Buy Heroin Siem Reap

__________________________

📍 Verified store!

📍 Guarantees! Quality! Reviews!

__________________________

▼▼ ▼▼ ▼▼ ▼▼ ▼▼ ▼▼ ▼▼

▲▲ ▲▲ ▲▲ ▲▲ ▲▲ ▲▲ ▲▲

Buy Heroin Siem Reap

Activities by an organized crime group involving the illegal entry, transit or residence of migrants for a financial or material benefit. The illicit trade and possession of species covered by CITES convention, and other species protected under national law. The poaching, illicit trade in and possession of species covered by CITES and other species protected by national law. Includes IUU fishing. The illicit extraction, smuggling, mingling, bunkering or mining of natural resources and the illicit trade of such commodities. The production, distribution and sale of heroin. Consumption of the drug is considered in determining the reach of the criminal market. The production, distribution and sale of cocaine and its derivatives. Consumption is considered in determining the reach of the market. The illicit cultivation, distribution and sale of cannabis oil, resin, herb or leaves. Consumption is used to determine the market's reach. The production, distribution and sale of synthetic drugs. Clearly defined organized crime groups that usually have a known name, defined leadership, territorial control and identifiable membership. Loose networks of criminal associates engaging in criminal activities who fail to meet the defining characteristics of mafia-style groups. Includes foreign nationals and diaspora groups. The State's role in responding to organized crime and its effectiveness. The degree to which states have put oversight mechanisms in place to ensure against state collusion in illicit activities. A country's supranational structures and processes of interaction, policy making and concrete implementation to respond to organized crime. The degree to which states are able to control their physical and cyber territory and infrastructure against organized criminal activities. Assistance provided to victims of various forms of organized crime, including initiatives such as witness protection programs. Refers to the existence of strategies, measures, resource allocation, programmes and processes that are aimed to inhibit organized crime. Cambodia is an origin, transit and destination country for human trafficking. The country is a destination market for victims from Vietnam, and a transit point for victims trafficked to Thailand. Women and girls are the primary victim group, trafficked for prostitution, while men are sent into forced labour. Cambodia is a key destination for the sexual exploitation of children, especially in the tourism industry. As poverty is rife, most victims of trafficking are lured by false job opportunities and tied into debt bondage. Trafficking operations are run mainly by Cambodian nationals with the help of corrupt officials. Cambodia is predominantly a source country of migrant smuggling throughout the region, most commonly into Thailand, where wages are higher and the cost of smuggling is much cheaper than using legal channels. Smuggling is run by loose and decentralized criminal groups, and facilitated by corrupt law enforcement, immigration and government officials. Smuggling groups have been successful in evolving their practices to avoid the legal frameworks that have been put in place to prevent irregular migration. Historically a significant source country for weapons, Cambodia has evolved into a transit country for arms smuggling, primarily into Myanmar. Though international intervention has diminished the national stockpile of weapons, a significant number of arms are still being recovered within the country, with government corruption putting state-held weapons at risk of being trafficked. A small domestic market also exists, with social media being used to advertise and sell illicit arms to citizens. The illegal flora trade is conducted in parallel with legal business, with the mixing of illicit and licit wood during its transportation being the most common method of concealing illegally procured timber. The illicit flora market provides lucrative income for low-paid foresters and farmers, and has a particularly close involvement with the ruling elite. The impact has been severe on Cambodian forests, which have declined significantly in the last two decades. Cambodia has a large illegal wildlife market and is a source country for many rare species. Combined with increasing consumer demand and weak law enforcement, this has created a diversified and well-consolidated market. The market is driven primarily by local demand for wild meat and wildlife ingredients used in traditional medicines. According to the UN, Cambodia has been significantly under-reporting the amount of sand it exports to Singapore, in particular. The facilitators and beneficiaries of non-renewable crimes are thought to be members of the ruling elite. Cambodia is an important transit country for synthetic drugs, which are smuggled through its north-eastern borders and then trafficked into the wider region and beyond. Due to the falling prices of methamphetamine and ecstasy, the number of synthetic drug