Factors facilitating and hindering safer sex negotiations among female sex workers in Pune, India: Conversations with women in sex work.

摘要

Female sex workers (FSW) are often targeted for Human Immune Deficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS) prevention because of their high risk behavior. Existing empirical evidence demonstrates that HIV prevention and control in this population cannot be achieved solely through HIV/AIDS education. Sexual behavior is complex and contextual factors play an important role in sexual decision making between FSW and their male partners. The purpose of this study was to understand these contextual factors that influence FSW safer sex (condom use) behavior with their male partners (customers, lovers, husbands) in Pune, India.; The study draws on qualitative data collected through semi-structured interviews with women in sex work. FSW working as peer educators assisted in recruiting participants for the study. Eight brothel-based sex workers, eight street sex workers, six brothel keepers, and four peer educators participated in in-depth, audiotaped interviews. Maximum variation sampling was used to enhance the diversity of respondents in terms of age, number of years in sex work, place of origin, and area of business operation. Interviews sought perceptions about HIV/AIDS awareness, experiences with violent and drunken clients, safer sex with lovers, and brothel keepers and peer support. All interviews were transcribed in the original language and coded for distinct and overlapping themes. Findings from the study reveal that FSW have to grapple with economic, social, and logistical factors existing in their environment to negotiate with their male partners for condom use to prevent HIV/AIDS transmission. Poverty, relationships with male partners (customers and lovers), relationship with brothel owners and peers, type of sex work (brothel based or street based), AIDS deaths in the community, fatalism, police, and violence are some of the contextual factors in the community that influence FSW safer sex negotiations for condom use with their male partners.; Despite the central role that HIV/AIDS prevention education plays in this community, this study brings forth the ecological factors influencing FSW safer sex negotiations in this geographical context. Understanding these issues is necessary to make HIV/AIDS prevention programs successful.