Perceptions of preventive and health seeking behavior for sexually transmitted infections among female sex workers in Semarang, Central Java- Indonesia : a qualitative study

Abstract

The Female sex workers (FSWs) are a key affected population for HIV transmission because they have risky sexual behavior with many partners. A study from the Ministry of Health and Semarang Provincial Health Department found that 32% of FSWs in Semarang were infected by gonorrhea and 56% with Chlamydia. The prevalence of Chlamydia, Gonorrhea, and active syphilis among FSWs in Indonesia is among the highest recorded among Asian countries in the year 2007. This research aims to investigate the perception and health seeking behavior of female sex workers in one community in Semarang province. The study used qualitative research methods to investigate these issues. Six female sex workers with sexually transmitted infection (STIs) experience participated in in-depth interviews and 12 female sex workers participated in two focus group discussions. Content analysis was used to analyze the data. The study found that the knowledge of STIs among female sex workers is still influenced by the myths that are prevalent in the community. Female sex workers are in a low level bargaining position regarding insistance on condom use with their clients. Their mami (mamasans or brothel managers) are not concerned about the FSWs' health, thinking only about the money that they make from the female sex workers. Thus the female sex workers are most likely to get information about STIs from their peers. Female sex workers will go to health care services if they are getting any symptoms, such as itchiness from their vagina and/or vaginal discharge with a strong odor. In order to improve the knowledge and perceptions about sexually transmitted infections among the female sex workers, it is recommended that programs address the awareness of the mami by conducting informal workshops.