Abstract
This study aimed to explore societal determinants of HIV vulnerability among the clients of female commercial sex workers (FCSWs) in Belu and Malaka districts, Indonesia. A qualitative inquiry using in-depth interviews was employed to collect data from participants (n = 42) recruited using a purposive and snowball sampling technique. Data analysis was guided by a qualitative data analysis framework. The study results revealed several societal determinants that supported vulnerability to HIV infection among the participants. They included low education level and sexual health literacy including the lack of knowledge and information about HIV transmission and prevention. Additional determinants identified were limited source of HIV/AIDS-related information, availability of and ease of accessibility of brothels and FCSWs, peer influence, and high mobility of the study participants. Findings of this study indicate the needs and call for interventions that aim to protect both FCSWs and their clients, through provision of HIV/AIDS and sexual health education and information and improvement in the availability and accessibility of condoms.
Highlights
The prevalence of HIV infection among the clients of female commercial sex workers (FCSWs) and the sex workers themselves has been reported to be ranging from 5.6% to 34.9% in multiple global studies [1,2,3,4,5,6,7,8]
Low level of education seemed to be one of the social determinants supportive of HIV vulnerability among the study participants. This was reflected in the fact that the majority of the participants (n = 24) lacked information and knowledge of HIV/AIDS especially the means of HIV transmission and prevention
This led to their consistent engagement in unprotected sexual behaviour with multiple FCSWs without realising the increased vulnerability to HIV as well as other sexually transmitted infections (STIs) transmission: Table 1
Summary
The prevalence of HIV infection among the clients of female commercial sex workers (FCSWs) and the sex workers themselves has been reported to be ranging from 5.6% to 34.9% in multiple global studies [1,2,3,4,5,6,7,8]. The World Health Organisation [9, 10] has identified the clients of FCSWs as well as the sex workers as one of the groups at higher risk for HIV infection. This group does not seem to be considered as an HIV high-risk group and has not been the target group for HIV prevention programs and interventions in Indonesia even though the number of annual HIV cases transmitted through heterosexual contacts is higher than that of through other modes of transmission [11].
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