Sexual risk behaviours and barriers to HIV testing among clients of female sex workers in Guatemala: A qualitative study

Culture, Health and Sexuality

Volumn 15, Issue 7, 2013, Pages 759-773

  Lahuerta, Maria ^a,b   Torrens, Míriam ^a   Sabidó, Meritxell ^a,c,d   Batres, Anabella ^e   Casabona, Jordi ^a,c,f,g  

^a Fundacio SIDA i Societat   (Spain)

^b Department of Medicine   (United States)

^c CIBER EPIDEMIOLOGÍA Y SALUD PÚBLICA CIBERESP   (Spain)

^d UNIVERSITY OF GIRONA   (Spain)

^e Health District of Escuintla Ministry of Health   (Guatemala)

^f Institut Català d'Oncologia Hospital   (Spain)

^g UNIVERSITAT AUTÒNOMA DE BARCELONA   (Spain)

Author keywords

Guatemala; HIV; risk behaviours; sex worker clients; sexually transmitted infection

Indexed keywords

ADOLESCENT; ADULT; ATTITUDE TO HEALTH; CONDOM; FEMALE; GUATEMALA; HIGH RISK BEHAVIOR; HIV INFECTIONS; HUMAN; MALE; MIDDLE AGED; PATIENT ATTITUDE; PROSTITUTION; PSYCHOLOGY; QUALITATIVE RESEARCH; SEXUAL BEHAVIOR; SEXUALLY TRANSMITTED DISEASES; UNSAFE SEX; UTILIZATION; YOUNG ADULT; ARTICLE; HUMAN IMMUNODEFICIENCY VIRUS INFECTION; PSYCHOLOGICAL ASPECT; SEXUALLY TRANSMITTED DISEASE; UTILIZATION REVIEW;

ADOLESCENT; ADULT; CONDOMS; FEMALE; GUATEMALA; HEALTH KNOWLEDGE, ATTITUDES, PRACTICE; HIV INFECTIONS; HUMANS; MALE; MIDDLE AGED; PATIENT ACCEPTANCE OF HEALTH CARE; PROSTITUTION; QUALITATIVE RESEARCH; RISK-TAKING; SEXUAL BEHAVIOR; SEXUALLY TRANSMITTED DISEASES; UNSAFE SEX; YOUNG ADULT;

EID: 84885020949     PISSN: 13691058     EISSN: 14645351     Source Type: Journal    
DOI: 10.1080/13691058.2013.777474     Document Type: Article

References (64)

