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Background: Chlamydia, caused by Chlamydia trachomatis, is the most common reportable infection in many developed countries. Testing, treatment, and partner notification (PN) are key strategies for chlamydia control. In 2008 the Let Them Know (LTK) PN website was established, which provided means for people to send anonymous PN messages by text messaging (short message service, SMS), email, or letter.Objective: We evaluated PN practices among Australian family planning clinicians following chlamydia diagnosis and assessed how often clinicians refer their patients to the LTK website.Methods: A mixed methods approach included a Web-based cross-sectional survey of Australian family planning clinicians to examine PN attitudes and practices and focus groups to explore the context of LTK website use.Results: Between May 2012 and June 2012, all clinicians from 29 different family planning services (n=212) were invited to complete the survey, and 164 participated (response rate=77.4%); of the clinicians, 96.3% (158/164) were females, 56.1% (92/164) nurses, and 43.9% (72/164) doctors. More than half (62.2%, 92/148) agreed that PN was primarily the client's responsibility; however, 93.2% (138/148) agreed it was the clinician's responsibility to support the client in informing their partners by providing information or access to resources. Almost half (49.4%, 76/154) of the clinicians said that they always or usually referred clients to the LTK website, with variation across clinics in Australian states and territories (0%-77%). Eleven focus groups among 70 clinicians at 11 family planning services found that the LTK website had been integrated into routine practice; that it was particularly useful for clients who found it difficult to contact partners; and that the LTK letters and fact sheets were useful. However, many clinicians were not aware of the website and noted a lack of internal clinic training about LTK.Conclusions: The LTK website has become an important PN tool for family planning clinicians. The variation in referral of patients to the LTK website and lack of awareness among some clinicians suggest further promotion of the website, PN training, and clinic protocols are warranted. [ABSTRACT FROM AUTHOR]

Background: Chlamydia, caused by Chlamydia trachomatis, is the most common reportable infection in many developed countries. Testing, treatment, and partner notification (PN) are key strategies for chlamydia control. In 2008 the Let Them Know (LTK) PN website was established, which provided means for people to send anonymous PN messages by text messaging (short message service, SMS), email, or letter. Objective: We evaluated PN practices among Australian family planning clinicians following chlamydia diagnosis and assessed how often clinicians refer their patients to the LTK website. Methods: A mixed methods approach included a Web-based cross-sectional survey of Australian family planning clinicians to examine PN attitudes and practices and focus groups to explore the context of LTK website use. Results: Between May 2012 and June 2012, all clinicians from 29 different family planning services (n=212) were invited to complete the survey, and 164 participated (response rate=77.4%); of the clinicians, 96.3% (158/164) were females, 56.1% (92/164) nurses, and 43.9% (72/164) doctors. More than half (62.2%, 92/148) agreed that PN was primarily the client's responsibility; however, 93.2% (138/148) agreed it was the clinician's responsibility to support the client in informing their partners by providing information or access to resources. Almost half (49.4%, 76/154) of the clinicians said that they always or usually referred clients to the LTK website, with variation across clinics in Australian states and territories (0%-77%). Eleven focus groups among 70 clinicians at 11 family planning services found that the LTK website had been integrated into routine practice; that it was particularly useful for clients who found it difficult to contact partners; and that the LTK letters and fact sheets were useful. However, many clinicians were not aware of the website and noted a lack of internal clinic training about LTK. Conclusions: The LTK website has become an important PN tool for family planning clinicians. The variation in referral of patients to the LTK website and lack of awareness among some clinicians suggest further promotion of the website, PN training, and clinic protocols are warranted. [ABSTRACT FROM AUTHOR]