users is increasing, and larger seizures are made by Cambodia's law enforcement agencies every year. As with most forms of organized crime in the country, corrupt officials facilitate the criminal market in Cambodia. Cannabis is widely used and culturally accepted in Cambodia, and its cultivation is widespread in rural areas, which supply the domestic and regional market. Among the arrests made in , the majority of traffickers were foreign nationals. Cambodia is both a destination and transit country for heroin trafficking, with the cities of Siem Reap and Phnom Penh acting as the largest transit points into neighbouring countries. However, Cambodia is not a significant player in the illicit heroin trade compared with its neighbours in the region, and the trade is run mainly by international criminal groups. Only a small number of seizures have been made, and most of the demand for heroin seems to have migrated to the synthetic drug market. Cambodia serves as a transit country for cocaine trafficking. While seizures are usually small, they increased in Nevertheless, the value of the market in Cambodia remains much lower than in neighbouring countries. Despite a few small gangs with hierarchical structures, there do not appear to be any significant mafia-style groups operating within Cambodia. While small, loose criminal networks exist in the country, they are not prominent and operate mainly in the human trafficking and smuggling markets. Most markets are run by international criminal groups, with varying levels of involvement from the Cambodian government and law enforcement. Organized crime is run mostly by international groups colluding with local Cambodian criminals. Taiwanese groups are also involved in drug markets, as are groups from Myanmar. Many Chinese organized crime groups use Phnom Penh as a safe haven and invest heavily in legitimate businesses in the country. These international groups are usually connected with and protected by the ruling elite in Cambodia. The ruling elite is also accused of allocating rights to oil and mineral resources without due process. Political figures at the highest levels of government, as well as law enforcement officials, appear to provide protection to criminal markets as a means to enrich themselves, with the prime minister and his allies reportedly stashing millions abroad. While the Cambodian political system has not been captured by organized crime, corruption is rampant and widespread, with little accountability or transparency, allowing many figures in the ruling elite to acquire wealth from criminal markets. Public trust in government institutions is low, while calls for more accountability in the public sector have not been met with commitments from government. Cambodia has enhanced its cooperation with its international partners by joining regional initiatives to combat drug and arms trafficking and signing UN conventions against its most prolific criminal markets. However, Cambodia diverges from the UN Model Treaty on Extradition and its penal code remains silent on a number of human rights issues. In spite of being a member of the Association of South East Asian Nations, which was established to promote intergovernmental and cross-border cooperation, Cambodia remains hostile towards Thai and Vietnamese policing agencies, and border liaison still appears to grant protection to favoured organized crime groups. While Cambodia has legislation in place to combat most forms of organized crime, sufficient enforcement is lacking. Legislative processes are slow, as can be seen with the Arms Trade Treaty being implemented years after it was signed and the fact that arms brokers and intermediaries remain unregulated. In the flora and fauna criminal markets, the penalties are considered insufficient to act as deterrents and national laws do not adequately implement the regulations set up by the Convention on International Trade in Endangered Species. Corrupt practices in government and law enforcement also act to undermine any national legislation aimed at preventing organized crime. The criminal investigation system is ineffective and corrupt and enforcement is rudimentary, with more emphasis placed on petty crime than on high-level organized crime. Political intervention also occurs in the judicial system, with the ruling party approving appointments to judicial offices. The prison system is underfunded, and overcrowding has ballooned since the government launched an anti-drug initiative in In May , the government announced plans to reform the criminal justice system to reduce the backlog in cases and prison overcrowding, which is largely due to the number of detainees being held in pre-trial detention facilities. Enhancing border security is a top priority for the government. However, despite these increased efforts, border control forces are poorly resourced and have insufficient specialized knowledge and a limited budget. Cambodia therefore has porous borders that are vulnerable to the trafficking of several illicit commodities. Its border with Thailand is particularly vulnerable to human trafficking and smuggling. Each year, thousands of