1. Alary, M., and C. M.Lowndes. 2004. "The Central Role of Clients of Female Sex Workers in the Dynamics of Heterosexual HIV Transmission in sub-Saharan Africa." AIDS18 (6): 945-947.
2. Alary, M., C. M.Lowndes, L.Mukenge-Tshibaka, C. A.Gnintoungbe, E.Bedard, N.Geraldo, P.Jossou, et al. 2003. "Sexually Transmitted Infections in Male Clients of Female Sex Workers in Benin: Risk Factors and Reassessment of the Leucocyte Esterase Dipstick for Screening of Urethral Infections." Sexually Transmitted Infections79 (5): 388-392.
3. Angotti, N., A.Bula, L.Gaydosh, E. Z.Kimchi, R. L.Thornton, and S. E.Yeatman. 2009. "Increasing the Acceptability of HIV Counseling and Testing with Three C's: Convenience, Confidentiality and Credibility." Social Science & Medicine68 (12): 2263-2270.
4. Aral, S. O., N. S.Padian, and K. K.Holmes. 2005. "Advances in Multilevel Approaches to Understanding the Epidemiology and Prevention of Sexually Transmitted Infections and HIV: An Overview." The Journal of Infectious Diseases191 (Suppl. 1): S1-S610.1086/425290.
5. Arandi, C. G., and M. Castro. 2010. "Informe Nacional sobre los Progresos Realizados en el seguimiento a la declaración de compromiso sobre el VIH y SIDA -UNGASS Guatemala.", Ministerio de Salud Pública y Asistencia Social de Guatemala; Ciudad de Guatemala, 2007. Available at: www.pasca.org/sites/default/files/guatemala_2010_country_progress_report_esfin.pdf. Accessed January 02, 2012.
6. Baker, Ricardo, and Nascimento. 2007. Engaging boys and Girls in Changing Gender-Based Inequity in Health: Evidence from Programmatic Interventions. Available at: http://www.who.int/gender/documents/Engaging_men_boys.pdf. Geneva: World Health Organization.
7. Barker, G., and C.Ricardo. 2005. "Young Men and the Construction of Masculinity in Sub-Saharan Africa: Implication fo HIV/AIDS, Conflict, and Violence." Social Development Papers: Conflict Prevention and Reconstruction26.
8. Couture, M. C., J. C.Soto, E.Akom, A. C.Labbe, G.Joseph, and M. V.Zunzunegui. 2008. "Clients of Female Sex Workers in Gonaives and St-Marc, Haiti Characteristics, Sexually Transmitted Infection Prevalence and Risk Factors." Sexually Transmitted Diseases35 (10): 849-855.
9. Decker, M. R., E.Miller, A.Raj, N.Saggurti, B.Donta, and J. G.Silverman. 2009. "Indian Men's Use of Commercial Sex Workers: Prevalence, Condom Use, and Related Gender Attitudes." Journal of Acquired Immune Deficiency Syndrome53: 240-246.
10. do Espirito Santo, M. E., and G. D.Etheredge. 2003. "HIV Prevalence and Sexual Behaviour of Male Clients of Brothels' Prostitutes in Dakar, Senegal." AIDS Care15 (1): 53-62.
11. Doherty, I. A., N. S.Padian, C.Marlow, and S. O.Aral. 2005. "Determinants and Consequences of Sexual Networks as they Affect the Spread of Sexually Transmitted Infections." The Journal of Infectious Diseases191 (Suppl. 1): S42-S5410.1086/425277.
12. Dunkle, K. L., and R.Jewkes. 2006. "Effective HIV Prevention Requires Gender-Transformative Work with Men." Sexually Transmitted Infections83 (3): 173-174.
13. Fishbein, M., and I.Ajzen. 1975. Belief, Attitude Intention, and Behaviour: An Introduction to Theory and Research Belief, Attitude Intention, and Behaviour: An Introduction to Theory and Research. MA: Addison-Wesley.
14. Fisher, J. D., and W. A.Fisher. 1992. "Changing AIDS-Risk Behavior." Psychological Bulletin111 (3): 455-47410.1037/0033-2909.111.3.455.
15. Genberg, Becky L., ZdenekHlavka, Kelika A.Konda, SuzanneMaman, SuwatChariyalertsak, AlfredChingono, JessieMbwambo, PreciousModiba, HeidiVan Rooyen, David D.Celentano, et al. 2009. "A comparison of HIV/AIDS-Related Stigma in Four Countries: Negative Attitudes and Perceived Acts of Discrimination Towards People Living with HIV/AIDS." Social Science & Medicine68 (12): 2279-2287.
16. Ghimire, L., W. C.Smith, E. R.van Teijlingen, R.Dahal, and N. P.Luitel. 2011. "Reasons for Non- Use of Condoms and Self- Efficacy Among Female Sex Workers: A Qualitative Study in Nepal." BMC Women's Health11 (1): 4210.1186/1472-6874-11-42.
