Introduction

HIV infection rates among teenage girls are often much higher than in teenage boys; the reason lies in girls’ greater biological and social vulnerability. Compared with that of males, the female reproductive tract is more susceptible to infection with HIV and other STDs, particularly in younger girls. And girls often risk infection very early. Compounding the biological vulnerability of girls are complex and unhealthy societal expectations that mean girls and young women have less control over their lives and bodies than do their male counterparts.

In Thailand, too many girls find themselves at an early age in the sex industry, usually for lack of other options for earning a living. Young girls are desirable because they are thought to be “safe” and uninfected with HIV, but the risk of infection to them, and thence to their clients, is very high. This case study describes some responses to that problem, focusing on changing the attitudes of girls and their parents in regard to prostitution, and on providing a means for girls to avoid becoming sex workers through improved education and career opportunities. The approach described is also an example of an AIDS response that takes account of regional and demographic differences in the nature and scope of the problem in the search for solutions.