Objectives: HIV prevalence among Cambodian female sex workers (FSW) is among the highest in Southeast Asia. We describe HIV prevalence and associated risk exposures in FSW sampled serially in Phnom Penh, Cambodia (Young Women's Health Study (YWHS)), before and after the implementation of a new law designed to combat human trafficking and sexual exploitation. Design: Cross-sectional analysis of baseline data from two prospective cohorts. Setting: Community-based study in Phnom Penh, Cambodia. Participants: Women aged 15-29 years, reporting ≥2 sexual partners in the last month and/or engaged in transactional sex in the last 3 months, were enrolled in the studies in 2007 (N=161; YWHS-1), and 2009 (N=220; YWHS-2) following information sessions where 285 and 345 women attended. Primary outcomes: HIV prevalence, sexual risk behaviour, amphetamine-type stimulant (ATS) and alcohol use, and work-related factors were compared in the two groups, enrolled before and after implementation of the new law. Results: Participants in the two cohorts were similar in age (median 25 years), but YWHS-2 women reported fewer sex partners, more alcohol use and less ATS use. A higher proportion of YWHS-2 compared with YWHS- 1 women worked in entertainment-based venues (68% vs 31%, respectively). HIV prevalence was significantly lower in the more recently sampled women: 9.2% (95% CI 4.5% to 13.8%) vs 23% (95% CI 16.5% to 29.7%). Conclusions: Sex work context and risk have shifted among young FSW in Phnom Penh, following implementation of anti-prostitution and anti-trafficking laws. While both cohorts were recruited using the same eligibility criteria, more recently sampled women had lower prevalence of sexual risk and HIV infection. Women engaging more directly in transactional sex have become harder to sample and access. Future prevention research and programmes need to consider how new policies and demographic changes in FSW impact HIV transmission. [ABSTRACT FROM AUTHOR]

Cambodia's 100% Condom Use Programme is credited with an increase in consistent condom use in commercial sexual interactions and a decrease in HIV prevalence among female sex workers (FSWs). There has been little improvement in condom use between FSWs and non-commercial partners, prompting calls for more innovative approaches to increasing condom use in these relationships. To understand why condoms are used or not used in sexual interactions involving FSWs, we examined condom negotiation across different types of relationships. We conducted 33 in-depth interviews with young (15 to 29 years) women engaged in sex work in Phnom Penh. There was an important interplay between the meanings of condom use and the meanings of women's relationships. Commercial relationships were characterised as inherently risky and necessitated condom use. Despite a similar lack of sexual fidelity, sweetheart relationships were rarely construed as risky and typically did not involve condom use. Husbands and wives constructed their sexual interactions with each other differently, making agreement on condom use difficult. The lack of improvement in condom use in FSWs' non-commercial sexual relationships needs to be understood in relation to both sex work and the broader Cambodian sexual culture within which these relationships are embedded. [ABSTRACT FROM AUTHOR]

ABSTRACT National surveillance data indicate marked differences between Indigenous and other Australians in the prevalence of many sexually transmitted infections (STIs). Young Indigenous people bear a particularly high burden of these infections. A collaboration of university researchers, Indigenous health workers and young Indigenous people conducted 45 field interviews to examine how young Indigenous Australians keep themselves healthy and protected against STIs. Our findings emphasise the complexity of health behaviours, where individuals are rarely always 'risky' or always 'safe', as well as subtle gender differences in health practices. Preventive strategies employed by the young people were contingent on beliefs and knowledge about sexual partners, the type of relationship, the context of the sexual encounter and access to condoms. Tangible strengths such as young Indigenous people's commitments to condoms and STI screening should be celebrated and bolstered to enhance their ability to protect themselves against adverse health outcomes and enhance their resilience against STIs. Focusing on strengths helps to counter the deficit model of health commonly deployed in Indigenous health research and draws attention to health issues facing young Indigenous people and their communities, without reinforcing negative stereotypes or focusing solely on individual risk behaviour. We provide concrete recommendations for health promotion and education. Copyright © 2011 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

This article draws on a discursive analysis of individual and group interviews with forty-five heterosexual men to examine how men take up and resist discourses of sexuality and gender to (re)produce a recognizable heterosexual subjectivity. It explores the commodification of sex in men's accounts and the various practices men described undertaking to obtain sex. The article argues that the contexts in which men (re)produce sexual subjectivity have significant implications for how they negotiate the discursive positions available to them. Three themes are presented to demonstrate the different discursive practices undertaken by single and partnered men. Finally, the article explores the difficulties, dilemmas, and ambivalences produced by the project of subjection and how individual men resolve them. [ABSTRACT FROM AUTHOR]

