I Just Trust Him: The Notion of Consideration as a Barrier to Condom Use amongst Women Who Inject Drugs in Central Java

Abstract

The HIV epidemic in Indonesia has risen sharply since 2004, from 2682 cases in 2004 to 19,973 in 2009. The main transmission route of HIV in Indonesia is injecting drug use. There is little research on women who inject drugs in Indonesia. In-depth interviews were carried out with 19 women who injected drugs in three small cities in central Java. The interviews explored the living conditions of the women and the context of HIV risk. The transcripts were coded and the data were thematically analyzed. In this paper we report on condom use with regular partners. Condom use was very low with their regular partners, even though both they and their partners were injecting drug users. The reasons women gave were that they trusted their partners (although they realised this trust was shaky). The women used traditional Javanese cultural concepts of consideration to explain why they did not use condoms. This was heightened by other cultural norms of women’s place in Javanese society. Although the women in the study were marginalized because of their drug use, they still hold to many Indonesian cultural precepts—of consideration and care for the other above oneself in their relationships with their regular partners which impede condom use. While notions of consideration and harmony were used to explain non-condom use, the same notions could also be used in couple-counseling to assist.

 

Share and Cite:

A. Saktiawati, H. Worth, E. Lazuardi, C. Spooner, Y. Subronto and R. Padmawati, "I Just Trust Him: The Notion of Consideration as a Barrier to Condom Use amongst Women Who Inject Drugs in Central Java," World Journal of AIDS, Vol. 3 No. 4, 2013, pp. 298-304. doi: 10.4236/wja.2013.34038.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] P. van Empelen, H. P. Schaalma, G. Kok and M. W. Jansen, “Predicting Condom Use with Casual and Steady Sex Partners among Drug Users,” Health Education Research, Vol. 16, No. 3, 2001, pp. 293-305.
http://dx.doi.org/10.1093/her/16.3.293
[2] T. D. Conley and B. E. Collins, “Differences between Condom Users and Condom Nonusers in Their Multidimensional Condom Attitudes,” Journal of Applied Social Psychology, Vol. 35, No. 3, 2005, pp. 603-620.
http://dx.doi.org/10.1111/j.1559-1816.2005.tb02137.x
[3] A. Stulhofer, V. Bacak, D. Ajdukovic and C. Graham, “Understanding the Association between Condom Use at First and Most Recent Sexual Intercourse: An Assessment of Normative, Calculative, and Habitual Explanations,” Social Science & Medicine, Vol. 70, No. 12, 2010, pp. 2080-2084.
http://dx.doi.org/10.1016/j.socscimed.2010.02.030
[4] F. Kapadia, M. Latka, Y. Wu, S. Strathdee, M. Mackesy-Amiti and S. Hudson, “Longitudinal Determinants of Consistent Condom Use by Partner Type among Young Injection Drug Users: The Role of Personal and Partner Characteristics,” AIDS and Behaviour, Vol. 15, No. 7, 2011, pp. 1309-1318.
http://dx.doi.org/10.1007/s10461-009-9569-3
[5] A. M. Nyamathi, C. Lewis, B. Leake, J. Flaskerud and C. Bennett, “Barriers to Condom Use and Needle Cleaning among Impoverished Minority Female Injection Drug Users and Partners of Injection Drug Users,” Public Health Reports, Vol. 110, No. 2, 1995, pp. 166-172.
[6] K. Shannon, T. Kerr, S. Allinott, J. Chettiar, J. Shoveller and M. W. Tyndall, “Social and Structural Violence and Power Relations in Mitigating HIV Risk of Drug-Using Women in Survival Sex Work,” Social Science & Medicine, Vol. 66, No. 4, 2008, pp. 911-921.
http://dx.doi.org/10.1016/j.socscimed.2007.11.008
[7] J. Lau, “Comparing Prevalence of Condom Use during Commercial Sex and Its Related Factors among Female Sex Workers Injecting (FSW-IDU) or Not Injecting Drugs (FSW-N-IDU) in China,” Culture, Health and Sexuality, Vol. 11, No. 1, 2009, pp. 53, 54.
