Poverty as a Contextual Factor Affecting Sexual Health Behavior Among Female Sex Workers in India

Abstract

A thorough understanding of the environmental and structural factors that precipitate unsafe sexual practices is necessary for HIV/AIDS-prevention research among high-risk population groups like commercial sex workers. I examined how poverty contextualizes sexual health behavior, including condom compliance among commercial female sex workers in a red light district in Calcutta, India. For my research I did an ethnographic study and conducted in-depth interviews of 37 commercial female sex workers. I found that poverty, instead of serving as a catalyst for poor health choices among sex workers, acted as an impetus for pursuing safe sex practices and remaining healthy. The results indicate that sex work, poverty, and health do not always have a paradoxical relationship.

Keywords

ethnography HIV/AIDS poverty risk sex workers

Get full access to this article

View all access options for this article.

References

Abdool Karim

S. S.

Nkomokazi

(1991). Sexual behavior and knowledge of AIDS among urban Black mothers. South African Medical Journal, 80, 340-343.

Airhihenbuwa

C. O.

(1995). Health and culture: Beyond the Western paradigm. Thousand Oaks, CA: Sage.

Airhihenbuwa

C. O.

(2007). Healing our differences: The crisis of global health and the politics of identity. Lanham, MD: Rowman & Littlefield.

Airhihenbuwa

C. O.

Obregon

(2000). A critical assessment of theories and models used in health communication for AIDS. Journal of Health Communication, 5(Suppl.), 5-15. doi:10.1080/10810730050019528

Amaro

H. R.

(2000). On the margin: Power and women’s HIV risk reduction strategies. Sex Roles, 42, 723-749. doi:10.1023/A:1007059708789

Basu

(2008). Subalternity and sex work: Re(scripting) contours of health communication in the realm of HIV/AIDS. (Unpublished doctoral dissertation). Purdue University, West Lafayette, IN.

Basu

(2010). Communicating health as an impossibility: Sex work, HIV/AIDS, and the dance of hope and hopelessness. Southern Communication Journal, 75(4), 413-432. doi:10.1080/1041794x.2010.504452

Basu

Dutta

(2008). Participatory change in a campaign led by sex workers: Connecting resistance to action-oriented agency. Qualitative Health Research, 18, 106-119. doi:10.1177/1049732307309373

Basu

Dutta

(2009). Sex workers and HIV/AIDS: Analyzing participatory culture-centered health communication strategies. Human Communication Research, 35, 86-114. doi:10.1111/j.1468-2958.2008.01339.x

10.

Campbell

Mzaidume

Williams

(1998). Gender as an obstacle to condom use: HIV prevention amongst commercial sex-workers in a mining community. Agenda, 39, 50-59. doi:10.1080/10130950.1998.9674432

11.

Chattopadhyay

McKaig

R. G.

(2004). Social development of CSWers in India: An essential step in HIV/AIDS prevention. AIDS Patient Care & STDs, 18(3), 159-168. doi:10.1089/108729104322994847

12.

Connell

R. W.

(1987). Gender and power. Stanford, CA: Stanford University Press.

13.

Cornish

(2006). Changing the stigma of sex work in India: Material context and symbolic change. Journal of Community & Applied Social Psychology, 16, 462-471. doi:10.1002/casp.894

14.

Dutta-Bergman

(2005). Theory and practice in health communication campaigns: A critical interrogation. Health Communication, 18(2), 103-112. doi:10.1207/s15327027hc1802_1

15.

Evans

Lambert

(2008). Implementing community interventions for HIV prevention: Insights from project ethnography. Social Sciences & Medicine, 66(2), 467-478. doi:10.1016/j.socscimed.2007.08.030

16.

Fetterman

D. M.

(1998). Ethnography step by step. Thousand Oaks, CA: Sage.

17.

Gubrium

J. F.

Holstein

J. A.

(2003). Postmodern interviewing. Thousand Oaks, CA: Sage.

18.

