Photo Credit: D. H. Friendly
Sineng1, 21, works in a beer hall in Phnom Penh, where her job is to serve and entertain men. Sometimes she sells sex to make extra money. In the last month, she was diagnosed with HIV. Sineng fears how the virus will affect her health, her relationships and her job. Afraid and timid, she stood before the SMARTgirl club, a support group for entertainment workers like herself, to tell peers about a recent day when she felt overwhelmed by the news of her status.
“I got up at 6 a.m., tired and upset. Since I found out I am HIV positive, I have not been sleeping well, and I am worried that my life will be so much more of a struggle. But that morning, I felt terrible because I had been out drinking with friends, trying to forget my fear. I needed to get to the health clinic but since I had spent all my money on alcohol the night before, I had to go to the market and sell my phone for the [US]$5 I needed for transport.
“As I rode on the back of the moto-taxi, I was thinking back to the day I told my parents about the diagnosis. They cried a lot. I begged them, on my knees, not to hate me. They feel sorry for me, but of course, there’s no reversing the situation. We haven’t told my extended family or my friends. I’m not ready to.
“With these thoughts running through my head, I was reduced to tears and forgot to tell the moto-taxi driver where to stop. I dried my face, told him to turn around and we went to the clinic.
“When I arrived, I had another thought. When people find out I’m positive, I wonder if they’ll hate me or pity me. In any case, I was ashamed.”
For Sineng, even entering the clinic was a hard step. Stigma against entertainment workers and people living with HIV makes seeking health care and other support difficult. However, Sineng goes to the Chhouk Sar clinic, which is an FHI 360-clinic that reaches out to entertainment workers and other high-risk populations and treats them respectfully.
“After visiting the clinic, I went to see my uncle. I couldn’t tell him where I had been. There’s no way he could cope with the embarrassment of having a niece with HIV.
“All my thoughts and feelings were weighing heavily on me, so I decided to visit the SMARTgirl club. There, I talked with an outreach worker who comforted me and helped me feel better.”
Outreach workers for SMARTgirl provide HIV prevention information, as well as counseling and psychosocial support. They also refer entertainment workers to HIV testing, testing and treatment for sexually transmitted infections, family planning services and for HIV care and treatment services.
“At 5 p.m., it was time to get ready for my six-hour shift at the beer garden. I went to the market and had my makeup done. The man I love came to the beer garden that night, and I couldn’t bear the thought of his reaction to my news; I said nothing about it. It had been an emotional day, so I went out to a nightclub after work with some friends and drank heavily. I got home at 3 a.m.”
Sineng says she is committed to taking better care of herself and not abusing alcohol. She says she doesn’t feel “normal” like before, and she worries about the implications of her diagnosis on her health, her reputation and her capacity to earn an income. Yet, with the advice and support she has been receiving from the SMARTgirl outreach worker, she is starting to understand and come to terms with her positive status.
1 In this series, real names of program participants are not used.