AbstractIn Australia, Aboriginal young people who are lesbian, gay, bisexual, trans, queer or otherwise sexuality and gender diverse (LGBTQ+) are recognised within several overlapping priority populations in state and federal sexually transmissible infection and HIV strategies. However, limited research has documented their unique sexual health experiences, needs and preferences. In this qualitative study, semi-structured interviews were conducted with 10 LGBTQ+ Aboriginal young people aged 16–24 years in New South Wales. Interviews incorporated questions about service access, positive and negative experiences and self-determined healthcare priorities. We conducted a strengths-based thematic analysis to understand the issues of greatest importance in sexual healthcare for participants. Using the framework of ‘imaginaries’, we explored how participants imagined sexual healthcare that would meet their individual and cultural needs. The dominant imaginary centred on respect, representation and the as-yet-unrealised possibility of sexual healthcare designed by and for people who shared the intersection of Aboriginal and LGBTQ+ experience. We identified individual-level, service-level and societal-level factors influencing this imaginary, including relationships, accessibility and experiences of racism. Analysing the imaginaries constructed by LGBTQ+ Aboriginal young people of empowering, culturally safe sexual healthcare that is ‘for them’ provides insight into potential service design to improve sexual health outcomes for this population. [ABSTRACT FROM AUTHOR]

The experience and positioning of affect is a material-discursive-intrapsychic experience, which can be interrogated through the examination of the intersubjective realm. This paper examines ways in which women experience and negotiate premenstrual change in affect, positioned as premenstrual syndrome (PMS), drawing on in-depth interviews conducted with fifty-nine women. All of the women interviewed described premenstrual changes in affect in a similar manner, as being characterised by intolerance, irritation, emotional sensitivity, feeling more negative towards others, and feeling overwhelmed in the face of life's demands. Without exception, women expressed a desire to be alone premenstrually, in order to escape relational demands and responsibilities, to reduce stimulation, or to avoid conflict. The way that these premenstrual changes and the woman's desire to be alone were positioned by the woman's partner, and dealt with within relationships, provided the material and discursive context for the woman's experience and negotiation of PMS. Women whose partners were accepting and supportive were more likely to take up a position of awareness, acceptance and self-care in relation to premenstrual change, whilst women whose partners were unsupportive were more likely to engage in self-castigation and self-pathologisation. This suggests that intersubjectivity, the examination of subjectivity and affect in the context of relatedness, will be a fruitful avenue of exploration for critical psychologists, as well as for researchers interested in the complexity of women's premenstrual experiences. [ABSTRACT FROM AUTHOR]

Background: In many countries, sexual minority women smoke at higher rates than their heterosexual counterparts. Analyses tend to combine lesbian and bisexual women, preventing an understanding of relevant factors associated with smoking for each group. This analysis used a representative sample of the Australian population to compare tobacco use between heterosexual, lesbian and bisexual women, and examine factors associated with smoking among these groups.Methods: In a secondary analysis of data from the National Drug Strategy Household Survey (N = 23,855), descriptive statistics were produced for heterosexual (n = 11,776), lesbian (n = 135) and bisexual (n = 167) women. Multivariate logistic regression modelling was undertaken to assess which factors were associated with current smoking among the different groups.Results: Compared to heterosexual women, lesbian and bisexual women were more likely to be current smokers (OR 2.9(1.8,4.5) and OR 3.6(2.4, 5.4) respectively). Employment, income and psychological distress were significant factors associated with smoking for lesbian women. Recent illicit drug use was the only significant factor associated with smoking for bisexual women.Conclusions: We need to better understand the psychological, social and cultural factors that influence initiation, and sustain smoking among lesbian and bisexual women. Our findings demonstrate that sexual minority women in Australia warrant specific policy attention in a national framework. [ABSTRACT FROM AUTHOR]

The authors propose that techniques from art and design can be used within social science research as part of a speculative methodology and provide a set of heuristic principles for speculative method, characterizing it as processual, performative, playful, promising and propositional. [ABSTRACT FROM AUTHOR]

