The Forgotten MARP: Effective Programmes for Clients of Sex Workers through the Workplace

Article | 01 July 2010

China – July 2010


In China’s Yunnan province, government and non-government programmes have targeted female sex workers (FSW) and injecting drug users (IDU) with intensive interventions, but these have not yet reduced the rate of new infections. Gejiu City, for example, has one of the highest prevalence rates in the country, recently increased to 10% among FSW. The majority of FSW clients were employed in a single state-owned mining company.

A pre-intervention survey conducted among area miners in 2005 showed that 72.6% said they frequently engaged in casual and commercial sex; 23.2% reported at least one STI; and consistent use of condoms was less than 20%.


In response, the International Labour Organization and its partners - the China Ministry of Human Resources, the All-China Federation of Trade Unions and grassroots NGOs - developed a comprehensive workplace programme using the delivery infrastructure and financial resources of the company. It included intensive behaviour change interventions at workplaces and in workers’ accommodation and entertainment areas. The programme also provided workplace policy protection for PLHIV, onsite STI treatment, VCT referrals and TB education.

In a two-year period the programme showed significant results with self-reported commercial sex relations dropping to 35.9% and consistent use of condoms increasing to 74.7%.

Lessons Learned

There is an urgent need to include workplace programmes targeting FSW and their clients within national and local responses in the Asia Pacific, especially where FSW lack bargaining power and/or are highly mobile.

Workplace programmes targeting FSW and their clients are both effective and cost efficient – with significant resources available from enterprise partners.

Next Steps

The ILO will work with UNAIDS partners and national AIDS programmes to scale up a targeted workplace approach in the Asia Pacific.