HIV susceptibility among clients of female sex workers in Indonesia: a qualitative inquiry

Mwanri, Lillian; Fauk, Nelsensius Klau; Kustanti, Christina Yeni; Ambarwati, Ambarwati; Merry, Maria Silvia

doi:10.1071/sh17137

Cited by 14 publications

(16 citation statements)

References 39 publications

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“…A low level of education attainment, which seemed to lead to poor health literacy, including the lack of knowledge about HIV/AIDS and preventive functions of condoms, was also a structural factor that played a role in the spread of HIV among the participants, which is consistent with previous findings of studies with different population groups [ 30 , 31 , 32 , 33 ]. It is plausible to consider health literacy among waria and transgender populations in general as an important factor to address because it affects their ability to access, understand and use health information and health system successfully to manage their own health [ 34 ].…”

Section: Discussionsupporting

confidence: 88%

Structural, Personal and Socioenvironmental Determinants of HIV Transmission among Transgender Women in Indonesia

Fauk

Merry

Siri³

et al. 2021

IJERPH

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Transgender populations are considered as a highly vulnerable group to HIV infection. This study aimed to understand structural, personal and socioenvironmental factors and the mechanisms through which these factors facilitate HIV transmission among transgender women (waria) in Yogyakarta, Indonesia. A qualitative inquiry using one-on-one in-depth interviews was employed to collect data from participants (n = 29). Thematic analysis was used to guide data analysis. Findings showed that poverty in families, a sense of responsibility to support family necessities, limited employment options and low education attainment were the structural factors driving participants’ engagement in sex work practices and unprotected anal intercourse, which facilitated HIV transmission among them. Personal need fulfilment and the desire for savings were personal factors driving their engagement in these high-risk practices that supported HIV transmission. Social relationships, social influence and the participants’ living environment were socioenvironmental factors that also supported sex work practices and HIV transmission among the participants. The findings indicate the need for capacity building in terms of knowledge and skills for waria populations to prepare and enable them to gain meaningful employment to prevent the vicious cycle of HIV transmission among them. As structural factors seemed to be the main drivers predisposing waria to HIV acquisition, further studies to explore effective HIV/AIDS interventions that address economic aspects of waria in Yogyakarta and other similar settings in Indonesia are recommended.

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Section: Discussionsupporting

confidence: 88%

Structural, Personal and Socioenvironmental Determinants of HIV Transmission among Transgender Women in Indonesia

Fauk

Merry

Siri³

et al. 2021

IJERPH

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“…Although the five dimensions offered by Healthcare access framework (approachability, acceptability, availability, affordability, and appropriateness) [36] seemed to be met by the provision of HIV/AIDS related services for waria in Yogyakarta, it should be noted that these services were only available in a few community health centres and hospitals in the study setting, reflecting unequal distribution of health resources required for HIV/AIDS health service delivery for waria populations as well as other population groups within communities in Yogyakarta and the other parts of Indonesia. Inequity in health service availability has been noted as one of the major barriers to the access to health services by waria and other population groups in Indonesia [4, 9, 40–42]. It is also worth noting the current study’s participants’ characteristics that match the five corresponding abilities of the Healthcare access framework (ability to perceive, ability to seek, ability to reach, ability to pay (through possession of health insurances) and ability to engage) (36), resulting into what appeared to be seamless interactions between them and service providers.…”