17. Gomes do Espirito Santo, M. E., and G. D.Etheredge. 2005. "Male Clients of Brothel Prostitutes as a Bridge for HIV Infection Between High Risk and Low Risk Groups of Women in Senegal." Sexually Transmitted Infections81 (4): 342-344.
18. Gorbach, P. M., H.Sopheab, T.Phalla, H. B.Leng, S.Mills, A.Bennett, and K. K.Holmes. 2000. "Sexual Bridging by Cambodian Men: Potential Importance for General Population Spread of STD and HIV Epidemics." Sexually Transmitted Diseases27 (6): 320-326.
19. Hor, L. B., R.Detels, S.Heng, and P.Mun. 2005. "The Role of Sex Worker Clients in Transmission of HIV in Cambodia." International Journal of STD & AIDS16 (2): 170-17410.1258/0956462053057567.
20. Instituto Nacional de Estadística (INE). 2002. "Estadísticas de pertinencia étnica. Censo 2002.", Gobierno de Guatemala. Available at: http://www.ine.gob.gt/np/biblioteca/index.htm.
21. Instituto Nacional de Estadística de Guatemala. 2002. IV Encuesta Nacional de Salud Materno Infantil (ENSMI). 2002. "Chapter 7. Sexual Behaviour among Men 15-59 Years Old.", Available at: http://www.ine.gob.gt/index.php/sociedad/44-sociedad/67-ensmi. Accessed January 23, 2012.
22. Jereni, B. H., and A. S.Muula. 2008. "Availability of Supplies and Motivations for Accessing Voluntary HIV Counseling and Testing Services in Blantyre, Malawi." BMC Health Services Research8 (1): 17.
23. Jurgensen, M., M.Tuba, K.Fylkesnes, and A.Blystad. 2012. "The Burden of Knowing: Balancing Benefits and Barriers in HIV Testing Decisions. A Qualitative Study from Zambia." BMC Health Services Research12 (1): 2.
24. Kaufman, M. R., T.Shefer, M.Crawford, L. C.Simbayi, and S. C.Kalichman. 2008. "Gender Attitudes, Sexual Power, HIV Risk: A Model for Understanding HIV Risk Behavior of South African Men." AIDS Care20 (4): 434-441.
25. Kerrigan, D., J. M.Ellen, L.Moreno, S.Rosario, J.Katz, D. D.Celentano, and M.Sweat. 2003. "Environmental-Structural Factors Significantly Associated with Consistent Condom Use Among Female Sex Workers in the Dominican Republic." AIDS17 (3): 415-423.
26. King, R., J.Lifshay, S.Nakayiwa, D.Katuntu, P.Lindkvist, and R.Bunnell. 2009. "The Virus Stops with Me: HIV-Infected Ugandans' Motivations in Preventing HIV Transmission." Social Science & Medicine68 (4): 749-757.
27. Lahuerta, M., M.Sabidó, F.Giardina, G.Hernandez, J. F.Palacios, R.Ortiz, V. H.Fernandez, and J.Casabona. 2011. "Comparison of Users of an HIV/syphilis Screening Community-Based Mobile Van and Traditional Voluntary Counselling and Testing Sites in Guatemala." Sexually Transmitted Infections87 (2): 136-140.
28. Lau, J. T., S. P.Wan, X. N.Yu, F.Cheng, Y.Zhang, N.Wang, L.Zhang, and J.Zhang. 2009. "Changes in Condom Use Behaviours Among Clients of Female Sex Workers in China." Sexually Transmitted Infections85 (5): 376-382.
29. Li, Q., X.Li, and B.Stanton. 2010. "Alcohol Use Among Female Sex Workers and Male Clients: An Integrative Review of Global Literature." Alcohol and Alcoholism45 (2): 188-19910.1093/alcalc/agp095.
30. Lowndes, Catherine M., MichelAlary, Cyriaque A. B.Gnintoungbe, EmmanuelleBedard, LeonardMukenge, NassirouGeraldo, PatrickJossou, EdgarLafia, FranceBernier, EniasBaganizi, JeanJoly, EricFrost, SeverinAnagonou, et al. 2000. "Management of Sexually Transmitted Diseases and HIV Prevention in Men at High Risk: Targeting Clients and Non-Paying Sexual Partners of Female Sex Workers in Benin." AIDS14 (16): 2523-2534.
31. Lowndes, C. M., M.Alary, A.-C.Labbe, C.Gnintoungbe, M.Belleau, L.Mukenge, H.Meda, M.Ndour, S.Anagonou, and A.Gbaguidi. 2007. "Interventions Among Male Clients of Female Sex Workers in Benin, West Africa: An Essential Component of Targeted HIV Preventive Interventions." Sexually Transmitted Infections83 (7): 577-581.
32. Lynch, I., P. W.Brouard, and M. J.Visser. 2010. "Constructions of Masculinity Among a Group of South African Men Living with HIV/AIDS: Reflections on Resistance and Change." Culture, Health & Sexuality12 (1): 15-27.
