Mwanri Lillian, Fauk Nelsensius Klau, Kustanti Christina Yeni, Ambarwati Atik, Merry Maria Silvia
College of Medicine and Public Health, Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia.
Institute of Resource Governance and Social Change, Jl. R. W. Monginsidi II, Kupang, East Nusa Tenggara, Indonesia, 85221.
Sex Health. 2018 Jun;15(3):246-253. doi: 10.1071/SH17137.
Background The spread of HIV infection among men in Indonesia continues to increase every year. Clients of female sex workers (FSWs) are a group at higher risk of acquiring HIV infection due to their frequent engagement in sexual acts with sex workers. This study aimed to identify factors of susceptibility to HIV infection among clients of FSWs.
A qualitative inquiry using one-on-one in-depth interviews was conducted in the Belu and Malaka districts of Indonesia from January to April 2017. The study participants (n =42) were the clients of FSWs recruited using the snowball sampling technique. The inclusion criteria were: being a client of FSWs and being aged 18 years or more. Data were analysed using a framework analysis.
Findings were grouped into two main emerging themes that included behavioural and socioeconomic factors. Behavioural factors that mediated HIV susceptibility among clients of FSWs were: frequent engagement in unsafe sex with multiple sex workers; low perceptions of the relevance of available HIV and AIDS services and limited access to these services; and HIV stigma or fear of being labelled as HIV positive. Socioeconomic factors included: participants' economic situation; and individuals' household responsibility and ability to afford FSWs services.
The study results indicate the need to reformulate and improve HIV and AIDS-related services, including increasing the level of availability of HIV service points and the dissemination of knowledge and information about HIV and AIDS and condom use and making them accessible to both FSWs and their clients in Belu and Malaka districts.
背景 印度尼西亚男性中艾滋病毒感染的传播每年持续增加。女性性工作者（FSW）的客户由于频繁与性工作者发生性行为，是感染艾滋病毒风险较高的群体。本研究旨在确定女性性工作者客户中易感染艾滋病毒的因素。
2017年1月至4月在印度尼西亚的贝鲁和马拉卡地区进行了一项采用一对一深入访谈的定性调查。研究参与者（n = 42）是使用雪球抽样技术招募的女性性工作者的客户。纳入标准为：是女性性工作者的客户且年龄在18岁及以上。使用框架分析法对数据进行分析。
研究结果分为两个主要的新出现主题，包括行为因素和社会经济因素。介导女性性工作者客户中艾滋病毒易感性的行为因素有：频繁与多名性工作者进行不安全的性行为；对现有艾滋病毒和艾滋病服务相关性的认知较低且获得这些服务的机会有限；以及艾滋病毒污名化或害怕被贴上艾滋病毒阳性的标签。社会经济因素包括：参与者的经济状况；以及个人的家庭责任和支付女性性工作者服务费用的能力。
研究结果表明需要重新制定和改进与艾滋病毒和艾滋病相关的服务，包括提高艾滋病毒服务点的可及性水平，传播有关艾滋病毒和艾滋病以及避孕套使用的知识和信息，并使贝鲁和马拉卡地区的女性性工作者及其客户都能获得这些服务。
