Trust as a Determinant Factor for Condom Use among Female Sex Workers in Bali, Indonesia

Trop Med Infect Dis. 2020 Aug 15;5(3):131. doi: 10.3390/tropicalmed5030131.

Abstract

Female sex workers (FSWs) decision to use or not to use condoms depends on several issues, including the decision to trust their client or not, a matter given little attention in previous research. This paper explores the role of trust in consistent condom use among FSWs. We used a cross-sectional survey among FSWs in Bali, Indonesia. The outcome variable for this study was condom use, and independent variables included sociodemographic characteristics, psychosocial factors, social capital dimensions and HIV prevention practices. In total, 406 FSWs participated in the study. Of these, 48% of FSWs used condoms consistently with paying clients over the last month. The following FSWs were less likely to consistently use condoms with clients: FSWs who did not trust that their peer FSWs will use condoms (AOR = 9.3, 95% CI, 3.3-26.2), FSWs who did not feel valued by the people at their location (AOR = 3.9, 95% CI, 1.4-11.6), FSWs who did not graduate from primary or never went to school (AOR = 2.4, 95% CI, 1.03-5.6), and FSWs who have worked more than five years as FSWs (AOR = 5.8, 95% CI, 1.2-29.2). Our results highlight higher rates of inconsistent condom use related to lower trust and feelings of being valued between FSWs, identifying areas for policy and practice attention.

Keywords: HIV; Indonesia; female sex workers; inconsistent condom use; social capital; social cohesion; trust.

Grants and funding