HIV knowledge, risk perception, and safer sex practices among female sex workers in Port Moresby, Papua New Guinea

Abstract

Sex workers are considered a high-risk group for sexually transmitted infections, including human immunodeficiency virus (HIV), and are often targeted by prevention interventions with safer sex messages. The purpose of this study was to explore the extent to which knowledge of HIV and perception of risk influence safer sex practices among female sex workers (FSWs) in Port Moresby, Papua New Guinea. FSWs (n = 174) were recruited from 19 sites to participate in the study. Qualitative data were collected using semistructured interviews with FSWs (n = 142) through focus group discussions and (n = 32) individual interviews. In addition, quantitative data were collected from all FSWs using a short structured, demographic questionnaire. Data were analyzed using recurring themes and calculations of confidence intervals. Despite some common misperceptions, overall, most FSWs were basically aware of the risks of HIV and informed about transmission and prevention modalities but used condoms inconsistently. Most reported using condoms ‘sometimes’, almost one-sixth ‘never’ used condoms, only a fraction used condoms ‘always’ with clients, and none used condoms ‘always’ with regular sexual partners (RSPs). Among these FSWs, being knowledgeable about the risks, transmission, and prevention of HIV did not translate into safe sex. The findings suggest that certain contextual barriers to safer sex practices exist. These barriers could heighten HIV vulnerability and possibly may be responsible for infection in FSWs. Specific interventions that focus on improving condom self-efficacy in FSWs and simultaneously target clients and RSPs with safer sex messages are recommended.

Women and HIV in a moderate prevalence setting: an integrative review

“…For women in urban and peri-urban environments in PNG where there are very limited employment opportunities, the selling or exchanging of sex for money or goods is often ‘survival sex’ [51]. Bruce et al [53] argue that economic deprivation is likely to influence sexual behaviours which increase the risk of HIV infection. Clark and colleagues support this position, stating that the selling of sex results from a high and increasing population density along with a rapid increase in poverty [61].…”

“…HIV is associated with sex and referred to as sik blong koap (which translates as ‘sexually transmitted infection’) [56]. On the whole, HIV is not believed to be associated with sexual relationships with regular partners or within marriage, with many believing condoms are not needed in relationships where trust is established [34,53,56,62]. Often, HIV is understood to come from outside the area in which one lives, by people who don’t belong to the area or from those who belong to the area but who have travelled outside and brought HIV back [13,62,68].…”

“…Women seen as responsible for the spread of HIV in the literature are mostly women who sell sex based in the Highlands and PNG’s capital, Port Moresby [30,50,53,61]. Women who sell sex are known as pamuk meri or pasin pamuk (prostitute) or tukina meri (literally a woman who sells sex for 2 Kina, the currency of PNG) [54].…”

Differences in risk behaviours and HIV/STI prevalence between low-fee and medium-fee female sex workers in three provinces in China

“…Analysing the effects of interventions across varying FSW subgroup strata would offer a greater understanding of successful intervention elements 28. Especially, since knowledge alone may not translate necessarily into safe sex, particularly in the context of low literacy levels,29 strategies to increase HIV/STI risk perception and condom negotiation self-efficacy are urgently needed 30. The socio-economic vulnerability, mobility of low-fee FSW, and reduced ability for structural interventions given the working environment, however, need to be considered in these interventions.…”

Association Between Causal Beliefs and Shoe Wearing to Prevent Podoconiosis: A Baseline Study

“…[10][11][12][13][14] However, other studies have not found risk perceptions to be associated with motivation or adoption of preventive behaviors. 15,16 The research described in this report was conducted in rural southern Ethiopia, in a location in which podoconiosis is endemic. Podoconiosis is a noninfectious form of lymphedema (leg swelling) that arises due to the joint contributions of genetic and environmental factors among susceptible people who have long-term barefoot exposure to irritant tropical soils.…”