Throughout the HIV/AIDS epidemic, female sex workers have been identified as a “risk group” and interventions developed to reduce their behavioral risk-taking. Both individual and structural level programs continue to target “risks” such as multiple partners and lack of condom use. Sex workers themselves, however, are likely to view their experiences more holistically, perceiving a range of risks within their work. This paper presents qualitative data from a participatory study conducted with brothel-based migrant Vietnamese sex workers in Cambodia, illuminating one community’s perceptions of the sex industry. It argues that design and implementation of effective HIV prevention activities must be based on sex workers’ own interpretations and responses to risk, using them as a realistic entry point for effecting change. Actively engaging with sex workers through participatory research and projects offers the first step in shifting the current epidemiological focus toward identifying feasible, contextspecific risk-reduction strategies.