Gupta

Parkhurst

Ogden

Aggleton

Mahal

(2008). Structural approaches to HIV prevention. Lancet, 372(9640), 764-775. doi:10.1016/S0140-6736(08)60887-9

19.

Jana

Banerjee

(1999). Learning a change: Seven years’ stint of STD/HIV intervention program at Sonagachi. Calcutta, India: Durbar Mahila Samanwaya Committee.

20.

Jana

Basu

Rotheram-Borus

M. J.

Newman

(2004). The Sonagachi Project: A sustainable community intervention program. AIDS Education and Prevention, 16(5), 405-414. doi:10.1521/aeap.16.5.405.48734

21.

Lupton

(2003). Medicine as culture. Thousand Oaks, CA: Sage.

22.

Madison

D. S.

(2005). Critical ethnography: Methods, ethics, and performance. Thousand Oaks, CA: Sage.

23.

National AIDS Control Organization. (2009). NACO annual report 2009-10. Retrieved from http://www.nacoonline.org/upload/AR%202009-10/NACO_AR_English%20corrected.pdf

24.

Preston-Whyte

(1999). Reproductive health and the condom dilemma: Identifying situational barriers to HIV protection in South Africa. In Caldwell

(Ed.), Resistances to behavioural change to reduce HIV/AIDS in predominantly heterosexual epidemics in Third World countries (pp. 57-67). Canberra, Australia: Australian National University.

25.

Schoepf

B. G.

(1992). Women at risk: Case studies from Zaire. In Herdt

Lindenbaum

(Eds.), In the time of AIDS: Social analysis, theory and method (pp. 259-286). London: Sage.

26.

Seidel

(1993). The competing discourses of HIV/AIDS in sub-Saharan Africa: Discourses of rights and empowerment versus discourses of control and exclusion. Social Science and Medicine, 36(3), 175-194. doi:10.1016/0277-9536(93)90002-L

27.

Shannon

Strathdee

S. A.

Shoveller

Rusch

Kerr

Tyndall

M. W.

(2009). Structural and environmental barriers to condom use negotiation with clients among female sex workers: Implications for HIV-prevention strategies and policy. American Journal of Public Health, 99(4), 659-665. doi:10.2105/AJPH.2007.129858

28.

Sobo

E. J.

(1993). Inner-city women and AIDS: The psychosocial benefits of unsafe sex. Culture. Medicine and Psychiatry, 17, 455-485. doi:10.1007/BF01379310

29.

UNAIDS Global Reference Group on HIV/AIDS and Human Rights. (2003). Sex work and HIV/AIDS. Retrieved from http://data.unaids.org/Topics/Human-Rights/hr_refgroup2_01_en.pdf

30.

Varga

C. A.

(1999). South African young people’s sexual dynamics: Implications for behavioral responses to HIV/ AIDS. In Caldwell

(Ed.), Resistances to behavioral change to reduce HIV/AIDS in predominantly heterosexual epidemics in third world countries. Canberra, Australia: Australian National University.

31.

Wilson

Sibanda

Mboyi

Msimanga

(1990). A pilot study for an HIV prevention programme among commercial sex workers in Bulawayo, Zimbabwe. Social Science and Medicine, 31(5), 609-618. doi:10.1016/0277-9536(90)90097-C

32.

Wingood

G. M.

DiClemente

R. J.

(2000). Application of the theory of gender and power to examine HIV-related exposures, risk factors, and effective interventions for women. Health Education and Behavior, 27(5), 539-565. doi:10.1177/109019810002700502

33.

Wojcicki

J. M.

Malala

(2001). Condom use, power and HIV/AIDS risk: Sex-workers bargain for survival in Hillbrow/Joubert Park/Berea, Johannesburg. Social Science & Medicine, 53, 99-121. doi:10.1016/S0277-9536(00)00315-4

34.

Wood

Jewkes

(1998). Love is dangerous thing: Micro-dynamics of violence in sexual relationships of young people in Umtata. Pretoria, South Africa: Medical Research Council.