Cambodians illegally cross the border into Thailand, where they use false documentation and permits to secure work. Corruption is present at the border, with some Chinese groups appearing to have privileged access in and out of the country. There is no clear distinction of roles for Cambodia's law enforcement agencies, and in many rural areas the Cambodian national police are severely under-resourced and dependent on user-pay models. Patron-client networks are rife at the highest levels of law enforcement, and recruitment processes are also open to patronage, which has led to a widespread lack of trust in the police and a low reporting rate of criminal victimization. Improvements have been made in complying with international standards regarding the criminalizing of money laundering, as well as to due diligence processes and the reporting of suspicious transactions. Cambodia is one of the countries in South-eastern Asia most open to foreign investment, allowing foreign investment and ownership in most industries. It has also implemented notable reforms to make the trade regime more open and transparent. However, due to corruption, the perpetration of property offences and an inefficient bureaucracy, Cambodia remains a very difficult place to do business. While domestic law legislates for the protection of witnesses and whistle-blowers, the measures are insufficient and ineffective in practice. While there are sporadic community-style policing efforts in some of the rural areas, these are undermined by poorly resourced and corrupt local policing services. Civil society organizations face ongoing intimidation and threats by the government, whose cooperation with them is very limited, but some progress has been made in recent years with regard to protecting the victims of child exploitation. The media environment is hostile, with 30 radio stations and the Cambodian Daily newspaper being closed without explanation by the government before the last election; Cambodians now only have access to news from media outlets that are linked to Prime Minister Hun Sen. Critical journalists are regularly imprisoned, and labour unions are kept under surveillance as well as subjected to intimidation and violence. The criminal markets score is represented by the pyramid base size and the criminal actors score is represented by the pyramid height, on a scale ranging from 1 to The resilience score is represented by the panel height, which can be identified by the side of the panel. A series of 13 discussion papers, one for each illicit market considered during the development of the Index. We're constantly working to improve the Index. By participating in this survey, you will be providing us with insights and suggestions that will help us make the Index an even better resource. This report was funded in part by a grant from the United States Department of State. The opinions, findings and conclusions stated herein are those of the Global Initiative Against Transnational Organized Crime and do not necessarily reflect those of the United States Department of State. Capital Phnom Penh. Income group Lower middle income. Population 16,, Geography type Coastal. Criminal markets 6. An assessment of the value, prevalence and non-monetary impacts of a specific crime type. Human trafficking 7. Human smuggling 6. Arms trafficking 5. Flora crimes 8. Fauna crimes 8. Non-renewable resource crimes 8. Heroin trade 4. Cocaine trade 2. Cannabis trade 4. Synthetic drug trade 7. Criminal actors 5. An assessment of the impact and influence of a specific criminal actor type on society. Mafia-style groups 2. Criminal networks 4. State-embedded actors 8. Foreign actors 7. Political leadership and governance 4. Government transparency and accountability 3. International cooperation 5. National policies and laws 4. A state's legal action and structures put in place to respond to organized crime. Judicial system and detention 4. Law enforcement 4. Territorial integrity 4. Anti-money laundering 4. Economic regulatory capacity 4. Victim and witness support 3. Prevention 3. Non-state actors 2. Analysis Download full profile english. People Cambodia is an origin, transit and destination country for human trafficking. Trade Historically a significant source country for weapons, Cambodia has evolved into a transit country for arms smuggling, primarily into Myanmar. Criminal Actors Despite a few small gangs with hierarchical structures, there do not appear to be any significant mafia-style groups operating within Cambodia. Leadership and governance While the Cambodian political system has not been captured by organized crime, corruption is rampant and widespread, with little accountability or transparency, allowing many figures in the ruling elite to acquire wealth from criminal markets. Civil society and social protection While domestic law legislates for the protection of witnesses and whistle-blowers, the measures are insufficient and ineffective in practice. Read the analysis Listen the podcasts View all events. Next Skip. How to measure organized crime? Read more on globalinitiative. Give us feedback We're constantly working to improve the Index.

