HIV Vulnerability and Sexual Risk Behaviour of the Drayang Girls in Bhutan

Abstract

Introduction: The rapid socio-economic development in Bhutan has brought changes in individual lifestyles resulting in increased risk behavior of the urban population, particularly the Drayang girls. This study investigated the underlying factors influencing the sexual risk behaviour of Drayang girls and their vulnerability to HIV and Sexually Transmitted Infection (STI). The Drayangs are dance bars in Bhutan where the women perform Bhutanese songs/dances on the stage to entertain the bar patrons and making them pay for their performance.
 Methods: This is a cross-sectional descriptive study conducted from May-July 2015 in three urban districts (Thimphu, Paro, and Phuentsholing) of Bhutan. The convenient non-random sampling method was used to recruit the respondents. We have collected the data using structured questionnaires including the taking of blood samples for HIV, Hepatitis B, and Syphilis testing.
 Results: Of the 245 Drayang girls recruited for this study, 28.2% have engaged in transactional sex and 71.8% in non-transactional sex within last month. Condom use during transactional sex was 36.2% and non-transactional sex was 21.6%. The prevalence of HIV was 0.82%, hepatitis B 6.9%, and syphilis 2.8%. The factors such as marital status (divorced and unmarried), living arrangements, current living cities, and alcohol consumption were significantly (p<0.05) associated with transactional sex among Drayang girls.
 Conclusion: Although the prevalence of HIV and STIs is low among the Drayang girls, the presence of high riskbehavior with low condom use still makes them vulnerable to HIV and STIs. The study recommends putting more effort in prevention of HIV and STI by increasing awareness of HIV and STI, targeted interventions like Behaviour Change Communications (BCC), condom promotion, condom negotiation skills and access for testing and treatment of HIV and STI.

Redefining the Mode of HIV Transmission through Analysis of Risk Attribution among the Reported HIV Cases from 1993 to 2021 in Bhutan

“…As exhibited in this study, the heterosexual contact with a female sex worker was consistent with the results of several past national studies where the prevalence of female sex workers and high multiple sexual relationships with low condom use were reported [ 5 , 22 , 23 ]. The 2019 population size estimation (PSE) study also depicted higher sexual partners among women acknowledging sex work, with a mean of 5.8 and 4.5 for female sex workers recruited outside of venues and at venues, respectively, as compared to 1.3 for high-risk women not engaging in sex work.…”

Characteristics and Population Size Estimation of Female Sex Workers in Bhutan

“…One study among drayang women found that those who consumed alcohol regardless of prohibition were more likely to engage in transactional sex than those reporting no alcohol consumption. 9 Female sex workers directly recruited at entertainment venues also report higher participation in prevention programs, such as STD testing, health education presentations, and outreach worker contact. Although more than four-fifths of FSW recruited by peers also report recent venue attendance, opportunities to engage them may be fewer compared with employees.…”

“…9,10 These venues include bars, karaoke clubs, and the unique Bhutanese entertainment locales called drayangs. [9][10][11] Drayangs are bars where women are hired to perform songs and dances on stage. By conversing with patrons, they obtain "sponsors" to pay for performances.…”

“…Accompanying modernization, entertainment venues have emerged in urban areas and along major corridors of transportation. 9,10 These venues include bars, karaoke clubs, and the unique Bhutanese entertainment locales called drayangs. [9][10][11] Drayangs are bars where women are hired to perform songs and dances on stage.…”

“…In one survey of women at drayangs, 28.2% engaged in commercial sex in the last month. 9 Whether engaging in commercial sex or not, women present in venues such as drayangs tended to have multiple sex partners and low condom use. Therefore, Bhutan's HIV prevention programs prioritize all such "women at high risk" (WHR) for outreach education.…”