33. Macia, M., P.Maharaj, and A.Gresh. 2011. "Masculinity and Male Sexual Behaviour in Mozambique." Culture, Health & Sexuality13 (10): 1181-1192.
34. MacPhail, C., and C.Campbell. 2001. "'I think Condoms are Good but, Aai, I Hate those Things': Condom Use Among Adolescents and Young People in a Southern African Township." Social Science & Medicine52 (11): 1613-1627.
35. Maman, Suzanne, LaurieAbler, LisaParker, TimLane, AdmireChirowodza, JacobNtogwisangu, NamtipSrirak, PreciousModiba, OliverMurima, KatherineFritz, et al. 2009. "A Comparison of HIV Stigma and Discrimination in Five International Sites: The Influence of Care and Treatment Resources in High Prevalence Settings." Social Science & Medicine68 (12): 2271-2278.
36. McClelland, L., G.Wanje, F.Kashonga, L.Kibe, R. S.McClelland, J.Kiarie, K.Mandaliya, N.Peshu, and A.Kurth. 2011. "Understanding the Context of HIV Risk Behavior among HIV-Positive and HIV-Negative Female Sex Workers and Male Bar Clients Following Antiretroviral Therapy Rollout in Mombasa, Kenya." AIDS Education and Prevention23 (4): 299-31210.1521/aeap.2011.23.4.299.
37. Meiberg, A. E., A. E.Bos, H. E.Onya, and H. P.Schaalma. 2008. "Fear of Stigmatization as Barrier to Voluntary HIV Counselling and Testing in South Africa." East African Journal of Public Health5: 49-54.
38. Ministerio de Salud Pública y Asistencia Social de Guatemala (MSPAS). 2009. "Encuesta Nacional de Salud Materno Infantil 2008 - 2009.", MSPAS, Ciudad de Guatemala, 2009. Available at: http://www.ine.gob.gt/np/ensmi/Informe_ENSMI2008_2009.pdf.
39. Murray, L., L.Moreno, S.Rosario, J.Ellen, M.Sweat, and D.Kerrigan. 2007. "The Role of Relationship Intimacy in Consistent Condom Use among Female Sex Workers and their Regular Paying Partners in the Dominican Republic." AIDS and Behavior11 (3): 463-470.
40. O'Sullivan, L. F., S.Hoffman, A.Harrison, and C.Dolezal. 2006. "Men, Multiple Sexual Partners, and Young Adults' Sexual Relationships: Understanding The Role of Gender in the Study of Risk." Journal of Urban Health83 (4): 695-70810.1007/s11524-006-9062-5.
41. Parker, R.2009. "Sexuality, Culture and Society: Shifting Paradigms in Sexuality Research." Culture, Health & Sexuality11 (3): 251-266.
42. Patterson, T. L., S.Goldenberg, M.Gallardo, R.Lozada, S. J.Semple, P.Orozovich, D.Abramovitz, and S. A.Strathdee. 2009. "Correlates of HIV, Sexually Transmitted Infections, and Associated High-Risk Behaviors among Male Clients of Female Sex Workers in Tijuana, Mexico." AIDS23 (13): 1765-1771.
43. Pope, C., S.Ziebland, and N.Mays. 2000. "Qualitative Research in Health Care: Analysing Qualitative Data." BMJ320 (7227): 114-11610.1136/bmj.320.7227.114.
44. Porras, C., M.Sabidó, P.Fernandez-Davila, V. H.Fernandez, A.Batres, and J.Casabona. 2008. "Reproductive Health and Healthcare among Sex Workers in Escuintla, Guatemala." Culture, Health & Sexuality10 (5): 529-538.
45. Pulerwitz, J., and G.Barker. 2007. "Measuring Attitudes Toward Gender Norms among Young Men in Brazil: Development and Psychometric Evaluation of the GEM Scale." Men and Masculinities10 (3): 322-33810.1177/1097184x06298778.
46. Remple, V. P., D. M.Patrick, C.Johnston, M. W.Tyndall, and A. M.Jolly. 2007. "Clients of Indoor Commercial Sex Workers: Heterogeneity in Patronage Patterns and Implications for HIV and STI Propagation through Sexual Networks." Sexually Transmitted Diseases34: 754-760.
47. Sabidó, M., F.Giardina, G.Hernandez, V. H.Fernandez, J. E.Monzon, R.Ortiz, A.Montoliu, and J.Casabona. 2009. "The UALE Project: Decline in the Incidence of HIV and Sexually Transmitted Infections and Increase in the Use of Condoms among Sex Workers in Guatemala." JAIDS Journal of Acquired Immune Deficiency Syndromes51 (Suppl. 1): S35-S41.