Why taking drugs in Cambodia is a bad idea

Buy Heroin Siem Reap

Harm Reduction Journal volume 12 , Article number: 33 Cite this article. Metrics details. While one in four Cambodian FESW report recent ATS use, little attention has been paid to how the occupational contexts of sex work shape patterns of use. Interviews were conducted and transcribed in Khmer and translated into English. Interview narratives were read and re-read and emerging themes reviewed and refined to develop an initial coding scheme. Data were formally coded using both open and axial coding to clarify and consolidate initial themes. ATS was seen as a performance enhancer, acting as an appetite suppressant and enabling women to meet the physiological demands of sex work, including long working hours, multiple clients and extended sexual transactions. FESW in Cambodia harness the pharmacological properties of ATS to meet the physiological demands of sex work in a context of limited economic opportunities. There is an urgent need to both provide Cambodian women with options for income generation that do not risk their health and to better regulate the conditions of sex work to provide safer working environments. Amphetamine-type stimulants ATS are synthetic psychostimulants such as methamphetamine, amphetamine and ecstasy which can be injected, smoked or taken orally. Administration results in feelings of euphoria, alertness, increased heart and respiratory rates, blood pressure, perceived increases in confidence and physical strength, and appetite suppression \[ 1 \]. With prolonged use and in high doses, ATS can produce anxiety, hyper-vigilance, paranoia, psychosis, panic and other adverse effects \[ 1 , 2 \]. Studies also suggest that ATS use can increase libido, lower inhibitions, enhance sexual pleasure, delay orgasm and prolong sexual intercourse \[ 3 — 7 \]. ATS use has been associated with increased HIV risk in a range of populations including men who have sex with men MSM \[ 4 \], people who inject drugs \[ 8 \], non-injection drug users \[ 9 \], heterosexual men and women \[ 10 , 11 \] and young people \[ 12 \]. In particular, ATS use is believed to have a disinhibiting effect on sexual decision-making \[ 5 \] and has been associated with unprotected sex and incident sexually transmitted infections STI , including HIV \[ 10 , 13 , 14 \]. ATS use has increased dramatically throughout Asia in recent years, including in Cambodia \[ 15 — 17 \]. The United Nations Office on Drugs and Crime has estimated that there are approximately , drug users in Cambodia and 30, tablets of methamphetamine yama are consumed daily \[ 18 \]. Methamphetamine in pill form is the leading drug of abuse, but crystal methamphetamine use has been rising since \[ 16 , 18 \]. While approximately 0. Incidence of HIV was 3. Factors independently associated with incident STI included duration per year of sex work adjusted hazard ratio AHR 1. Further analyses revealed independent associations between ATS use and higher number of sex partners adjusted relative ratio 1. Intoxicated clients frequently requested unprotected sex, and strategies typically employed by FESW to negotiate condom use were reported as less effective in this context \[ 20 , 21 \]. As part of the development of this programme, we conducted formative qualitative research to further examine the occupational context of ATS use. Specifically, the current study aimed to clarify gaps in our understanding by documenting patterns of ATS use and the settings in which it occurred, exploring motivations for, and perceived negative consequences of, ATS use and examining experiences of attempting to abstain from or reduce consumption. Using a stepped wedge randomised cluster trial in ten provinces, CIPI will evaluate whether the intervention, consisting of a week programme combining a week CCT programme based on urine toxicology screening for ATS and a 1-month weekly aftercare component, results in larger decreases in HIV risk compared to SMARTgirl. Also being evaluated is a microenterprise programme combining financial literacy education and microloan opportunities for ATS-free FESW. Eligibility criteria were that participants be aged at least 18 years, biologically female, understand spoken Khmer, used existing SMARTgirl services and reported ATS use and at least two different sexual partners in the last month. Participants engaged in sex work in a range of venues, including brothels, entertainment venues, streets and parks were recruited through outreach by SMARTgirl programme staff in each province. Interviews were conducted in Khmer by trained interviewers and took 30—90 minutes to complete. Interviews were digitally recorded and transcribed verbatim in Khmer. Transcripts were checked for accuracy against the original recordings before being translated into English. Following the general tenets and principles of grounded theory \[ 23 \], data were analysed using an inductive approach. Interview narratives were read and re-read and emerging themes discussed and refined to develop an initial coding scheme. Data were formally coded using both open and axial coding to clarify and consolidate initial themes \[ 24 \]. All participants provided voluntary informed consent, and ethical approval for the study was provided by the Cambodian National Ethics Committee and the University of California San Francisco Institutional Review Board. Pseudonyms have been provided so that excerpts from the same participant are easily identified throughout the paper. In order to inform the design of the CCT intervention, we sought to better understand the occupational context and drivers