With some of the lowest development indicators in Southeast Asia, remote upland areas of the Lao People's Democratic Republic are among the poorest in the region. The advent of improved transport and communication links, along with opportunities for wage employment, have accelerated the growth of a cash economy in traditionally isolated farming communities of Luang Namtha Province. Interviews and focus group discussions with young people, women in the sexual service business and health workers indicate that the lure of the new economy is wooing villagers away from their agrarian roots. Motorbikes and mobile phones have expanded the sexual territory of indigenous youth at a time when international commerce and a cash economy along improved highways are bringing new people into the region. Among the concerns for their health and safety are at-risk behaviours involving alcohol and sexual practices, especially HIV and sexually transmitted infections. Of particular concern is the sexual trade in the province with a predominance of young, poorly educated Khmou women providing sexual services in a growing number of entertainment places.