Inequalities in addressing the HIV epidemic: the story of the Indonesian Ojek community

Abstract

If you would like to write for this, or any other Emerald publication, then please use our Emerald for Authors service information about how to choose which publication to write for and submission guidelines are available for all. Please visit www.emeraldinsight.com/authors for more information. About Emerald www.emeraldinsight.comEmerald is a global publisher linking research and practice to the benefit of society. The company manages a portfolio of more than 290 journals and over 2,350 books and book series volumes, as well as providing an extensive range of online products and additional customer resources and services.Emerald is both COUNTER 4 and TRANSFER compliant. The organization is a partner of the Committee on Publication Ethics (COPE) and also works with Portico and the LOCKSS initiative for digital archive preservation. AbstractPurpose -The purpose of this paper is to identify the potential socio-cultural determinants contributing to inequalities and the susceptibility of the Ojek to Human Immunodeficiency Virus (HIV) infection. Design/methodology/approach -In 2010 a qualitative enquiry was employed to collect data concerning the susceptibility of the Ojek to HIV infection. Both one-on-one open-ended in-depth interviews and focus group discussions were employed. Participants included Ojek (hired motorcycle drivers), religious and community leaders, staff from the HIV/Acquired Immune Deficiency Syndrome (AIDS) Commission of Belu and staff from two HIV/AIDS non-governmental organisations. A thematic analysis and a framework approach were used to analyse the data. Findings -The findings showed four socio-cultural determinants of susceptibility to HIV infection within the Ojek community. These included: first, mobility and migration; second, patterns of sexual behaviours, sexual networks and sexual incentives; third, cultural norms and social interactions; and fourth, the lack of resources, knowledge and awareness of HIV/AIDS. Underpinned by these factors, the main determinant of HIV susceptibility for the Ojek is an individual's engagement in sexual intercourse with multiple sex partners, including female commercial sex workers (FCSWs). Social implications -There is a need to disseminate HIV/AIDS information and education throughout the Ojek communities, and to engage the general population in the promotion of sexual behavioural change among the Ojek in Belu. Empowerment strategies should also be employed to empower the general community, the Ojek and FCSWs in order to address HIV/AIDS transmission. Originality/value -This paper provides evidence of the socio-cultural determinants of HIV inequalities within the Ojek community in Indonesia. An understanding of these determinants would enable the planning, implementation and application of a holistic approach addressing the determinants of HIV in Belu and other similar settings. Additionally, knowledge of such determinants would provide an understanding of the role of inter-sectoral collaboration and community participation in tackling the susceptibility t...

Perceptions of Determinants of Condom Use Behaviors Among Male Clients of Female Sex Workers in Indonesia: A Qualitative Inquiry

“…Lack of information or knowledge of the existence of condoms and the lack of knowledge of protective functions of condoms depicted in this study seemed to be among the main reasons for low perceived benefits of condom use behavior among the majority of the study participants, leading to condomless sexual practices that made them vulnerable to HIV transmission. Supporting the findings of previous studies ( Fauk, Crutzen et al, 2017 ; Fauk & Mwanri, 2015 ; Lin, Simoni, & Zemon, 2005 ; Steers & others, 1996 ; Zak-Place & Stern, 2004 ), the results of this study report positive relationship between self-efficacy or the belief about one’s ability to use condoms correctly and condom use behavior among several participants. Meanwhile, the majority of study participants who did not know to use condoms correctly reported having used condoms inconsistently or not using condoms at all.…”

“…Factors such as high prices of condoms, not knowing the places to access or buy condoms, feeling ashamed or uncomfortable to access or buy condoms, as well as unawareness of the existence of condoms and their protective functions were also barriers to condom use or safe sex behaviors reported among the clients of FCSWs. Meanwhile, other barriers to condom use as previously reported ( Fajans et al, 1995 ; Fajans et al, 1994 ; Fauk & Mwanri, 2015 ; Ford et al, 2002 ; Voeten et al, 2002 ), including taking prophylactic antibiotics, good appearance of FCSWs such as pretty, young, clean, and healthy and trusting a steady FCSW, drunkenness, FCSWs not liking condoms, condoms burst, and belief that condoms do not protect against HIV infection, were not identified in the current study.…”

“…Male clients of female commercial sex workers (FCSWs) are one of the groups at risk for the acquisition of HIV and other sexually transmitted infections (STIs) due to frequent unprotected sexual encounters with FCSWs ( Fajans, Wirawan, & Ford, 1994 ; Ford, Wirawan, & Muliawan, 2002 ; Kementrian Kesehatan RI, 2017 ). Condomless sex has been the most effective route of HIV transmission especially among sexually active age groups in Indonesia ( Fauk & Mwanri, 2015 ; Kementrian Kesehatan RI, 2017 ). For instance, of the total 155,444 HIV cases diagnosed in the past 5 years, 59% (91,719 cases) were transmitted through condomless sexual encounters, 5.6% (8,670 cases) were spread through injecting drug use, and the rest were unknown ( Kementrian Kesehatan RI, 2017 ).…”

The role of social determinants on tuberculosis/HIV co-infection mortality in southwest Ethiopia: a retrospective cohort study

“…Social determinants of health have broadly been defined as social, economic, cultural and environmental factors and circumstances that influence health outcomes of populations [ 1 , 2 ]. These factors influence health at different levels including, at individual behavioral level, health care system level and the surrounding environmental level [ 3 ].…”

Exploring Determinants of Unprotected Sexual Behaviours Favouring HIV Transmission among Men who Have Sex with Men in Yogyakarta, Indonesia

“…Unprotected sexual behaviours have been incriminated as the main contributors to the spread of HIV infection among Indonesian population (Fauk & Mwanri, 2015;Kementrian Kesehatan RI, 2017;Prasetyo et al, 2014). For example, over the past five years, more than half of the new HIV cases were due to unprotected sexual behaviours (Kementrian Kesehatan RI, 2017).…”