48. Sabidó, M., M.Lahuerta, A.Montoliu, V.Gonzalez, G.Hernandez, F.Giardina, J. E.Monzon, M. I.Pedroza, and J.Casabona. 2011. "Human Immunodeficiency Virus, Sexually Transmitted Infections, and Risk Behaviors among Clients of Sex Workers in Guatemala: Are they a Bridge in Human Immunodeficiency Virus Transmission?" Sexually Transmitted Diseases38: 735-742.
49. Safika, I., T. P.Johnson, and J. A.Levy. 2011. "A Venue Analysis of Predictors of Alcohol Use Prior to Sexual Intercourse among Female Sex Workers in Senggigi, Indonesia." International Journal of Drug Policy22 (1): 49-55.
50. Semple, S. J., S. A.Strathdee, M.Gallardo Cruz, A.Robertson, S.Goldenberg, and T. L.Patterson. 2010. "Psychosexual and Social-Cognitive Correlates of Sexual Risk Behavior among Male clients of Female Sex Workers in Tijuana, Mexico." AIDS Care22 (12): 1473-1480.
51. Sirotin, N., S. A.Strathdee, R.Lozada, L.Nguyen, M.Gallardo, A.Vera, and T. L.Patterson. 2010. "A Comparison of Registered and Unregistered Female Sex Workers in Tijuana, Mexico." Public Health Reports125 (Suppl. 4): 101-109.
52. Sistema Nacional de Información Monitoreo y Alerta de la Inseguridad Alimentaria y Nutricional (SINSAN). 2011. "Indicadores Socio-Económicos. Secretaria de Seguridad Alimentaria y Nutricional.", Gobierno de Guatemala. Available from: http://www.siinsan.gob.gt/IndicadoresSocioEconomicos/tabid/67/Default.aspx.
53. Smith, D. J.2003. "Imagining HIV/AIDS: Morality and Perceptions of Personal Risk in Nigeria." Medical Anthropology22 (4): 343-372.
54. Soto, R. J., Frye, Victoria, Mary HLatka, YingFengWu, Eduardo EValverde, Amy RKnowlton, Kelly RKnight, Julia HArnsten, K. K.Holmes, et al. 2007. "Sentinel Surveillance of Sexually Transmitted Infections/HIV and Risk Behaviors in Vulnerable Populations in 5 Central American Countries." Journal of Acquired Immune Deficiency Syndrome46 (Supplement 2): 101-111.
55. Subramanian, Thilakavathi, Mohan DGupte, Ramesh SParanjape, Ginnela NVBrahmam, LakshmiRamakrishnan, RajatashuvraAdhikary, BoopathiKangusamy, Beena EThomas, SrinivasanKallam, and CPKGirish. 2008. "HIV, Sexually Transmitted Infections and Sexual Behaviour of Male Clients of Female Sex Workers in Andhra Pradesh, Tamil Nadu and Maharashtra, India: Results of a Cross-Sectional Survey." AIDS22 (Suppl. 5): S69-S7910.1097/01.aids.0000343765.00573.ce.
56. Sumartojo, E.2000. "Structural Factors in HIV Prevention: Concepts, Examples, and Implications for Research." AIDS14 (Suppl. 1): S3-S1010.1097/00002030-200006001-00002.
57. Thomas, F.2008. "Indigenous Narratives of HIV/AIDS: Morality and Blame in a Time of Change." Medical Anthropology27 (3): 227-256.
58. UNAIDS/WHO. 2009. AIDS Epidemic Update: November 2009. Geneva, Switzerland: UNAIDS.
59. UNAIDS/WHO. 2010. Guatemala Country Progress Report.
60. United Nations Development Program. 2012. "Guatemala Country Profile: Human Development Indicators.", http://hdrstats.undp.org/en/countries/profiles/GTM.html.
61. United Nations International Children's Emergency Fund (UNICEF). 2005. "Salud Reproductiva en Adolescentes en Guatemala: Un análisis cualitativo y cuantitativo.", UNICEF, Ciudad de Guatemala. Avaialble at: http://www.unicef.org.gt/1_recursos_unicefgua/publicaciones/salud_reproductiva_adolescentes.pdf.
62. Voeten, H. A., O. B.Egesah, M. Y.Ondiege, C. M.Varkevisser, and J. D.Habbema. 2002. "Clients of Female Sex Workers in Nyanza Province, Kenya: A Core Group in STD/HIV Transmission." Sexually Transmitted Diseases29 (8): 444-452.
63. Vuylsteke, Bea L, Peter DGhys, MoussaTraoré, YaoKonan, GuessanMah-Bi, ChantalMaurice, DramaneSoroh, Jeanne NDiarra, Thierry HRoels, MarieLaga, et al. 2003. "HIV Prevalence and Risk Behavior among Clients of Female Sex Workers in Abidjan, Côte d'Ivoire." AIDS17 (11): 1691-169410.1097/00002030-200307250-00014.
64. Xu, J. J., N.Wang, L.Lu, Y.Pu, G. L.Zhang, M.Wong, Z. L.Wu, and X. W.Zheng. 2008. "HIV and STIs in Clients and Female Sex Workers in Mining Regions of Gejiu City, China." Sexually Transmitted Diseases35 (6): 558-565.