An anthropological study on cervical cancer screening among female sex workers in Ho Chi Minh City, Vietnam

Abstract

The research aims to understand the attendance in cervical cancer screening among Vietnamese female sex workers in Ho Chi Minh City, and to explore how the sociocultural factors influence their attendance. Qualitative research was designed with in-depth interview, observation, key informant and secondary data. Fifteen female sex workers aged 18-44 years were recruited by a non-government group. In addition, two health professionals and three community leaders were recruited as key informants in this study. To analyze data, theoretical concepts of discourse by Michel Foucault, felt-stigma by Goffman, beliefs by Kleinman and perceived quality of health service were used. The study found that the various institutionalized discourses on sex work and sex workers such as a source of transmitted diseases , risk group definition of cervical cancer influenced not only individualized discourses but also attendance in cervical cancer screening of female sex workers. These discourses created fear for cancer and stigma of female sex workers. Although most female sex workers considered that they were at risk for cervical cancer, they still postponed doing cervical cancer screening. The reasons for non-attendance were most often economic burden, beliefs about cervical cancer and screening, perceived quality of health services and felt-stigma. Some female sex workers had fatalistic attitudes which were associated with the idea of God. Others believed that cervical cancer was a specific genital infection which resulted from white blood discharge, poor hygiene, having unsafe sex with multiple sexual partners. In addition, fear of cancer, fear of being blamed as promiscuous woman and embarrassment were mentioned as barriers to cervical cancer screening. In terms of perceived quality of health services, interpersonal relationships, adequate information and convenience affected their non-attendance in gynecological examination as well as cervical cancer screening. The findings suggest that health promotion and education about t