Section: Discussionmentioning

confidence: 99%

Perceptions among transgender women of factors associated with the access to HIV/AIDS-related health services in Yogyakarta, Indonesia

et al. 2019

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Access to HIV/AIDS-related health services among transgender women living with HIV is still a major public health issue in many developing countries, and Indonesia is not an exception. However, reportedly compared to other settings in the country, transgender women in Yogyakarta have a good access to the HIV-related health services. This study aimed to explore perceptions among transgender women living with HIV, locally known as waria , of factors supportive of their access to the services in Yogyakarta, Indonesia. A qualitative inquiry using in-depth interview method was conducted from December 2017 to February 2018 to collect the data from a selection of waria living with HIV (n = 29) recruited using both purposive and snowball sampling techniques. Data analysis employed a thematic approach which was guided by the framework analysis for qualitative data. The findings indicated several health service system-related determinants supportive of waria’s access to HIV/AIDS-related health services. These included the availability of the services, the simplicity and convenience of accessibility to the services and the comfort felt by the participants while accessing the services. Health professionals’ positive attitudes during healthcare provision, social relationships between waria and health professionals, proximity to healthcare facilities, free access to the services, and information sessions on HIV infection and prevention were also reported to enable participants’ access to the services. These findings call to efforts and strengthening of HIV health service system to support and provide equal access to HIV/AIDS-related services including to all Indonesians living with HIV, but more so for transgender women and other high-risk groups such as sex workers and their clients and men who have sex with men.

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“…This is a significant finding as an indication of acceptance MSM by the Yogyakarta community and health sector. As stigma and discrimination are significant barriers to accessing health services ( Mwanri et al, 2018 ), tolerance and a nonjudgmental approach toward MSM, which seem to be the case in this study, could be an important factor ( Tribun Jogja, 2016 , February 25; Wardhana, 2016 , November 28) to enhance positive health and well-being outcomes of MSM in the Yogyakarta city.…”

Section: Discussionmentioning

confidence: 74%

“…However, supportive of previous studies ( Adih & Alexander, 1999 ; Albarracin et al., 2001 ; Bandawe & Foster, 1996 ; Ross, 1992 ), the current study informs that attitudes such as individual beliefs about the positive outcomes or attributes of accessing health services had positive influence on participants’ intention to attend and access HIV/AIDS program. Mwanri et al (2018) claim that limited knowledge or limited information about the existence of the available services and their benefits can hinder access to HIV/AIDS services. The current study observed a similar finding with one of the reasons stated as that many MSM in the province were not reached and may thus not access the HIV/AIDS program.…”

Section: Discussionmentioning

confidence: 99%

The Intention of Men Who Have Sex With Men to Participate in Voluntary Counseling and HIV Testing and Access Free Condoms in Indonesia

et al. 2018

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This study aimed to identify factors that influenced the intention of men who have sex with men (MSM) to participate in voluntary counseling and HIV testing (VCT) and in accessing free condoms. A qualitative inquiry using one-on-one in-depth interviews was conducted with MSM participants who were recruited using a purposive sampling technique. Data analysis was guided by a framework analysis for qualitative data by Ritchie and Spencer, and the Theory of Planned Behavior (TPB) framework was used to analyze the data. The findings were grouped into three themes—namely, (a) attitude encompassing knowledge about HIV/AIDS and HIV/AIDS services and the belief about the positive outcomes of the services; (b) subjective norms including support from MSM peers and family members and motivation to comply with the support; and (c) perceived behavioral control, which is associated with resource availability and having confidence and positive intention to participate in VCT and willingness to access free condoms. Findings indicated that personal, community, and structural factors were predictors to intention to accessing services. Interventions targeting large numbers of MSM population and further studies to understand what needs to be done by nongovernmental organizations and governmental institutions to halt the spread of HIV infections among MSM populations and increase their intention to use HIV/AIDS services are also recommended.

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HIV susceptibility among clients of female sex workers in Indonesia: a qualitative inquiry

Cited by 14 publications

References 39 publications

Structural, Personal and Socioenvironmental Determinants of HIV Transmission among Transgender Women in Indonesia

Structural, Personal and Socioenvironmental Determinants of HIV Transmission among Transgender Women in Indonesia

Perceptions among transgender women of factors associated with the access to HIV/AIDS-related health services in Yogyakarta, Indonesia

The Intention of Men Who Have Sex With Men to Participate in Voluntary Counseling and HIV Testing and Access Free Condoms in Indonesia

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