Background: Sexual minority women consume both alcohol and tobacco at higher rates than heterosexual women. However, various sociodemographic and cultural factors associated with these practices among sexual minority women in Australia are not well understood, nor are the factors associated with seeking alcohol-related support.Methods: This study utilised data from cisgender sexual minority women respondents of Private Lives 3: a national, online, cross-sectional survey of the health and wellbeing of LGBTIQ adults in Australia aged 18+ conducted in 2019. Multivariable analyses were performed to identify co-existing smoking and alcohol use, sociodemographic factors associated with smoking, alcohol consumption and seeking alcohol-related support.Results: Of 2,647 sexual minority women respondents, 16.90% were currently smoking tobacco, 7.67% smoking tobacco daily and 60.50% reported potentially risky patterns of alcohol consumption. Tobacco and potentially risky alcohol consumption were found to frequently co-occur. Women who identified as queer were more likely than lesbian identifying women to currently smoke tobacco and to smoke tobacco daily. Tobacco consumption was associated with increased age, unemployment, low-mid range income and secondary-school education, while potential risky drinking was associated with living in outer urban or rural areas and being Australian born . Self-reporting having struggled with alcohol in the past twelve months was associated with residential location. Less than 3% of the sample has sought help for alcohol use. Seeking support was more likely as women aged, and with potentially risky drinking, and much more likely with self-perceived struggles with alcohol.Conclusions: The findings highlight the need for future alcohol and tobacco use health promotion strategies focussing on sexual minority women to attend to within group differences that relate to risk of higher consumption. They also highlight the need for approaches that empower sexual minority women to self-identify when they are struggling with alcohol use and encourage seeking support with organisations that are affirming of sexual minority women. [ABSTRACT FROM AUTHOR]

Childhood and adolescent traumas are exceptionally prevalent worldwide. Despite their high prevalence and substantial impact, little research has investigated the rates and specific types of early trauma by gender. It is also unknown whether the types of early trauma are differentially associated with heightened or hindered prosocial attitudes and behaviours. To address this gap, this study aims to explore the rates of different types of early trauma (i.e., abuse: sexual, physical, and emotional; neglect: physical and emotional) among young Australian adults and investigate whether these differ according to participant gender (female, male and transgender/gender diverse). The study will also examine the associations between the different types of early trauma and current altruistic attitudes and behaviours (including the affective, behavioural and cognitive altruism domains), among a young adult Australian cohort. Cross-sectional data was collected from 511 young Australians aged 18–20 years using an online self-report survey. Multiple regression analyses revealed that transgender/gender diverse individuals were over 3-times more likely to experience all types of maltreatment than females and over 3-times more likely to experience emotional and sexual abuse and emotional neglect than males. Experiencing one or more trauma types was negatively associated with the cognitive domain of altruism, experiencing physical neglect was associated with the affective domain, and having a family member involved in domestic violence was associated with the behavioural domain, after controlling for gender. Findings show how early traumatic experiences can influence individuals' attitudes and behaviours during the pivotal developmental period of young adulthood. [ABSTRACT FROM AUTHOR]

This article explores the relationship between gender, sexuality and alcohol consumption among lesbian, bisexual, and queer (LBQ) women in Australia. On average, LBQ women consume alcohol at a higher rate than heterosexual women, yet the use of alcohol and its gendered meanings in this population remain under-explored. We conducted semi-structured interviews with 42 cisgender women, 10 transgender women, and 8 non-binary people who identify as lesbian, bisexual, and/or queer. Participants were aged 18-72. Interviews explored participants' experiences with alcohol, gender, and sexuality. Interviews were thematically analysed, informed by a critical alcohol and other drug scholarship lens. While 'minority stress' is often cited as a key factor in explaining LBQ women's high rates of alcohol consumption, our findings suggest a more complex relationship between drinking, gender and sexuality. Drinking is gendered for LBQ women, enabling both performance of and resistance to gendered norms. Additionally, alcohol emerged as a tool for navigating gendered vulnerability in public spaces, with some participants shaping their alcohol intake to their environment. Our findings highlight the need for approaches to LBQ women's health that recognise alcohol as a social tool that can facilitate confidence, pleasure, and community connection. Rather than focusing solely on risk and vulnerability, policies and health promotion efforts should consider the diverse ways in which LBQ women use alcohol to navigate their identities and social environments., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Purpose: Adolescent participation in health research studies is critical yet complex given the lack of clarity around issues such as consent. This study aimed to understand how those conducting research in Australia navigate research ethics in health research involving adolescents, through qualitative interviews., Methods: Purposive sampling was used to recruit 23 researchers involved in adolescent health research using semi-structured in-depth interviews. Interviews were conducted via Zoom and audio-recorded after obtaining informed consent. Thematic analysis was used to construct themes and data were organised using NVivo., Results: Two contrasting positions emerged from the data: (1) framing of adolescents as inherently vulnerable, their participation in research understood in terms of risk and protection and (2) adolescent engagement in research is understood in terms of empowerment, emphasising their capacity to make decisions about research participation. We traced these positions through three key themes, particularly in relation to the role of ethics committees: (1) competing positions as a result of inferior or superior knowledge about adolescent lives, (2) competing positions resulting in a risk averse or an empowerment approach, and (3) reflections on processes of obtaining consent which involves gatekeeping and tokenism., Discussion: Our study highlights the contentious topic of navigating ethics committee requirements for the needs of adolescents. Majority of participants felt the current research ethics establishment is not favourable for researchers or adolescents themselves. While it is imperative that perceptions of ethics committees also be studied in the future, our study provides preliminary understanding of how experiences and perceptions shape how researchers interact with the research ethics establishment., (Copyright © 2024 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

