siapa selalunya klien anda: Bangsa Umur mereka

c:::=J bujang c:::=J berkahwin, c:::=J Tempatan c:::=J orang asing

5. Adakah klien guna kondom:

Cl Yo: Kalau Yo, siapa beri kondom 0

klien bawa

o o

sendiri; c=J soya berikan Tak: adakah anda c=J terima klien tanpa kondom atau reject klien

6. Pernah ke klinik untuk check penyakit kelamin/STD c=J Yo; Bila last check Pernah check HIV/AIDS c=J Yo, bila - - Tidak, Kalau tak, tahu tak nak check di mana c=J Yo Tidak Yo c=J Tidak

o o

7. Tahu mengenai HIV / AIDS D

Jika Yo, dari mana anda dapat maklumat

8. Adakah anda ambil alkohol!minuman keras: c=J Yo Tidak Rokok Dadah

D D

c=JTidak

Yo c=J Tidak

Kalau Yo, jenis apa yang selalu _ __ Guna jarum suntikan untuk ambil dadah c=J Ya c=J tidak ANGGARAN BIL. PEKERJA SEKS DI KAWASAN ini: Low Estimate: _ __ High estimate: _ __

APPENDIX II • Tabulation of the Survey

Gender of respondents

~-----Male Female

~~~~q

Marital status

Not Married Total

40 142 Respondents with children

100.0

~------------~~

Number of children 1 2

3 4

Family knowledge of sex worker's profession

Age of respondents 15-20 21-25 26-30 31-35 36-40 41-45 46-50

66 41 23 8 10

26.1 16.2 9.1 3.2 4.0

Ethnic of respondents

Age of respondents when start work as sex worker

Frequency 15-20 21-25 26-30 31-35 36-40 Total 86 110 48 7 1 252

Per cent 34.1 43.7 19.0 2.8 0.4 100.0

Reasons for starting work as sex worker

Frequency Follow Friends Economic Reasons For Fun Other 138 42 54 11

Percent 56.3 17.1 22.0 4.5

Total

245

100_0

How long working as sex worker

Frequency Less Than 1 Years 2 To 5 Years 6 To 10 Years 11 Years And Above 54 71 60 66

Percent 2l.5 28.3 23_9 26_3

Total

251

100_0

Who manage your job as sex-workers

Frequency Self Managed Pimp 154 93

Percent 62.3 37.7

T9tal .,=

247 --,~_.,

100.0

State where respondents come from l:Ereque.e~

•••

;R1ii,cl!i6.t.·······.·· < 5.1 6.3 9.5 7.9 4.0 6.3 11.1

Perlis Kedah Penang Perak Negeri Sembilan Melaka Johor Pahang Terengganu Kelantan Sarawak Sabah Kuala Lumpur

I!r~f:d-/

. •. •. . •. /. .•. . . . •. I>

13 16 24 20 10 16 28 16 15 10 18 20 47 ..

6.3 5.9 4.0 7.1 7.1 18.6 .'

2$3 ..•.... '.'

100.0

.....

SW as Part or full time job

Full Time Part Time t?f~~.)

. . . . . . . . . .•.

.. . . . •

· .• ···.·Ft'equel),cY 138 110 I . 248

.•.......

Per cent 55.6 44.4 100.0 ........ "

SW Service - Oral

Yes No ..

79 164 243 ....1

32.5 67.5 100.0 .. ....•......

SW Service - Vaginal r---------------,

SW Service - Anal

SW Number of client per week ~--------~@~~~~.

Ethnic of clients

Malay clients

Chinese clients es No

Indian clients

Age of clients

c:===~

es No

Married clients

lfrequency Yes No 189 52 .

Percent 78.4 21.6 100.0

Total

241

Local clients '

Ftequency 160 82

Percent 66.1 33.9 100.0

Yes No