of ATS use in this group. Women were asked about their patterns of ATS use and the settings in which it occurred, as well as motivations for using ATS, perceived negative consequences of use and experiences attempting to abstain or reduce consumption. The mean age of participants was 25 years, just over one quarter The majority of women Primary work venues at the time of interview included karaoke bars Participants highlighted the salience of ATS in the context of sex and entertainment work. Women reported using ATS for occupational performance—to stay awake longer and to work more hours, enabling them to see more clients. We could not stand \[solicit clients\] feeling sleepy until dawn as we could earn no money Vanna, 32 year-old FESW, Battambang. For those who work in entertainment services, when we smoke it, we can earn money. How can we earn money? We can stand till dawn. Stand all night till dawn. It is up to us. ATS were valued for their pharmacological properties, primarily the inducement of insomnia and increased energy or strength. Outside the occupational setting and without this functional purpose, women indicated that they were less likely to use ATS. I use it a little not to feel sleepy so that I can earn money to support my children. Most importantly, I am happy as I sleep with my children at home. I ate rice. I went to the market to buy clothes for my children. We just sleep to gain power and eat fully and wait until the time we earn money and we use it then we have power Chorphum, 30 year-old FESW, Banteay Meanchey. While insomnia, increased energy and endurance were not seen as functional outside the workplace, within the context of sex work functionality, the performance-enhancing aspects of ATS were the most commonly mentioned motivations for use. A minority of women indicated that using ATS also made them feel happy or helped to alleviate boredom and hunger. And feel happy and delicious. Delicious and happy. However, most women reported using ATS not because they were seeking pleasure or avoidance, but rather out of economic necessity engendered by extreme poverty and the occupational realities of sex work. For the women in our study, the pharmacological properties of ATS rendered them functional in the context of sex work. Indeed the physiological effects of ATS reported here, including insomnia and appetite suppression, enabled women to work long hours, see more customers and avoid the need for rest or food. While previous research also indicates that some sex workers use drugs to cope with their work \[ 25 \], women in our study described ATS as a central, normalized, and even obligatory aspect of their work practice. Some women also described how ATS use made them feel less shy or inhibited with clients, making them more comfortable and amicable. The reason why I started to use it is that I could not stand being sleepy and when we receive the guests, we are not shy with them. Since I began my work six months ago I use it much. We have to use it. It feels like this and that. I would say we do such work, we have to take risk. Employers and managers, as well as colleagues and friends, also exerted pressure on women to use ATS. At that time I used it without thinking about anything because I had house, space for sleeping and meals to eat. Although I did not generate any income, I still had rice to eat and place to sleep, so I did not care about anything. Therefore, no money remained even if I calculated it once per month. Women who used ATS worked longer hours and saw more clients, potentially earning additional income for managers. However, a minority of women indicated that some managers and bosses discouraged women from using ATS. I was reducing it a little bit then. Previous research has shown that alcohol consumption is related to sex work occupational settings, with women working in entertainment venues more likely to drink more alcohol than brothel or street-based FESW \[ 26 \]. Several women who worked in entertainment venues drew attention to this further dimension of occupational ATS use. These women indicated that they and others used ATS in order to moderate or reduce the effects of occupational alcohol consumption. When people \[first\] called me to use it \[yama\] I thought I did not want to touch it but at that time I was forced to do so because I had to drink heavily so I thought that I could control my feeling as people said that when using it, \[yama\] our feeling would be clear and weaken the effect of alcohol. When I get drunk, I also want it. No matter how many cases of alcohol. I work at night and I need to drink \[alcohol\]. Our previous research found that almost half The high prevalence of alcohol use among Cambodian FESW is of concern, and currently, no interventions target alcohol use in this population. The data presented above suggest that some FESW use ATS in order to mitigate the effects of alcohol consumption that is an inherent part of their employment in entertainment venues. This combination of individual and structural risk factors presents a complex jeopardy for FESW—not only to their health but also their livelihood—and a very challenging situation for the development of interventions aimed at reducing risks. Women also reported negative consequences of ATS use, including undesirable and adverse impacts on physical and mental health. We would lose our intention and energy and anything we want, may lose it accordingly as the drugs could make us unable to sleep much. First it makes me addicted. If I smoke it on any day and have any feeling of hatred for anyone, I provoke them at once. I provoke them, want to