Background: Sifon is ritual sexual intercourse after male circumcision from the Atoin Meto tribe that contributes to HIV/AIDS transmission. Ritual Sifon may put at risk for HIV infection and also sexual transmission diseases (STDs). Doing ritual Sifon as a culture, without using protection during intercourse becomes one way to get HIV infection from infected men. Few studies explore this phenomenon among women who become Sifon. Therefore, the aim of this study is to explore the experience of Sifon women in the context of HIV/AIDS transmission.
Design and Methods: The data were collected from March to July 2020. This study used a phenomenological approach with a purposive sampling technique. Inclusion criteria: the women from Atoin Meto tribe aged above eighteen years old who have been Sifon women for at least six months. The participants were recruited through traditional healers in Nekbaun village of Kupang District and Timor Tengah Selatan District. The data were analyzed by the Colaizzi method.
Results: Thirteen women were interviewed and we found four themes: lack of knowledge about HIV/AIDS transmission, unaware Sifon women, women who experienced STDs, using traditional medicine to treat STDs (Timor medicine).
Conclusions: The interpretation of Sifon women’s experiences that performed Sifon rituals indicated that Sifon is a risk factor for transmitting HIV/AIDS. Preventive and promotional educational programs with a cultural approach are needed to reduce the risk of HIV/AIDS transmission.
UNAIDS data 2017. Geneva: Joint United Nations Programme on HIV/AIDS; 2017. Accessed: 2020 Dec 13. Available from: https://www.unaids.org/en/resources/documents/2017/2017_data_book
UNAIDS data 2019. Geneva: Joint United Nations Programme on HIV/AIDS; 2019. Accessed: 2020 Dec 13. Avaiable from: https://www.unaids.org/en/resources/documents/2019/2019-UNAIDS-data
Ministry of Health of the Republic of Indonesia. [Infodatin: situasi umum HIV/AIDS dan tes HIV (Infodatin: common HIV / AIDS situation and HIV testing)]. Jakarta: Ministry of Health of the Republic of Indonesia; 2018. Accessed: 2020 Dec 13. Available from: http://www.depkes.go.id/resources/download/pusdatin/infodatin/infidatinAIDS.pdf
East Nusa Tenggara Provincial Health Office. [Profil kesehatan Provinsi Nusa Tenggara Timur tahun 2018 (Health profile of East Nusa Tenggara Province in 2018)]. Kupang: East Nusa Tenggara Provincial Health Office; 2019. Accessed: 2020 Dec 13. Available from: dinkes.nttprov.go.id
Jengamal Y. [Jumlah ODHA di NTT capai 7.032 orang (The number of people living with HIV in NTT reached 7,032 people)]. Victory News 2020 Sep 15. Accessed: 2020 Dec 13. Breaking News: [about 2 screens]. Available from: https://www.victorynews.id/jumlah-odha-di-ntt-capai-7-032-orang/#
Rodriguez VJ, Chahine A, de la Rosa A, et al. Identifying factors associated with successful implementation and uptake of an evidence-based voluntary medical male circumcision program in Zambia: the Spear and Shield 2 Program. Transl Behav Med 2020;10:970-7. DOI: https://doi.org/10.1093/tbm/ibz048
Kibira SPS, Atuyambe LM, Sandøy IF, et al. “Now that you are circumcised, you cannot have first sex with your wife”: post circumcision sexual behaviours and beliefs among men in Wakiso district, Uganda. J Int AIDS Soc 2017;20:21498. DOI: https://doi.org/10.7448/IAS.20.1.21498
Lake P. [Sifon: antara tradisi dan risiko penularan PMS (Sifon: Between tradition and the risk of transmitting STDs)]. Yogyakarta: Collaboration between the Ford Foundation and the Population Research Center, Universitas Gadjah Mada; 1999.
Saba KR. Wanita sifon (studi ethno-phenomenology). [Thesis in Indonesian]. Yogyakarta: Universitas Gajah Mada; 2016.
Halimatusa’diyah I. Moral injury and the struggle for recognition of women living with HIV/AIDS in Indonesia. Int Sociol 2019;34:696-715. DOI: https://doi.org/10.1177/0268580919865099
Martins-Fonteyn E, Loquiha O, Baltazar C, et al. Factors influencing risky sexual behaviour among Mozambican miners: a socio-epidemiological contribution for HIV prevention framework in Mozambique. Int J Equity Health 2017;16:17. DOI: https://doi.org/10.1186/s12939-017-0674-z
Ortblad KF, Musoke DK, Ngabirano T, et al. Is knowledge of HIV status associated with sexual behaviours? A fixed effects analysis of a female sex worker cohort in urban Uganda. J Int AIDS Soc 2019;22:e25336. DOI: https://doi.org/10.1002/jia2.25336
Salem BE, Bustos Y, Shalita C, et al. Chronic disease self-management challenges among rural women living with HIV/AIDS in Prakasam, Andhra Pradesh, India: a qualitative study. J Int Assoc Provid AIDS Care 2018;17:2325958218773768. DOI: https://doi.org/10.1177/2325958218773768
Rokhmah D, Khoiron. The role of sexual behavior in the transmission of HIV and AIDS in adolescent in coastal area. Procedia Environ Sci 2015;23:99-104. DOI: https://doi.org/10.1016/j.proenv.2015.01.015
Irmayati N, Yona S, Waluyo A. HIV-related stigma, knowledge about HIV, HIV risk behavior and HIV testing motivation among women in Lampung, Indonesia. Enferm Clin 2019;29 Suppl 2:546-50. DOI: https://doi.org/10.1016/j.enfcli.2019.04.084
Jaspal R, Lopes B, Jamal Z, et al. HIV knowledge, sexual health and sexual behaviour among Black and minority ethnic men who have sex with men in the UK: a cross-sectional study. Sex Health 2019;16:25-31. DOI: https://doi.org/10.1071/SH18032
Saberi P, Neilands TB, Lally MA, et al. The association between use of online social networks to find sex partners and sexually transmitted infection diagnosis among young men who have sex with men and transgender women living with HIV. J Int Assoc Provid AIDS Care 2019;18:2325958219867324. DOI: https://doi.org/10.1177/2325958219867324
Schönfeld A, Feldt T, Tufa TB, et al. Prevalence and impact of sexually transmitted infections in pregnant women in central Ethiopia. Int J STD AIDS 2018;29:251-8. DOI: https://doi.org/10.1177/0956462417723545
Kloos H, Mariam DH, Kaba M, Tadele G. Traditional medicine and HIV/AIDS in Ethiopia: herbal medicine and faith healing: a review. Ethiop J Health Dev 2013;27:141-55.