Total

242

Foreign clients

Frequency Yes No 68 176 244.<

Per cent 27.9 72.1 100.0

Total

Condom usage during service

..'. . . . Frequency···· Yes No 231 9

Percent 96.3 3.7 100.0

Total

240

Who supply the condoms during sex

Frequency Chent Self/SW 99 134 '

Per cent 42.5 57.5 100.0

Total >. -',0'"

2&3 . ., ,. '''~''~. _' ,., .. ~t"

Respondents accepting or reject clients who do not use condom

Accept Reject

Respondents who check for STDs

Respondents who check for HIV / AIDS

When did respondents check for STls 2 5 8 52

2003 2004

3.4 5.4

34.9

When did respondents check HIV / AIDS ...

2001 2003 2004 2005 2006

Total

FtequeltCY·· 2 5 9 61 75 •. •. •. 152 .•................

Percent l.3 3.3 5.9 40.1 49.3 100.0

.•....

Respondents know where to checked for HIV / AIDS Jrl'eq\l~~',;.·.·.·. .

Per.centu 99.6 0.4 '·100.0'

Yes No

227 1

Total

228 ................. Respondents know about HIV / AIDS

•

Yes

253

100.0

Where did respondents get information on HIV / AIDS

Friends Media Rehabilitation centers

~eq\l"I1~ 37 207 9 ..

P~l'

cent

14.6 8l.8 .

Total .

....

..•

258':

.•.

...

3.6 100.0 >''''

Respondents who drink alcohol

Percent . . Yes No 160 86 65.0

35.0 ~Qll.o

Total

..................•

Respondents who smoke cigarettes

Frequency··· Yes No 216 37 ......... .

P~rcent

...

85.4 14.6 . ........

TOW!! .• .

......

253

•••••

·100.0

Respondents who take/use drugs Frequen~

L.,·

P~cent

Yes No .T~ta1li .......

52 181

. .•. •. . <.

.i; !.

"233·•

.. f;.· .

22.3 77.7

'100.0 '( '

...

Type of drugs used by respondents Heroin Ganja Ice 22 8 11 3 44.9 16.3 22.4 6.1

Respondents who inject drugs

~~;

When did respondents check HIV / AIDS

Sex

Men

Count % Within Sex' % Within Work Woman Count % Within Sex I% Within Work Sponsor Transsexual Count % Within Sex

26 86.7% 16.9% 81 15.9 f}{) 52.6\~/O

..j 13.3f~~i)

81 51.9%

4.3% 75 48.1'% 80.6% 75 48.1 'Yo,

30 100.0% 12.1% 156 100.0% 63.2% 156

Cross tabulation between gender and condom usage

Sex

I Count , % Within Sex '% Within Using Count Woman % Within Sex % Within Using Transsexual Count

Men

29 96.7% 12.6°"0 150 97.4'% 64.9% .52 92.9%

1 3.3%)

30 100.0% 12.5%

11.1% 4 2.0% 44.4°'0 4

7.1%

154 100.0% 64.2% 56 100.0% 23.3% 240 100.00"':' 100.0%

For aU the following cross-tabulation results, this inciicate stati~ti(:~ yv'it~in columr's Indicate statistics with rows

Cross tabulation between gender and condom supply

CoildomFrol1l Clients Self Count 16 % Within Sex 63.3% 16.2% % Within Condom From Woman Count 69 % Within Sex 46.3% I 69. 7% , % Within Condom From ~------------~~~------------~~~ . Transsexual I Count 14 ; % Within Sex 25.9% I . % Within Condom From 14.1% Sex Men 14 16.7?-i, 10.4% SO 53.7% 59.7% 40 74.1% 29.9%