beat them, want to kill them. Several women also described the impact on their physical appearance as a negative consequence of ATS use. I always wonder and could not eat rice. I have hollow cheeks and I was not like this before. When looking around my house, there are a lot of drugs users. Talking about their appearance, they look ugly. Their beauty gets worse. When we use it, what a face \[laughter\]. It looks bad. However, in the face of limited income-generating options, perceptions of negative health impacts rarely provided sufficient motivation for women to reduce their use. Last month I used it almost every day per week. I went there almost every day. I turned black, pale, thin and my clothes are all loose and when I go to work, they no longer accept me for work. They said I have a very ugly face. When we suffer from its effects, we think that we are beautiful. Others see us as a crazy person. Consistent with this literature, women in the current study reported that ATS use by clients often delayed ejaculation, resulting in prolonged sexual activity. They like to use it so that they do not ejaculate so fast. It makes them do it for a long time. When they sleep with us, they say that they want it to be long … and they say that when they use it, it makes them happy and sexually aroused Haratey, 24 year-old FESW, Phnom Penh. So without drugs I cannot have sex either. Our data are consistent with previous studies which have documented associations between ATS use and increased sexual risk \[ 5 , 10 , 28 \]. However, the association between ATS use and sexual risk is often attributed to disinhibition and the impact of the drug on sexual decision-making \[ 4 \]. There is potential for increased HIV risk associated with tissue damage in this context \[ 29 \]. Few women believed that they were physiologically dependent on ATS. It is very easy for us to stop when the effect of the addictive substances is weakened. We feel sleepy. We sleep only and we are hungry. We start eating for a period of one day and within a period of two days the effect of the addictive substances is weakened. This functional purpose dominated other considerations and, as noted above, was the primary driver of ATS use among the women interviewed. I had nothing for our children to eat daily so I needed it. I stayed until three or two and a half \[am\] to earn money for raising my children on a daily basis … I completely quit it myself when I did not go to work. For most women, poverty, low literacy and limited skills meant that sex work was often the only occupation open to them. However, the functional role of ATS in helping women to stay awake and work long hours meant that it was difficult for women to quit or reduce their use while working as sex workers. As the accounts below illustrate, many women were able to stop or reduce ATS use during periods when they were not working—either going to their home town to visit family or following childbirth. Yes, in the past I used to stop. I used to stop it … Stay with friends, relatives who may not know this. We stay normally. We forget and we eat only rice and sleep… \[And why later on did you use it again? To abstain from it, I went to do farming … I committed myself to transporting seedlings alone and tried to ignore it when I wanted to use it. I abstained from drugs for a short period … Unfortunately, my mom fell sick. I decide to come back to work in Poipet and then my mom came to live with me. I went to rent a house outside for two months and I did not use drugs for those two months. It was because my mom was with me. For the women in our study, ATS use was deeply enmeshed with sex work and embedded in the occupational role. The elder one was at a hospital and we spent all the money. We did not have money then borrowed interest-bearing loan from others to send my child to hospital and needed to meet guests \[return to sex work\] to earn money to repay Haratey, 24 year-old FESW, Phnom Penh. I started using it since I was 16 years old. When I was 23 years old I got married and I stopped going … I stopped \[working\] for fifteen years and I quit forever. Then I also got drunk \[at work\]. And I could not stand feeling sleepy then my friends said that if I used it before I could use it again. But I thought that I did not want to use it. I said to myself that I would not do it again. But I could not stand it. I felt sleepy and if I did not do this, I would not use it. We try not to feel sleepy but we could no longer be able to earn money to support our children Sopha, 32 year-old FESW, Battambang. These data indicate a need for interventions designed to provide women with both short-term incentives for behaviour change and longer-term alternative methods of income generation. Given the occupational salience of ATS use, CCT interventions offer the potential to incentivise women who wish to reduce their use by rewarding them for negative urine toxicology screens, as well as compensating them for fewer hours worked. Most participants in our study had little formal education and few options for income generation beyond sex work. The key driver of ATS use in this group was increased functionality, including physical stamina, and coping with the multiple demands of work comprising long working hours, multiple clients and extended sexual transactions. This was true even when these benefits correlated with increased sexual risk. Even where women were aware that ATS use could affect their health and income-generating capacity in the longer term, occupational functionality in terms of increased stamina and performance at work was at the core of their narrative