Reasons For Not Using Condoms Among Female Sex Workers in Indonesia

Abstract

The aim of this study was to gather data on condom use among brothel-based female sex workers in Indonesia and to study the reasons for not using condoms in order to provide new and existing condom promotion programs with information to improve their performance. Quantitative data were gathered by KABP surveys (n = 1450) and a condom diary with a sample of 204 female sex workers. Qualitative data were collected by conducting focus group discussions and in-depth interviews among female sex workers and pimps. Around 53% of sexual intercourses were reported to be protected, and 12% of these protected intercourses were preceded by clients' argumentation against it. Only 5.8% of sex workers consistently used condoms for a 2-week period of observation, and this figure decreased to 1.4% for a 4-week period. Reasons for not using condoms from the clients' side, as mentioned by the sex workers, were perceived less pleasure due to the condom and the belief that clients that are acquainted with the sex workers do not need protection against sexually transmitted diseases (STDs) or AIDS. The main reasons of female sex workers for not using condoms were the beliefs that boyfriends, native Indonesians and healthy-looking clients cannot spread STDs. Another reason stated was that sex workers had already taken other preventive measures, like taking antibiotics. The research also showed that pimps were not very supportive of condom use programs in Indonesia. Condom unacceptability is an important reason for not using condoms for both clients and female sex workers, whereas pimps, who are in the best position to encourage condom use, unfortunately consider condom use as a threat to their business. For the successful introduction of consistent condom use, it is necessary to design interventions for both sex workers and clients and to provide appropriate educational materials and preferred brands of condoms. Also, pimps must be involved in intervention programs.

Condom Use and Its Correlates Among Female Sex Workers in Hanoi, Vietnam

“…Thus, there is a potential risk of infection through the sexual route for FSWs, especially through their regular clients and love mates, and from them to their other clients. This pattern of low condom use with regular clients and love mates was also observed in other studies among FSWs (Basuki et al, 2002;Le et al, 2000;Wong et al, 2003). In this study, we found that it was FSWs who were the ones who did not feel it was necessary to use condoms with regular clients and love mates.…”

“…The need for this knowledge is urgent, given that the epidemic is still largely confined within high-risk populations but has the potential to quickly spread to the general population. Although condom use by FSWs has been studied extensively in other parts of the world (Basuki et al, 2002;Ward et al, 2004;Larsen et al, 2004;Witte et al, 2000), little information is available on FSWs in Vietnam. In our previous qualitative study among FSWs in Hanoi (Tran et al, 2004), they reported higher condom use with irregular clients, although use was still low with regular clients and their love mates.…”

Pleasure and Prevention: When Good Sex Is Safer Sex

“…1,[7][8][9] This is the ''power of pleasure'' . Since condoms are generally perceived to reduce sexual pleasure, [10][11][12] it is vital for public health campaigns to address how to increase sexual pleasure when promoting condoms. There are many reasons why people choose not to use condoms, and instead practice riskier sex.…”

Beliefs that Condoms Reduce Sexual Pleasure—Gender Differences in Correlates Among Heterosexual HIV-Positive Injection Drug Users (IDUs)

“…Because condoms are worn by men, and thus, because men may be the ones to actually experience physical discomfort such as erection problems and loss of sensation, [30][31][32][33] men may have more negative condom beliefs than women and differential correlates of negative condom beliefs could be found between men and women. To explore gender differences, the majority of analyses were conducted separately by gender.…”