Reasons For Not Using Condoms Among Female Sex Workers in Indonesia
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.
Alary, M., Worn, A. M., & Kvinesdal, B. (1994). Risk behavior for HIV infection and sexually transmitted diseases among female sex workers from Copenhagen. International Journal of STD and AIDS, 5, 565–367. Crossref, Google Scholar Corby, N. H., & Wolitski, R. J. (1992, July). Relationship between street sex workers' attitudes and condom use by type of partner. Paper presented at the Eighth International Conference on AIDS/III STD World Congress, Amsterdam. Google Scholar
- Departemen Kesehatan Republik Indonesia, Direktorat Jendral PPM (Directorate General Communicable Diseases & Environmental Health, Department of Health) (2001). Available at http://www.depkes.go.id/Ind/ News/HIV-aids/DATA/2001/meii.htm Google Scholar
Fajans, P., Ford, K., & Wirawan, D. N. (1995). AIDS knowledge and risk behaviors among domestic clients of female sex workers in Bali, Indonesia. Social Science & Medicine, 41, 409–417. Crossref Medline, Google Scholar Fajans, P., Wirawan, D. N., & Ford, K. (1994). STD knowledge and behaviors among clients of female sex workers in Bali, Indonesia. AIDS Care, 6(4), 459–475. Crossref Medline, Google Scholar Ford, K., Wirawan, D. N., & Fajans, P. (1995). AIDS knowledge, risk behaviors, and condom use among four groups of female sex workers in Bali, Indonesia. Journal of Acquired Immune Deficiency Syndrome and Human Retrovirology, 10(5), 569–576. Crossref Medline, Google Scholar Ford, K., Wirawan, D. N., Reed, B. D., Muliawan, P., & Sutarga, M. (2000). AIDS and STD knowledge, condom use and HIV/STD infection among female sex workers in Bali, Indonesia. AIDS Care, 12(5), 523–435. Crossref Medline, Google Scholar Ford, K., Wirawan, D. N., Suastina, S. S., Reed, B. D., & Muliawan, P. (2000). Evaluation of a peer education program for female sex workers in Bali, Indonesia. International Journal of STD and AIDS11(11), 731–733. Crossref Medline, Google Scholar Ingshi-Mamahit, E. S. (1998). 100% condom policy in brothel complexes in Indonesia: Lessons learned from Kramat Tunggak Study [Abstract No. 43268]. International Conference on AIDS, Geneva. Google Scholar Joesoef, M. R., Kio, D., Linnan, M., Kamboji, A., Barakbah, Y., & Idajadi, A. (2000). Determinants of condom use in female sex workers in Surabaya, Indonesia. International Journal of STD and AIDS, 11(4), 262–265. Crossref Medline, Google Scholar Jones, E. F., & Forrest, J. D. (1992). Contraceptive failure rates based on the 1988 NSFG. Family Planning Perspectives, 24, 12–19. Crossref Medline, Google Scholar Lim, L. L. (1998). The sex sector: The economic and social bases of prostitution in Southeast Asia. Geneva: International Labour Office. Google Scholar Mamahit, E. (1996). Determinants of the STD/AIDS-related behaviors of female commercial sex workers in Kramat Tunggak, Jakarta, Indonesia. Unpublished master's thesis, Boston. Google Scholar Rhebergen, D. (1999). Anak-anak Jalan Diponegoro. Female street sex workers in Surabaya, Indonesia. Amsterdam: Vrije Universiteit. Google Scholar Rosenberg, M. J. & Weiner, J. M. (1988). Prostitutes and AIDS: A health department priority? American Journal of Public Health, 8(4), 418–422. Crossref, Google Scholar Trussel, J., Hatcher, R. A., Cates, W., Steward, F. H., & Kost, K. (1991). Contraceptive failure in the United States: an update. Studies in Family Planning, 21, 51–54. Crossref, Google Scholar
- UNAIDS and World Health Organization (2000). Epidemiological Fact Sheet on HIV/AIDS and sexually transmitted diseases, Indonesia. Geneva: Author. Google Scholar
Wolffers, I., Triyoga, R. S., Basuki, E., Yudhi, D., Devillé, W., & Hargono, R. (1999). Pacar and Tamu: Indonesian women sex workers' relationships with men. Culture, Health and Sexuality, 1(1), 39–53. Crossref Medline, Google Scholar Wolffers, I. (1997). Culture, media, and HIV/AIDS in Asia. Lancet, 349(9044), 52–54. Crossref Medline, Google Scholar