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    National surveillance data from 1995 to 2009 show stable infection rates among sex workers at 8000 police officers and the closing of 256 brothels and detention of 1132 sex workers [17].

    Law enforcement approaches drive sex workers underground, affecting both safety and access to outreach services and have led to “online” red light districts through chat rooms and online solicitations for both male and female sex workers [18].

    In Guangdong province bordering Hong Kong, a resurgent syphilis epidemic and booming sexual services industry have raised heterosexual transmission of HIV from 4.89% of new infections in 2001 to 37.9% in 2007 [8].

    Among 44% of sexually transmitted HIV infections in 2005, almost 20% were among sex workers and their clients.

    A recent meeting in Asia brought together voluntary sex workers’ coalitions and international agencies to develop recommendations for effective prevention of human immunodeficiency virus (HIV) infection, including decriminalization [4].

    A variety of policy (and moral) responses to sex work has emerged in Asia.

    Harm reduction programs for sex workers have been hampered by the prioritization of law enforcement over AIDS prevention.

    For example, the April 2010 “strike-hard” campaign against prostitution in Beijing, during which bars, nightclubs, saunas, and karaoke bars were raided, created an atmosphere that critically impeded human immunodeficiency virus (HIV) outreach activities for sex workers.

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    This article examines the organization and political context of sex work in China and shows how criminalization of sex work in China interferes with HIV prevention efforts.Some nations arrest prostitutes in top-down mobilized state responses [5].Other Asian nations foster grassroots nongovernmental organizations’ (NGOs’) efforts to empower sex workers in client negotiations using rights-based approaches [6].This article examines civil society groups working on AIDS prevention and care for female sex workers in China and reviews constraints to their operations.China’s HIV prevention programs for sex workers are compared with sex worker HIV prevention in other Asian states where more well-developed NGOs exist and criminalization has been better balanced with harm reduction approaches, and recommendations are offered on improving China’s policies and programs.

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