accounts and remained the primary motivation for use. ATS use was a central, and often acceptable, part of their work. Our results are consistent with studies which have identified occupational functionality as a driver of drug use in other settings including among fisherman \[ 30 \], truck drivers \[ 31 , 32 \], military personnel \[ 33 \], artists, musicians and writers \[ 34 , 35 \] and, most recently, the academically-oriented use of cognitive-enhancing drugs in higher education \[ 36 , 37 \]. In Asia, a study examining the social and economic functions of methamphetamine use among Thai youth found that more than a third reported using the drug prior to job-related activities \[ 38 \]. Most recently, Choo \[ 40 \] has shown how injecting drug use represented an adaptive response by Malay fisherman to declines in traditional fisheries and increases in commercial vessels and foreign labour. Within this setting, while drug use increased exposure to HIV, it also provided Malay fisherman with a way of enhancing occupational functioning \[ 40 \]. Similarly, we found that while ATS use by Cambodian FESW increased their risk of HIV, it enhanced their occupational functioning, enabling them to work longer hours, see more clients and forgo food and rest. Elsewhere, the presence of social, family and occupational supports and obligations has been associated with the controlled use of drugs, including heroin and cocaine \[ 41 — 43 \]. Economic pressures on women were often intensified by obligations to support partners and families—the latter being particularly strong in Cambodian culture. Participants gave us insight into narratives of ATS use as functional and as facilitating a sense of power and agency. Such narratives contrast with those found in the literature on MSM, where ATS use has been situated almost exclusively within discourses of enhanced sexual performance \[ 44 , 45 \] and sexual risk \[ 4 \]. Our results suggest that some of the negative effects of ATS use, including the risk of HIV, may be mediated by perceived occupational functionality in sex and entertainment work settings. Our analysis has implications for HIV prevention efforts in Cambodia and elsewhere. Current approaches focus on empowering individual FESW to negotiate condom use. However, these strategies often fail to appreciate the complexities of commercial sex transactions where drug use, including ATS use, is involved. Our data highlight the need for a harm-reduction framework that acknowledges not only the intersection of drug use and sex work \[ 46 \], but also the existence of strong occupational incentives to use ATS. The acceptance and, in some situations, active encouragement of ATS use suggests a need to engage both venue owners and employers, as well as clients, in harm-reduction efforts. An important challenge for Cambodia at this stage of its HIV epidemic—when it aims to eliminate new HIV infections \[ 47 \]—is to target interventions where they will have greatest impact. Recent mathematical modelling based on data from Africa indicates that sex workers with the highest rates of partner change have a disproportionately high impact on transmission \[ 48 \]. Our results suggest that targeting FESW who use ATS is likely to yield prevention benefits in terms of identifying an active sub-population who see more clients, report higher levels of unprotected sex, and are greater risk of HIV and other sexually transmitted infections. Our data also highlight the role of alcohol in mediating the effects of ATS, suggesting that interventions also need to address the occupational use of alcohol by FESW working in entertainment venues. And while behavioural interventions designed to reduce HIV risk among methamphetamine users have been developed, most of these interventions target MSM in developed countries \[ 49 \] rather than FESW in resource-poor settings. In this setting, where up to one in four young FESWs are infected with HIV, there is an urgent need to both provide women with options for income generation that do not risk their health, to better regulate the conditions of sex work to promote safer working environments \[ 50 , 51 \], and to afford sex workers the same benefits and protections afforded other workers \[ 52 \]. The need for speed: an update on methamphetamine addiction. J Psychiatry Neurosci. The methamphetamine experience: a NIDA partnership. Crystal methamphetamine and sexual sociality in an urban gay subculture: an elective affinity. Cult Health Sex. Article PubMed Google Scholar. J Urban Health. A comparative analysis of methamphetamine use: black gay and bisexual men in relation to men of other races. Addict Behav. The context of sexual risk behavior among heterosexual methamphetamine users. Stimulant-induced enhanced sexual desire as a potential contributing factor in HIV transmission. Am J Psychiatry. Risk of prevalent HIV infection associated with incarceration among injecting drug users in Bangkok, Thailand: case-control study. Methamphetamine use and sexual and injection risk behaviors among out-of-treatment injection drug users. Am J Drug Alcohol Abuse. Association of methamphetamine use during sex with risky sexual behaviors and HIV infection among non-injection drug users. West J Med. J Acquir Immune Defic Syndr. Young women engaged in sex work in Phnom Penh, Cambodia, have high incidence of HIV and sexually transmitted infections, and amphetamine-type stimulant use: new challenges to HIV prevention and risk. Sex Transm Dis. Chouvy PA, Meissonnier J. Yaabaa: production, traffic and consumption of methamphetamine in Mainland Southeast Asia. Singapore: Singapore