..... . . . Total 30 100.0% 12.9% 149 100.0% 63.9% 64 100.0% 23.2%

Totat····

...•.•• ·CotUit···

··'99

I X'(2) = 20.29, P<0.05

~~i~,~ ...../ ......•...•. ,4J)t.?% . ··%Wl~CbndPni~u:i"'l,OO;O% Cross tabulation between gender and accepting clients without condom

Without Condom Ae~~Pt ...~~d~e~

Cllent$ Clients Sex Count . % Within Sex i % Witlrin Without Condom Woman Count % Within Sex % Witlrin Without Condom Transsexual Count % Within Sex I

Men

35.0~ 2.06% 23 19.2% 67.6% 4 lS.2%

13 65.0% 10.2% 97 SO.S% 75.S'X, lS S1.S% 14.1%

20 100.0% 12.3% 120 100.0% 74.1 % 22 100.0% 74.1%

1~~162

7itU%lOQ.OO4> : ·:t~;P~lPP!Q%

Cross tabulation between gender and STDs check up

Using Condom

2001 2'00312004 2006 Sex Men ,

.., 2006 ~~ .•..

....•

I' Chmt 0' 0 4 14 19 i % Witlrin Sex 5.3";(': 0"10 1 0"101 21.1% 73.7% 100.0"10 % Witlrin Check STD 50.0"10 , 0"10 , 0"10 7.7%' 17.1% 12.8"10 • ._--w.;-unt· Woman 81 11 41 4~1 46 100 % Witlrin Sex 1.0"10 4.0"10 , 8.0"10 41.0"10 46.0"/0 100.0"10 ~Witlrin Check STD 50.0"10 80.0"10 100.0"10 I 78.8"10 i 56.1 67.1% Transsexual, Count 1 0 7 22 0: 30 % Witlrin Sex 0"10 3.3"10 0"10 23.3"10 73.3% 100.0"10 % Witlrin Check STD 20.0"10 0"10 13.5% 26.8"10 20.1% 0"10 I 8 .' "$2 .....:' ".: .............. 2 Total' . Q:,unt "'5 $i F '''!II:! % Within Sex 13'10 3;4% 5.4% 3i<I9'1o 55.P'~ lWlrn . '. % WrthinCheck:~ ::1i.OO.fi% 1mU'1o 1(X}'.()'I1o 100»'10 lOOit'Ai··l00.\1}Il4 ..

1" ~-

,'.'

X'(21

= 15.11. P>O.05

--<

,~--'''-,<,

Cross tabulation between gender and AIDS check up

Sex Men

. ,',

:Count 1 0 0 12 6 % Witlrin Sex 5.3"10 0"10 0"10 31.6'Yo 63.2% %WithinAJDSchrlnlp 50.0"10 0"10 0"10 9.8"10 16.0"10 'r-:::' Woman Count 1, 4, 8 42 44 % Witlrin Sex 1.0"10 1 4.0"10 I 8.1% 42.4% 44.4% , % WIthinAIDScffikup 50.0"10 80.0"10 88.9'10 68.9'10 58.7% -_. Transsexual Count 1 13 19 I ;% Witlrin Sex 2.9'101 38.2%1 55.9'10 0"10 I 20.0"10 11.1% 21.3"10 25.3"10 %WIthinAIDScffikup I ", . .... 1) Total Count 9 """"""·2 61 75 % WJtbin Sex sglo 4(1.1% 1.3% 3;3% 493'10 %~~ 1 _ 101 100»'11, 100»'10 1~ 1000"10

.. -AIJ)Scheckqp '. . . .

.':"

:'~I!' 19 100.0"10 12.5% 99 100.0"10 . 65.1% 34 100.0"10 4

------O"~I 2·9'~1

....

lOOJ)"Ai

'X'(21 ;:8:00, P>O:{}~

....

.. ....;

...

loom11

Cross tabulation between gender and drinking alcohol

Sex

Count % Within Sex % Within Drink Count Woman % Within Sex % Within Drink Transsexual Count Men

13.1% 96 61.9% 60.0% 43 70.5%

100.0% 12.2% 155 63.0% 61 100.0%

Cross tabulation between gender and smoking

Sex

Men

Count % Within Sex % Within Smoke Woman Count % Within Sex % Within Smoke Transsexual Count % Within Sex

30 93.8% 13.9% 132 83.5% 61.1% 54 85.7%

2 6.3% 5.4% 26 16.5% 70.3% 9 14.3%

32 100.0% 12.6% 158 100.0% 62.5% 63 100.0%

Cross tabulation between gender and drug use

Drugs No Yes Sex I

Total 31 100.0% 13.3% 143 100.0% 61.4% 59 100.0% 25.3%

