Mazeingia Yohannes Teka, Olijjira Lemessa, Dessie Yadeta
Debre Markos University, Debre Marqos, Ethiopia.
Haramaya University, Harar, Ethiopia.
Glob Health Res Policy. 2017 Sep 8;2:27. doi: 10.1186/s41256-017-0047-6. eCollection 2017.
Female sex workers have been disproportionately affected with HIV and anal sexual experience elevate their vulnerability. Anal intercourse has more risk of HIV transmission than vaginal intercourse for receptors that coupled with low condom and proper lubricant use behavior during anal sex. Besides majority of them did not understand HIV transmission risk of anal intercourse. In Ethiopia, studies on anal sexual experience is almost none existent, so the purpose of this study is to explored anal sexual experience and HIV transmission risk awareness among female sex worker in Dire Dawa, Eastern Ethiopia.
Qualitative study with thematic analysis approach was conducted among 18 female sex workers and recruitment of study participants performed until saturation of information. The principal investigator conducted in-depth interviews using local language (Amharic) and it was recorded on audio recorder. Tape recorded data was transcribed and translated to English and entered into open code version 3.4 for coding and theme identification. Data collection conducted simultaneously with data analysis.
Female sex workers practiced anal sex for different themes like financial influence, coercion, intentionally, peer pressure and as a sign of intimacy and love. Coercion, negative attitudes, poor awareness about HIV transmission risks of anal sex and protection capacity of condom and proper lubricants are the identified themes for not using condom and proper lubricants during anal sex by female sex workers. Inaccessibility and unavailability of health services for issues related to anal sex was the core reason for female sex workers' misperception and risk anal sexual experience.
Female sex workers practiced anal sex without risk reduction approaches and they did not understand exacerbated risk of anal sex to HIV transmission. Stakeholders including ministry of health need to incorporate potential awareness raising tasks and programs about risk of anal sex and methods of risk reduction for female sex workers.
女性性工作者受艾滋病毒影响的比例过高，肛交经历增加了她们的易感性。对于接受方而言，肛交比阴道性交有更高的艾滋病毒传播风险，同时肛交时避孕套使用率低且缺乏正确使用润滑剂的行为。此外，她们中的大多数人不了解肛交的艾滋病毒传播风险。在埃塞俄比亚，几乎没有关于肛交经历的研究，因此本研究的目的是探讨埃塞俄比亚东部德雷达瓦市女性性工作者的肛交经历及艾滋病毒传播风险意识。
采用主题分析法对18名女性性工作者进行定性研究，持续招募研究参与者直至信息饱和。首席研究员用当地语言（阿姆哈拉语）进行深入访谈，并录音。录音数据被转录并翻译成英文，录入开放式编码版本3.4进行编码和主题识别。数据收集与数据分析同时进行。
女性性工作者进行肛交的原因多种多样，包括经济影响、胁迫、自愿、同伴压力以及作为亲密和爱的象征。胁迫、消极态度、对肛交艾滋病毒传播风险及避孕套和正确润滑剂保护能力的认识不足，是女性性工作者在肛交时不使用避孕套和正确润滑剂的原因。与肛交相关问题的卫生服务难以获得且无法提供，是女性性工作者产生误解及有肛交风险经历的核心原因。
女性性工作者在没有降低风险措施的情况下进行肛交，且不了解肛交对艾滋病毒传播的加剧风险。包括卫生部在内的利益相关者需要为女性性工作者开展关于肛交风险及降低风险方法的潜在提高认识任务和项目。
