Factors Influencing Brothel-Based Female Sex Workers' Self-Perceived Risk for HIV Infection in Surabaya

AIMS: To investigate to what extent sex work history, perception on certain diseases, self- perceived control over becoming infected by HIV and protective actions including condom use consistency influence self-perceived risk for HIV among brothel-based female sex workers (FSWs) in Surabaya, Indonesia METHODS: This was a cross-sectional study with 155 brothel-based FSW participants recruited through convenience sampling from six brothel compounds in Surabaya, Indonesia in 2012. Unlike FSWs who practice commercial sex in social environments where little information about HIV is available, FSWs working in Surabayan brothels are required by the local commitment to have regular clinical check-ups that include counseling sessions about how to avoid STIs. A close-ended questionnaire with binary answer options was used in the interview to explore to what extent perceived-controls over becoming infected by HIV and protective actions were positively associated with self-perceived risk for HIV acquisition. Bi-variate and multivariate binary logistic regressions analyses at α = 0.05 using SPSS version 20 were applied to explore the hypothesis that more perceived-control and more protective actions would be positively associated with less self-perceived risk for HIV acquisition. RESULTS: Self-perceived control over becoming infected by HIV was not related to self-perceived risk for HIV. Self-perceived risk for HIV was significantly related to consistent condom use (p= .035, OR=.423, 95% CI = .190 - .939), experience of working in a bar/discotheque in the last 12 months (p=.026, OR=5.382, 95% CI=1.226-23.629), self-perceived risk for gonorrhea (p=.039, OR=3.439, 95% CI= 1.056 -7.821) and self-perceived risk for syphilis (p<.001, OR=6.882, 95% CI =2.341-20.233). CONCLUSION: Sex work experience may be examined at the higher level of the social-ecological model such as the organizational environment level. Studies that include the higher levels of social ecological model and assessment on risk for venereal diseases also are needed to better explain the range of influences on HIV risk self-assessment. This may involve the clients’ perception on condom use at the interpersonal level of environment.