What ways of thinking and concrete strategies can assist qualitative health researchers to transition their research practice to online environments? We propose that researchers should foreground inclusion when designing online qualitative research, and suggest ethical, technological and social adaptations required to move data collection online. Existing research shows that this move can aid in meeting recruitment targets, but can also reduce the richness of the data generated, as well as how much participants enjoy participating, and the ability to achieve consensus in groups. Mindful and consultative choices are required to prevent these problems. To adapt to ethical challenges, researchers should especially consider participant privacy, and ways to build rapport and show appropriate care for participants, including protocols for dealing with distress or disengagement, managing data, and supporting consent. To adapt to technological challenges, research plans should choose between online modalities and platforms based on a clear understanding of their particular affordances and the implications of these. Finally, successful research in virtual social environments requires new protocols for engagement before data collection, attention to group numbers and dynamics, altered moderator teams and roles, and new logistical tasks for researchers. The increasing centrality of online environments to everyday life is driving traditional qualitative research methods to online environments and generating new qualitative research methods that respond to the particularities of online worlds. With strong design principles and attention to ethical, technical and social challenges, online methods can make a significant contribution to qualitative research in health., (© 2021. The Author(s).)

Introduction and Aims: Lesbian, bisexual and queer (LBQ) women in Australia and internationally are smoking at least twice the rate of women in the general population. An understanding of smoking behaviours in this population is essential in order to develop effective interventions. Our analysis aimed to investigate differences in smoking patterns and contexts of smoking between current smokers and recent quitters (<2 years to 1 month)., Design and Methods: Data were collected through an online anonymous survey conducted in mid-2015. Participants were recruited online from a variety of social networking sites and community-based mailing groups., Results: Overall 257 lesbian, bisexual and queer women completed the survey, 73% current smokers and 27% recent quitters; nearly all had smoked daily at some point in their lives. Multivariate analysis showed recent quitters were less likely to have some (adjusted odds ratio [aOR] 0.19, 95% confidence interval [CI] 0.05-0.71) or half/most/all (aOR 0.12, 95% CI 0.03-0.048) close friends who smoked compared to none, and were more likely to have a non-smoking (aOR 10.2, 95% CI 3.86-27.0) or no regular partner (aOR 4.01, 95% CI 1.47-10.9) than one who smoked. Non-Anglo-Australian women were also more likely to be recent quitters (aOR 2.45 [95% CI 1.10-5.42]) than Anglo-Australian women., Discussion and Conclusions: Understanding the social significance of partners and friends in lesbian, bisexual and queer women's smoking and cessation efforts will be important for developing meaningful, effective and targeted interventions to address the persistent high rates of smoking in this population., (© 2018 Australasian Professional Society on Alcohol and other Drugs.)

