Indonesian Fishermen at Increased Risk of HIV Because of Social, Cultural Factors, Study Says
Fisherman in Indonesia are at an increased risk of HIV because of several social factors, according to a study recently conducted by Bali, Indonesia, researcher Made Setiawan, who holds a doctorate degree in public health from the University of Illinois at Chicago, the Jakarta Post reports.
For the study, Setiawan observed and talked with fisherman at ports and dormitories and interviewed 29 crew members of small fishing boats. He found that fisherman often place themselves in risky situations because they are separated from their wives and families, as well as their status as migrant workers. In addition, many fishermen use alcohol and have sex with commercial sex workers, according to the study.
Setiawan also found that fishermen and officers can influence their peers or subordinates toward either safer or riskier behaviors because they often have either accurate information about HIV/AIDS and access to services or are unaware of the virus or how to prevent it. Although the government and local nongovernmental organizations encourage sex workers to use condoms, most fishermen will not agree to use a condom, the Post reports. Instead, many fishermen have sex with sex workers who are younger and appear to be healthy, take antibiotics prior to sex, wash after sex and stay healthy, which they believe make them immune to sexually transmitted infections, including HIV. In addition, many fishermen insert plastic or glass implants in their penises, which often leads to infection and increases risk of HIV and other STIs.
Few efforts have been made to implement effective and acceptable intervention programs that address the social, cultural and economic contexts that place fishermen at higher risk of HIV, the Post reports. According to Setiawan's research, knowledge about HIV and access to condoms likely will not encourage fishermen to engage in safer-sex practices if their peers or cultural beliefs do not support such practices.
According to UNAIDS, the estimated HIV prevalence among Indonesia's general population is 0.1%, compared with an estimated 10% prevalence among sex workers in Bali, Indonesia (Raniati, Jakarta Post, 1/17).