Condom use among brothel-based sex workers and clients in Bali, Indonesia
Kathleen Ford A and Dewa Nyoman Wirawan BA Department of Epidemiology, University of Michigan, Ann Arbor, MI 48109-2029, USA. Corresponding author. Email: kford@umich.edu
B Kerti Praja Foundation, Jalan Raya Sesetan, Bali, Indonesia.
Sexual Health 2(2) 89-96 https://doi.org/10.1071/SH04051
Submitted: 17 November 2004 Accepted: 21 March 2005 Published: 16 June 2005
Abstract
Background: The objective of this paper is to describe the situation among Indonesian sex workers and clients in Bali, Indonesia, through a series of studies conducted during the 1990s. Methods: Five surveys of sex workers and clients were conducted from 1992 through to 1999. Results: The proportion of female sex workers who have heard about AIDS and condom use has increased tremendously in this area. In 1992–93, 51% of women reported ever hearing of AIDS and this had increased to 97% by 1999 (P < 0.01). Reported condom use with clients increased from 19% in 1992–93 to 78% in 1999 (P < 0.01). However, condom use is still far from 100% and perceived susceptibility towards HIV infection among female sex workers and their male clients remains low. Ineffective preventive strategies such as medication use remain common. HIV infection was very low in this population, although the prevalence of other sexually transmitted infections such as gonorrhea and chlamydia was very high. Conclusions: Educational interventions have been conducted with the sex workers, but the main source of education for clients has been through the media. Future programs need to develop more focused efforts to reach clients. These interventions may include worksite interventions, mass media campaigns, youth programs or other models.
Additional keywords: prostitution, sexually transmitted infections, Southeast Asia.
Acknowledgements
The 1997–99 survey was supported by grant number 1 R01 MH55942 from the AIDS Program of the National Institute of Mental Health. Earlier surveys were supported through the AIDSTECH and AIDSCAP projects of Family Health International with funding from USAID.
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