Condom, no! unsafe sex, yes : sexual meanings and condom use among Myanmar migrant fishermen in Ranong, Thailand

Abstract

Sexually transmitted infection including HIV/AIDS as a result of resistance to condom use has been examined as one of the major health issues among Myanmar migrant fishermen in Ranong although HIV prevention interventions including condom promotion have been established there for a decade. As a response, a qualitative study using an ethnographic approach was done to explore the reasons of inconsistent condom use among unmarried fishermen in their socio-cultural context through their social interactions, sexuality, and masculinity. In order to grasp the relationship among their social interactions, sexual meanings, and reasons for inconsistent condom use, symbolic interactionism concept was applied, in-depth interviews, and two sessions of focus group interview with fifteen unmarried fishermen (18-35 yr) were done. Moreover, non-participant observation and informal interviews with five sex workers, two guesthouse cleaners, two community health volunteers and one NGO clinic doctor reinforced this data, and computerized data analysis followed this study. The results showed that legal status, job nature, and social relationships of the fishermen shaped their lives resulting in drinking and sex as routine recreational outlets, and creation and re-creation of sex-related meanings. Despite having positive impressions and fair knowledge about condoms, reasons for inconsistent condom use were shaped by many dynamic meanings of sex, love, and condoms, which were categorized into individual, relational and cultural, according to time and space in their migrant context. Moreover, in this study, condoms threaten self, condoms threaten sexual relationship, condoms denaturalize sex, condoms are not needed and condoms are against the norms were examined as the main reasons for inconsistent condom use among the fishermen. This study highlighted how dynamic sex-related meanings and values are important and how they influence decisions towards condom use. Therefore, it is expected that the results will to be useful for implementat