In Vietnam, write Khuat Thu Hong, Le Bach Du’o’ng, and Nguy~n Ngoc Hong, sexuality has long been considered a taboo subject, and today, ‘sexuality still carries negative associations and is seen as a possible cause for many social problems’ (Khuat et al. 2009: 16). Yet when sex has procreative purposes, its meaning changes. In connection with childbearing, most people hold, sexual activity becomes an obligation, a duty, and an honourable undertaking. It contributes to maintaining families, kin groups, and the Vietnamese ‘race’/’stock’ (giong not). These popular conceptions of sex are, as Khuat Thu Hong, Le Bach Du’o’ng, and Nguy~n Ngoc Huong observe, reinforced by official directives and laws such as the Law on Marriage and the Family, which only recognises marriages between women and men and only legitimates sex within marriage (2009: 103). Heterosexual marital sex is, in short, approved by the state and considered as an ethical practice which contributes to upholding centuries-old moral visions of ‘a good family, a good society’.

Yet some forms of sex depart from these moral ideals. The most socially visible of these are commercial sexual relations. Unfolding in streets, parks, cafes, and restaurants, sex work is ubi­quitous in Vietnam, posing direct and persistent challenges to official notions of proper sexual relations (Nguyen-vo 2008).

Prostitution runs counter to the State’s relevant policy and laws, to social standards, cultural value and the traditional life-style of the Vietnamese; degrades our fine traditions and practices, causes harm to men’s dignity, leads to increasing corruption; brings about crimes, including trade in children and women for commercial purposes and exploitation; causes great economic losses because it is associated with the debauched mode of life, and great expenditure by the State on curing social diseases and re-education of street-walkers; ruins many families, facilitates the spread of sexually transmitted diseases, HIV/AIDS thus diminishing the quality of the nation’s race (Hoang 1999: 54).

Most commentators blame sex workers for this mass of moral problems, while their more socially privileged customers are rarely held responsible. In Vietnam today, sex work is probably one of the most stigmatised ways in which an individual can earn a living. Partly as a consequence of the Government’s social evils campaigns, sex workers are regarded as morally depraved persons whose lifestyle undermines other people’s family happiness and security. Sex work is illegal in Vietnam, and if detected, sex workers risk being placed in forced rehabilitation centres where they are given education and counselling and must undergo mandatory HIV testing. After a stay at these centres, however, many individuals return to sex work (Rushing 2004: 26-28; Tru’o’ng et al. 2004: 389-404). While the majority of sex workers in Vietnam are female, observers suggest that male sex work is on the increase (Dinh 2007, Nguyen V. H. 2012).

In a stigmatised environment, sex work entails substantial health risks. Sex workers are often subjected to ill-treatment such as violence and rape, yet due to the illegality of their work they rarely report such incidents to the police (Nguyen T. H. 2011). Drug use is common among sex workers in Vietnam, and many female sex workers engage in sexual relationships with male drug users (Tran et al. 2004: 189-95; Nemoto et al. 2008: 435-53). Since rates of HIV infection are high among injecting drug users in the country, and condom use often sporadic, these close linkages between drug use and sex work place commercial sex workers at an elevated risk of HIV infection. In Vietnam as elsewhere, however, the illegality of their trade makes it difficult for sex workers to access preventive and/or curative health care services for HIV and other STIs. This poses health risks not only to sex workers themselves, but also to their customers and the sex partners of customers. Since the clients of sex workers are often married men, this places wives at risk of contracting HIV from their husbands. In her research on men’s extramarital sexual relations, Harriet Phinney (2008: 650-60) found that women are often held responsible for their husbands’ sexual escapades while also having to bear the health consequences of the extramarital relations that their husbands engage in.

Ironically, individuals who live from sex work – thereby placing themselves in a position where they are seen as persons who ‘ruin families’ – usually enter the sex trade out of a desire to help their families (Rushing 2006: 471-94; Lainez 2012: 149-80). Young women employed in the sex industry often come from rural areas and seek work in larger cities – or are sent there by their parents – in an effort to contribute financially to their families, thereby acting as responsible daughters and sisters. Once in the city, however, they are tricked or forced into sex work, and thrown into situations of exploitation from which it is difficult for them to escape. Individuals working in the sex industry often tend to share the dominant moral perceptions of sex work, internalising the ‘spoiled identities’ ascribed to them by others. Ngo Duc Anh and his collea­gues found that female sex workers in Da Nang and Hanoi felt ashamed, useless, and full of anguish. ‘Doing this job’, one of them said, ‘my worth and my ethics are degraded. I feel worthless’ (Ngo et al. 2007: 555-70; see also Nguyen V. H. 2012). This limited self-esteem, the authors found, increased sex workers’ vulnerability to physical violence and sexual exploitation, making it more difficult for them to negotiate condom use and practice safer sex. Their nega­tive views of themselves, moreover, made it difficult for them to leave sex work for other occupations. Along similar lines, Ramona Vijeyarasa has shown how the language of social evils undermines the efforts of victims of sexual trafficking to reintegrate into their communities when they return to them. ‘This government approach’, she notes, ‘has only served to promote the perception of victims as criminals’ (Vijeyarasa 2010: S94).