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CONTEXT CONTINUITIES OF HIV RISK BEHAVIOUR A multi-methodological study of urban and rural female sex workers in Indonesia

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CONTEXT CONTINUITIES OF HIV RISK BEHAVIOURA multi-methodological study of urban and rural female sex workers in Indonesia

BACKGROUND

THE SETTINGINDONESIA

THE SETTINGINDONESIA

SECONDARY DATA

THE WOMENFEMALE SEX WORKERS

THE GAPKNOWLEDGE VS BEHAVIOUR

Figure 1: Knowledge about the protective effects of condoms and consistent condom use in commercial sex, female sex workers, BSS 1996 - 2000

69.976.1 78.9

84.377.8

10.7 10 10.1 12.3 12.1

0

10

20

30

40

50

60

70

80

90

1996 1997 1998 1999 2000

BSS year

Pe

rce

nt

dis

trib

uti

on

(%

)

Know that consistent condom use prevents HIV

Always use a condom in commercial sex

THE BEHAVIOUR REASONS FOR NON-CONDOM USE

CONCEPTS METHODOLOGY

THE QUESTION

The problem: Persistent gap between AIDS awareness and HIV preventive

behaviour

Underlying assumption: Health knowledge does not necessarily translate into

healthy behaviours

Primary question: Why do/don’t female sex workers adopt risky HIV-

associated behaviour (condom non-use) in sex work?

THE FRAMEWORK A THEORY-BASED MODEL

THE STUDY PROCESS MULTIPLE METHODS/MULTIPLE DATA

THE SAMPLE POPULATION

Fixed locations: brothel complexes (lokalisasi), both official and unofficial; massage parlours (panti pijat); brothel houses (rumah bordil, lokalisasi)

Entertainment establishments: nightclubs (klub malam); salons (salon kecantikan); discotheques (disko); call-girl establishments; lobbies, bars and coffee shops of certain hotels

Independent operators: call-girls (wanita panggilan) who cater to the upper-class market; streetwalkers (wanita jalanan) who cater to the lower to middle-class market; perek (experimental girls); ABGs (precocious teenagers)

CRITERIA

THE SAMPLING STRATEGY RESPONDENT-DRIVEN

SAMPLING

Essential elements of RDS:

Documentation of who recruited whom must be tracked generally through a coupon system;

Recruitment must be rationed with generally no more than three coupons allotted per ‘seed‘;

Information on personal network size must be gathered and recorded;

Recruiters and recruits must know one another (i.e. have a preexisting relationship)

Figure x: Example of a Respondent Driven Sample ‚tree‘ (Source:)

FEASIBILITY STUDY

THE WOMENINDRAMAYU

“People would say we are exaggerating.

‘Oh, we‘re not Africa,

We‘re not Thailand, we‘re different‘.

It‘s that denial thing. Even now.“ Nafsiah Mboi, HIV/AIDS activist.

“People would say we are exaggerating.

‘Oh, we‘re not Africa,

We‘re not Thailand, we‘re different‘.

It‘s that denial thing. Even now.“ Nafsiah Mboi, HIV/AIDS activist.

THE WOMENINDRAMAYU

“People would say we are exaggerating.

‘Oh, we‘re not Africa,

We‘re not Thailand, we‘re different‘.

It‘s that denial thing. Even now.“ Nafsiah Mboi, HIV/AIDS activist.

“People would say we are exaggerating.

‘Oh, we‘re not Africa,

We‘re not Thailand, we‘re different‘.

It‘s that denial thing. Even now.“ Nafsiah Mboi, HIV/AIDS activist.

THE WOMENINDRAMAYU

Dewi Ismajani Puradiredja under the supervision of Dr Ernestina Coast & Dr Rebecca Sear