“We Cannot Avoid Drinking”: Alcohol Use among Female Entertainment Workers in Cambodia

Abstract

Background: Female entertainment workers (FEWs) in Cambodia work in predominantly alcoholbased venues and therefore may face occupational risks. Studies have suggested that FEWs are pressured to consume alcohol while at the workplace, which may have adverse health outcomes. This study aims to explore the experiences of alcohol use among FEWs in Cambodia. Methods: Twenty-seven focus group discussions (FGDs) with FEWs were conducted across five sites in four provinces in Cambodia. FGD participants were FEWs who worked at entertainment venues, including karaoke TV bars, beer gardens, and massage parlors, as well as women who worked as on-call or street-based sex workers, and women across entertainment venues who were parenting. Results: The authors modified a conceptual model to create a framework based on the major themes identified within the FGDs on autonomy in alcohol use among FEWs. The framework and thematic components highlight the continuum of autonomy from pressured or coerced alcohol use to, economically or socially rational alcohol use to voluntary alcohol use. Factors that impacted alcohol use across the spectrum include experiencing an economic shock, needing to maintain a livelihood, experiencing psychological distress, having the desire to thrive in employment environment and drinking socially for personal enjoyment. Conclusion/Importance: Much of the motivation behind alcohol use is related to the need for economic security. For women who do not have other employment or income-generating options, individual behavior change programing is unlikely to be effective. Structural changes are needed to improve the health and safety of FEWs in Cambodia.

Improving Access to Health and Gender-based Violence Services for Female Entertainment Workers in Cambodia: Findings From the Mobile Link Randomized Controlled Trial

“…Our study did not detect changes in health outcomes, perhaps because these changes take longer to occur. It is also possible that several trial implementation challenges may have limited ability to detect health outcomes changes, including the high loss to follow-up, which was identi ed as an issue for other mHealth studies in Cambodia [30][31][32].…”

Gender-Based Violence and Factors Associated with Victimization among Female Entertainment Workers in Cambodia: A Cross-Sectional Study

“…Also, clients mainly forced FEWs to use substances. The high prevalence of forced substance use is unsettling as it has been previously linked to higher levels of psychological distress among FEWs in Cambodia (Brody et al, 2016;Brody, Kaplan, et al, 2019). In addition, alcohol use before commercial sex has been associated with unsafe sex and heightened risk for HIV and other STIs (Wang et al, 2010).…”

“…The types of violence were further categorized into different dimensions of GBV (physical, psychological, and sexual violence). Forced substance use was added as an extra dimension as FEWs have frequently reported this in Cambodia (Brody, Kaplan, et al, 2019). For data analyses, the types of GBV were merged into four categories: emotional abuse (verbal threats, controlling the ability to leave the house), physical abuse, forced sex, and forced substance use (alcohol, drugs).…”

Developing a WhatsApp hotline for female entertainment workers in Cambodia: a qualitative study

“…As more secondary themes arose during codebook development (e.g., the stressors experienced by FEWs and their current coping strategies), an inductive thematic analytical approach was selected to categorize these data (22). However, as stressors and coping mechanisms used by FEWs have been well documented in other published studies (23), this study only provided a brief summary of those results.…”