Men

Count

'% Within Sex ,% Within Drugs

Count % Within Sex % Within Drugs Count I Transsexual % Within Sex % Within Drugs I I

Woman

4 12.9% 7.7% , 37 25.9% 71.2% 11 18.6% 21.2% "

27 87.1% 14.9% 106 74.1% 58.6% 48 81.4% 26.5%

!j,Y~S:;.:i!".":i./ ""f "'. x,(2) - 3,08. P>O.OS

%Wlthiri,~

'", ",

% WIthin Drugs

52 22.3% 100.0%

181 233 77.7% 100.0% 100.0% 100.00;(, ,',',

Cross tabulation between gender and needle usage

Total Sex Men Count % Within Sex % Within Needle Usage Count Woman % Within Sex 0'0 Within Needle U Transsexual I Count , % Within Sex 1 6.3% 14.3% 6 6.0% 85.7% 15 93.8% 9.2% 94 94.0% 57.7%. 54 100.0% 16 100.0% 9.4% 100 100.0% 58.8% 54 100.0%

100.00;(,

100.0%

Cross tabulation between status of work and condom usage

Work Full Time

Part Time

Count % Within Sex % Within Condom Usage Count % Within Sex

131 96.3% 58.0% 95 96.0%

5 3.7% 55.6% 4 4.0%

136 100.0% 57.9% 99 100.0%

Cross tabulation between status of work and condom from

Work Full Time

Count % Within Sex % Within Condom From Count % Within Sex % Within Condom From

38.8% 51.0% 48 48.0%

61.2% 60.3% 52 52.0%

100.0% 56.3% 100 100.0%

Cross tabulation between status of work and without Condom

Work Full Time

Part Time

Count % Within Sex % Within Without Condom Count % Within Sex % Within Without Condom

23.3% 70.6% 10 18.2%

76.7% 63.7% 45

Cross tabulation between status of work and STD check up

ark Full Time

Part Time

Count % Within Sex % Within sm check up Count

91.8% 62.3% 61 81.3%

8.2% 39.1% 14 18.7%

Cross tabulation between status of work and AIDS check up

Work Full Time

Count % Within Sex % Within AIDS check

Part Time

87.4% 61.9% 64 80.0%

12.6% 48.4% 16 20.0%

59.8% 80 100.0%

Cross tabulation between status of work and drink

ork Full Time

Count % Within Sex

Part Time

64.5% 56.7% 68 66.0%

35.5% 58.3% 35 34.0%

Cross tabulation between status of work and smoking

Count 'Ii, Within Sex

% Within Smoke

Part Time

ll8 85.5% 55.9% 93 84.5%

14.5% 54.1'% 17 15.5%

138 100.0'% 55.6% 110 100.0%

Cross tabulation between status of work and using drug

ark Full Time

Part Time

Count % Within Sex % Within Drugs Count % Within Sex

26.6% 68.0% 16 16.0%

73.4% 52.8% 84 84.0%

100.0% 56.1% 100 100.0%

Cross tabulation between status of work and needle use

Work· Full Time

Part Time

Count % Within Sex % Within Needle Usage Count

3 3.1% 42.9% 4 5.6%

93 96.9% 58.1% 67 94.4%

96 100.0% 57.5% 71 100.0%

X'(2)

=0.64. p>o.os·

Cross tabulation between ethnic of SW and client races

Malay

Chinese

Count % Within Race % Within Client Races Count

Indian

Other

Cross tabulation between ethnic of SW and Malay client

!Malay

COlUlt

% Within Race % Within Malay Clients

Chinese

Count '}~ Within Race

Indian

'}o Within Malay Clients Count

