Condom-use negotiation, alcohol consumption, and HIV-risk sexual behavior among female sex workers in Kupang, East Nusa Tenggara, Indonesia: A cross-sectional study

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  • Khumaidi Khumaidi
    Pelni Nursing Academy of Jakarta, Indonesia.
  • Sri Yona
    Department of Medical Surgical Nursing, Faculty of Nursing, Universitas Indonesia, Depok, West Java, Indonesia.
  • Agung Waluyo
    Department of Medical Surgical Nursing, Faculty of Nursing, Universitas Indonesia, Depok, West Java, Indonesia.


Background: Female sex workers play a crucial part in HIV transmission. Having unprotective condom during sexual activity can lead to HIV infection. Having lower power in condom negotiation with clients can lead  FSW not to using condoms during sexual activity. Alcohol consumption was also mediated HIV risk behavior among FSW. This study aimed to evaluate the relationship between condom use-negotiation, alcohol consumption and HIV-risk sexual behavior among female sex workers (FSW) in Kupang.

Design and 
Methods: A cross-sectional study was conducted with 125 FSWs aged 18 to 60 years recruited from Yayasan Tanpa Batas Kupang with consecutive sampling. The data were analyzed using univariate and the Chi-square test.

: The majority of FSWs (61.6%) reported had low negotiation condom use with their clients, about 77.6% reported high levels of alcohol consumption and 64.8% had high-risk sexual behavior. Condom-use negotiation (p-value: 0.003) and alcohol consumption (p-value: 0.037) were found to be significantly associated with HIV-risk sexual behavior.

: Future interventions on HIV prevention should focus on empowering young FSWs with condom negotiation skills in order to increase condom use. It is also recommended to include information about alcohol consumption and its relationship with HIV-risk behavior in order to have better health outcomes for FSW.


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