Although Cambodia has made significant strides in reducing HIV prevalence, from 2.1% in 1998 to an estimated 0.8% in 2011, there remain pockets of high risk, particularly among entertainment workers (EWs—direct and indirect sex workers who are collectively referred to as EWs), men who have sex with men (MSM), transgender (TG), and injecting drug users. Of note, many members of these most-at-risk populations are young.

Globally, young people—defined by the United Nations as 15-24 year olds—account for 40% of all new HIV infections. High risk behaviors, laws and policies that exclude young people from accessing sexual health care and HIV related services, and the lack of age appropriate sex and HIV prevention education puts young people at increased risk of HIV infection. According to a recent National AIDS Authority (NAA) report, a minority of young people in Cambodia have comprehensive knowledge of HIV. Further, although sex by the age of 15 is relatively uncommon the 2010 MARYP survey reveals pockets of high risk, with limited use of condoms in sweetheart relationships.

To support the development of appropriate HIV prevention and protection efforts for young EWs (YEWs), UNICEF and FHI 360 conducted a formative assessment from May to October 2012. The study objectives were to:

1. Conduct a ‘situational’ analysis on young people (male, female and self-identified transgender individuals) engaged in transactional sex/sex work, including socioeconomic profiles; age and causes/ mechanisms of initiation into transactional sex/sex work, and any individual/multiple vulnerabilities by using existing data and supplementing it with the collection of qualitative data
2. Investigate viable alternatives to transactional sex/sex work from the perspective of younger and older EWs
3. Assess the situations of child bearing and rearing experiences of YEWs, and to determine the feasibility of a family-based approach
4. Assess the existence of an enabling environment for younger EWs compared to older EWs, particularly in terms of access to services, stigma and discrimination

Recognizing the multi-sectoral nature of this exploratory study, a Steering Committee was established. This Committee guided the study and its implementation, reviewed the findings, developed the recommendations, and supported the dissemination of the report. This committee was comprised of senior representatives from the Ministry of Education, Youth and Sports (MoEYS), the Ministry of Women’s Affairs (MoWA), the National Center for HIV and AIDS, Dermatology, and STIs (NCHADS), in collaboration with UNICEF and FHI 360.