108 00.6"10 61.7% 10 45.5% 5.7% 8 57.1% 4.6"10

19.4% 37.1% 12 54.5% 17.1% 6 42.9% 8.6"10

Other

26 34.7"'0

134 100.0% 54.7% 22 loo.a:,o 9.CYJ'u 14 1ooJJ'/o 5.7% 75 100.0%

X'(2) = 15.55. P<005

Cross tabulation between ethnic of SW and Chinese client

O:lUnt

% Within Race % Within Chinese Clients Chinese

54 40.3"10

38.8% 19 86.4'VD

00 59.7% 75.5% 3 13.6"{'

134 100.0% 54.710

22 100.0'10

Indian

Other

13.7"10 8 57.1% 5.8% 58 77.Cf!·o

2.8% 6 42.9%

.5.7"10

17 22.7%

X'(2) = 35.58. P<O.05

Cross tabulation between ethnic of SW and Indian client

. . . 'imai$Ctients ".t"fj$i . . . . .

r:&

Total 98 134

Race Malay

'Count

Chinese

I Indian

% Within Race 73.1% 100.0% .1 % Within Indian Clie_n_ts_-+_ _.4O_.4_%.......:.1_ _62_o8_l1<.o_t--_54_.7'l_Yo--J !Count 7 15 22 I% Within Race 31.8% I 68.2% 100.C1?10 I % Within Indian Clients 7.9"10 9.6% 9.0"10

36 : 26.9"10 I

Count

I I I

I% Within Race % Within Indian Clients Other

Count % Within Race

% Within Indian Clients I i;··

78J5)10 12.4% 35 46.7% 39.3%

21.4%

14 100.0'10

1.9"10 5.7'l·~ -.+---'-----1 40 75

53.3% 25.6%

100.0% 30.6"10

Total . ...

156 ,.'. . . ...... '.. 2t5

i;. X'(2)

loo,l1'41 lOO.l1'41 =35.58. P<O.05

Cross tabulation between ethnic of SW and reason for starting work as SW

COlmt

81 00.4% 59.1% 12 50.0% 8.8% 7 46.7%

13.4% 43.!J'1o 4 16.7% 9.8% 5 33.3%1 12.2%

53.7% 7' 29.2%1 13,(1'10

Other

3 20.0% 5.6% 15

Cross tabulation between ethnic of SW and SW local clients Crosstab

Malay

Chinese

Indian

Other

ColUlt % Within Race % Within Lx:ru Clients ColUlt % Within Race % Within Lx:ru Clients ColUlt % Within Race % Within Lx:ru Clients ColUlt

81 60,(1'10 5OH'/r, 16 00,(1'10 10.1% 7 46.7% 4.4% 55 78.6%

40,(1'10 66.7% 4 20,(1'10 4.9'% 8 53.3% 9.9'10 15

135 100,(1'10 56.3% 20 100,(1'10 8.3% 15 100,(1'10

X'(2}

= 11.37. P>O.05

Cross tabulation between ethnic of SW and SW foreign clients

Malay

Chinese

Count Within Race % Within Foreign C1ients Count % Within Race Clients % Within Race % Within Foreign Clients Count % Within Race

23 16.9'/0 34.3'Yo 5 23.8% 7.5% 7 46.7"ltl 10.4%

83.1% 64.6% 16 76.2"10

Indian

Other

32 45.7"10

9.1%, 8 53.3% 4.6'Yo 38

100.0'% 56.2% 21 100.0"10 8.7%

15 100.0"10 6.2"10

70 100.0"10

X'(2) = 22.10. P<0.05

Cross tabulation between ethnic of SW and reason for starting work as SW

Cross tabulation between gender of SW and local clients

Sex

Count % Within Sex % Within Local Clients Count % Within Sex % Within Local Clients Transsexual Count % Within Sex

Men

79.3% 14.4% 111 73.5% 69.4% 26 41.9%

12.0% 151 62.4% 62

Cross tabulation between gender of SW and clients races

Key facts

Organisation World Health Organization (WHO)

Document type Publications

Adoption date December 31, 2009

Source World Health Organization