Introduction: Tobacco use among lesbian, gay, bisexual, and transgender (LGBT) people is double the general population. Limited evidence suggests high smoking rates among intersex people. Lesbian, gay, bisexual, transgender, and intersex (LGBTI) people are a priority population in Australian health policy, particularly mental health and aging. Despite associations between smoking and noncommunicable diseases relevant to aging and mental health, LGBTI-targeted smoking cessation interventions in Australia have been limited to people living with HIV. Applying existing interventions to marginalized populations without modification and evaluation may fail and exacerbate inequities., Aims: To assess outcomes and characterize the populations served, cultural modifications, and behavior change techniques (BCTs) of interventions to reduce LGBTI smoking., Methods: We searched MEDLINE, six additional databases, and contacted authors to retrieve published and unpublished program evaluations., Results: We retrieved 19 studies (3663 participants). None used control groups. Overall quit rate was 61.0% at the end of interventions and stabilized at 38.6% at 3-6 months. All studies included gay men, 13 included lesbians, 13 "LGBT," 12 bisexual people, five transgender people, and none included intersex people. Transgender people comprised 3% of participants. Of programs open to women, 27.8% of participants were women. Cultural modifications were used by 17 (89.5%) studies, commonly meeting in LGBT spaces, discussing social justice, and discussing LGBT-specific triggers. Common BCTs included providing normative information, boosting motivation/self-efficacy, relapse prevention, social support, action planning, and discussing consequences., Conclusions: Quit rates were high; using control groups would improve evaluation. Existing programs may fail to reach groups other than gay men., Implications: This review examines the evidence for LGBTI-targeted smoking cessation interventions. Populations within LGBTI are not proportionally represented in smoking cessation research, and no study addressed intersex smoking. Overall, LGBT-targeted interventions appear to be effective, and simply having an LGBT-specific group may be more effective than groups for the general population. More rigorous research is necessary to draw firm conclusions. Our study space analysis provides suggestions for areas of more targeted research on mechanisms underlying these complex interventions' success., (© The Author 2016. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

While repressive laws and policies in relation to sex work have the potential to undermine HIV prevention efforts, empirical research on their interface has been lacking. In 2008, Cambodia introduced antitrafficking legislation ostensibly designed to suppress human trafficking and sexual exploitation. Based on empirical research with female sex workers, this article examines the impact of the new law on vulnerability to HIV and other adverse health outcomes. Following the introduction of the law, sex workers reported being displaced to streets and guesthouses, impacting their ability to negotiate safe sex and increasing exposure to violence. Disruption of peer networks and associated mobility also reduced access to outreach, condoms, and health care. Our results are consistent with a growing body of research which associates the violation of sex workers' human rights with adverse public health outcomes. Despite the successes of the last decade, Cambodia's AIDS epidemic remains volatile and the current legal environment has the potential to undermine prevention efforts by promoting stigma and discrimination, impeding prevention uptake and coverage, and increasing infections. Legal and policy responses which seek to protect the rights of the sexually exploited should not infringe the right to health of sex workers., (Copyright 2015 Maher et al. This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: The risk environment framework provides a valuable but under-utilised heuristic for understanding environmental vulnerability to HIV and other sexually transmitted infections among female sex workers. Brothels have been shown to be safer than street-based sex work, with higher rates of consistent condom use and lower HIV prevalence. While entertainment venues are also assumed to be safer than street-based sex work, few studies have examined environmental influences on vulnerability to HIV in this context., Methods: As part of the Young Women's Health Study, a prospective observational study of young women (15-29 years) engaged in sex work in Phnom Penh, we conducted in-depth interviews (n = 33) to explore vulnerability to HIV/STI and related harms. Interviews were conducted in Khmer by trained interviewers, transcribed and translated into English and analysed for thematic content., Results: The intensification of anti-prostitution and anti-trafficking efforts in Cambodia has increased the number of women working in entertainment venues and on the street. Our results confirm that street-based sex work places women at risk of HIV/STI infection and identify significant environmental risks related to entertainment-based sex work, including limited access to condoms and alcohol-related intoxication. Our data also indicate that exposure to violence and interactions with the police are mediated by the settings in which sex is sold. In particular, transacting sex in environments such as guest houses where there is little or no oversight in the form of peer or managerial support or protection, may increase vulnerability to HIV/STI., Conclusions: Entertainment venues may also provide a high risk environment for sex work. Our results indicate that strategies designed to address HIV prevention among brothel-based FSWs in Cambodia have not translated well to street and entertainment-based sex work venues in which increasing numbers of women are working. There is an urgent need for targeted interventions, supported by legal and policy reforms, designed to reduce the environmental risks of sex work in these settings. Future research should seek to investigate sex work venues as risk environments, explore the role of different business models in mediating these environments, and identify and quantify exposure to risk in different occupational settings.