A strengths-based analysis of social influences that enhance HIV testing among female sex workers in urban Indonesia

Abstract

Background: HIV prevalence among female sex workers in Indonesia remains high and large proportions of female sex workers have never been tested for HIV. International research highlights the importance of communityled strategies to increase HIV testing in this population. Little qualitative research has been conducted to address these issues in Indonesia or other Asia-Pacific countries. This paper documents social influences that enhance HIV testing among female sex workers in urban Indonesia. Methods: This was an interpretive qualitative study in Yogyakarta, Denpasar and Bandung. In total, 57 female sex workers participated in 11 focus group discussions, and four participated in individual semi-structured interviews. Deductive and inductive thematic analysis techniques were used to identify narratives of strengths pertaining to uptake of HIV testing. Results: Participants described supportive relationships with peers, community-based organisations and 'bosses'. Participants reported trusted networks with peers within which to share information about HIV testing and receive emotional support. Relationships with community outreach workers facilitated HIV testing through reminders, accompanied visits, and emotional/informational support. Community-based organisations worked with health services to facilitate mobile, community-based testing to overcome employmentand family-related constraints that inhibited women's clinic attendance. 'Bosses' employed a variety of practices to encourage HIV testing among their workers. Conclusions: Relationships, practices and action in community-and workplace-based settings outside formal health service spaces enhanced HIV testing among female sex workers. Community-or workplace-based HIV testing with outreach support from health services, peer-led HIV testing within existing social and work-based networks, and working with bosses to implement HIV prevention strategies can address low HIV testing rates in this key population.

Does the perception of HIV risk among Female sex workers affect HIV prevention behavior? application of the Health Belief Model (HBM)

“…This is in line with a similar study conducted in the Afar region [18] and Dire Dawa [22], Indonesia [23]. The similarity of these findings could be due to the closeness of socio-culture, the way of living of the FSWs, and the nature of the work [24]. However, this figure is greater than the cross-sectional studies conducted in northern parts of Ethiopia [19,25].…”

Challenges to integrating programs for the elimination of mother-to-child transmission of HIV, syphilis, and hepatitis B into antenatal care: Experiences from Indonesia

“…Building staff competency through training is therefore essential to raising their confidence and skills especially in communicating test results to women and their partners. The problem of stigma, which persists in hampering HIV testing coverage, might potentially be countenanced in the future by building stronger partnerships with community organisations experienced in working closely with communities [ 54 , 55 ].…”