University Press; Google Scholar. The rise of methamphetamine in Southeast and East Asia. Drug Alcohol Rev. World drug report. United Nations Office of Drugs and Crime. Accessed 23 April Accessed 21 April Correlates of amphetamine-type stimulant use and associations with HIV-related risks among young women engaged in sex work in Phnom Penh, Cambodia. Drug Alcohol Depend. Int J Drug Policy. Selling sex in unsafe spaces: sex work risk environments in Phnom Penh, Cambodia. Harm Reduct J. Effect of a cash transfer programme for schooling on prevalence of HIV and herpes simplex type 2 in Malawi: a cluster randomised trial. Strauss A, Corbin J. Basics of qualitative research: grounded theory procedures and techniques. Newbury Park: Sage; Ezzy D. Qualitative analysis: practice and innovation. Sydney: Allen and Unwin; Drug use, sexual behaviours and practices among female sex workers in Hanoi, Viet Nam—a qualitative study. Article Google Scholar. Alcohol use among female sex workers and male clients: an integrative review of global literature. Alcohol Alcohol. Sexual marathons and methamphetamine use among HIV-positive men who have sex with men. Arch Sex Behav. Predictors of frequent use of amphetamine type stimulants among HIV-negative gay men in Sydney, Australia. Incidence of HIV and sexually transmitted infections and risk factors for acquisition among young methamphetamine users in northern Thailand. Safe havens and rough waters: networks, place, and the navigation of risk among injection drug-using Malaysian fishermen. Prevalence of psychoactive substances in truck drivers in the Nord-Pas-de-Calais region France. Forensic Sci Int. Fatigue and beyond: patterns of and motivations for illicit drug use among long-haul truck drivers. Traffic Inj Prev. Logan BK. Methamphetamine-effects on human performance and behavior. Forensic Science Review. Winick C. The use of drugs by jazz musicians. Social Problems. Dobkin de Rios M, O J. LSD spirituality and the creative process. New York: Baer; Sahakian B, Morein-Zamir S. Towards responsible use of cognitive-enhancing drugs by the healthy. Patterns of risky behaviors associated with methamphetamine use among young Thai adults: a latent class analysis. J Adolesc Health. Lasco G. Pampagilas: methamphetamine in the everyday economic lives of underclass male youths in a Philippine port. Choo M. Kuala Lumpur: University of Malaya; Blackwell J. Drifting, controlling and overcoming: opiate users who avoid becoming chronically dependent. Journal of Drug Issues. Cohen P, Sas A. Cocaine use in Amsterdam in non-deviant subcultures. Addiction Research. Zinberg N. Drug, set and setting: the basis for controlled intoxicant use. New Haven: Yale University Press; Reasons for stimulant use among Latino gay men in San Francisco: a comparison between methamphetamine and cocaine users. Crystal methamphetamine and ecstasy differ in relation to unsafe sex among young gay men. Can J Public Health. PubMed Google Scholar. Correlates of HIV infection among female sex workers in Vietnam: injection drug use remains a key risk factor. Halting and reversing HIV epidemics in Asia by interrupting transmission in sex work: experience and outcomes from ten countries vol 11, pg , Expert Rev Anti-Infe. A comparison of contingency management and cognitive-behavioral approaches for stimulant-dependent individuals. Day SE, Ward H. British policy makes sex workers vulnerable. Goodyear MD, Cusick L. Protection of sex workers. Punishment as prevention: impact of legislative and policy changes designed to prevent human trafficking and sexual exploitation on female sex workers in Phnom Penh, Cambodia. Health Hum Rights. Download references. You can also search for this author in PubMed Google Scholar. Correspondence to Lisa Maher. LM and KP conceived and designed the study. TCD and LM drafted the manuscript, and all authors provided feedback and revisions. All authors read and approved the final manuscript. Reprints and permissions. Dixon, T. Pharmacology, physiology and performance: occupational drug use and HIV risk among female entertainment and sex workers in Cambodia. Harm Reduct J 12 , 33 Download citation. Received : 27 April Accepted : 15 September Published : 16 October Anyone you share the following link with will be able to read this content:. Sorry, a shareable link is not currently available for this article. Provided by the Springer Nature SharedIt content-sharing initiative. Skip to main content. Search all BMC articles Search. Download PDF. Download ePub. Conclusions FESW in Cambodia harness the pharmacological properties of ATS to meet the physiological demands of sex work in a context of limited economic opportunities. Background Amphetamine-type stimulants ATS are synthetic psychostimulants such as methamphetamine, amphetamine and ecstasy which can be injected, smoked or taken orally. Results and discussion In order to inform the design of the CCT intervention, we sought to better understand the occupational context and drivers of ATS use in this group. ATS use in the context of sex work Participants highlighted the salience of ATS in the context of sex and entertainment work. Conclusions Most participants in our study had little formal education and few options for income generation beyond sex work. Google Scholar Ezzy D. Google Scholar Blackwell J. Article Google Scholar Zinberg N. View author publications. Additional information Competing interests The authors declare that they have no competing interests. About this article. Cite this article Dixon, T. Copy to clipboard. Contact us Submission enquiries: journalsubmissions springernature.

Buy Heroin Siem Reap