[8] A. K. S. Krishnan, E. Hendriksen, S. Vallabhaneni. S. L. Johnson, S. Raminani, N. Kumarasamy, et al., “Sexual Behaviors of Individuals with HIV Living in South India: A Qualitative Study,” AIDS Education and Prevention Vol. 19, No. 4, 2007, pp. 334-345.
http://dx.doi.org/10.1521/aeap.2007.19.4.334
[9] S. Y. P. Choi, Y. W. Cheung and K. Chen, “Gender and HIV Risk Behavior among Intravenous Drug Users in Sichuan Province, China,” Social Science & Medicine, Vol. 62, No. 7, 2006, pp. 1672-1684.
http://dx.doi.org/10.1016/j.socscimed.2005.08.046
[10] UNODC, “HIV/AIDS Prevention and Care for Female Injecting Drug Users,” UNDOC, 2006.
[11] V. Chakrapani, P. A. Newman, M. Shunmugam and R. Dubrow, “Prevalence and Contexts of Inconsistent Condom Use among Heterosexual Men and Women Living with HIV in India: Implications for Prevention,” AIDS Patient Care and STI, Vol. 24, No. 1, 2010, pp. 48-58.
[12] J. Gu, R. Wang, H. Chen, J. T. F. Lau, L. Zhang, X. Hu, et al., “Prevalence of Needle Sharing, Commercial Sex Behaviors and Associated Factors in Chinese Male and Female Injecting Drug User Populations,” AIDS Care, Vol. 21, No. 1, 2009, pp. 31-41.
http://dx.doi.org/10.1080/09540120802068787
[13] J. Gu, H. Chen, X. Chen, J. T. F. Lau, R. Wang, C. Liu, et al., “Severity of Drug Dependence, Economic Pressure and HIV-Related Risk Behaviors among Non-Institutionalized Female Injecting Drug Users Who Are Also Sex Workers in China,” Drug and Alcohol Dependence, Vol. 97, No. 3, 2008, pp. 257-267.
http://dx.doi.org/10.1016/j.drugalcdep.2008.03.029
[14] S. Pinkham and K. Malinowska-Sempruch, “Women, Harm Reduction, and HIV,” 2007.
http://www.soros.org/initiatives/health/ focus/ihrd/articles_publications/publications /women_20070920/women_20070920.pdf
[15] P. M. Spittal, K. J. P. Craib, E. Wood, N. Laliberté, K. Li, M. W. Tyndall, et al., “Risk Factors for Elevated HIV Incidence Rates among Female Injection Drug Users in Vancouver,” Canadian Medical Association Journal, Vol. 166, No. 7, 2002, pp. 894-899.
[16] C. Sterk, K. Theall, K. Elifson and D. Kidder, “HIV Risk Reduction among African-American Women Who Inject Drugs: A Randomized Controlled Trial,” AIDS and Behaviour, Vol. 7, No. 1, 2003, pp. 73-86.
http://dx.doi.org/10.1023/A:1022565524508
[17] H. Klee, “HIV Risks for Women Drug Injectors: Heroin and Amphetamine Users Compared,” Addiction, Vol. 88, No. 8, 1993, pp. 1055-1062.
http://dx.doi.org/10.1111/j.1360-0443.1993.tb02124.x
[18] M. Magnus, I. Kuo, G. Phillips 2nd, A. Rawls, J. Peterson, L. Montanez, et al., “Differing HIV Risks and Prevention needs among Men and Women Injection Drug Users (IDU) in the District of Columbia,” Journal of Urban Health, Vol. 90, No. 1, 2012, pp. 157-166.
http://dx.doi.org/10.1007/s11524-012-9687-5
[19] W. M. Wechsberg, W. K. Luseno, W. K. Lam, C. D. Parry and N. K. Morojele, “Substance Use, Sexual Risk, and Violence: HIV Prevention Intervention with Sex Workers in Pretoria,” AIDS and Behaviour, Vol. 10, No. 2, 2006, pp. 131-137.
http://dx.doi.org/10.1007/s10461-005-9036-8
[20] L. Shulga and T. Andreeva, “Condom Use among Longterm Intimate Partners Using Drugs Baseline Results from a Randomized Trial in Ukraine,” Retrovirology, Vol. 9, Suppl. 1, 2012, p. P109.
http://dx.doi.org/10.1186/1742-4690-9-S1-P109
[21] A. Uuskula, K. Abel-Ollo, A. Markina, L. A. McNutt and R. Heimer, “Condom Use and Partnership Intimacy among Drug Injectors and Their Sexual Partners in Estonia,” Sexual Transmitted Infections, Vol. 88, No. 1, 2012, pp. 58-62. http://dx.doi.org/10.1136/sextrans-2011-050195
[22] Indonesian National AIDS Commission, “Integrated Biological-Behavioral Surveillance among Most-at-Risk Groups (AMRG) in Indonesia—Surveillance Highlights Injecting Drug Users,” National AIDS Commission, Indonesia, 2007.
[23] UNAIDS, “Report on the Global AIDS Epidemic,” 2008.
http://www.unaids.org/en/KnowledgeCentre/HIVData/GlobalReport/2008/2008_Global_report.asp
[24] Indonesian National AIDS Commission, “Republic of Indonesia Country Report on the Follow up to the Declaration of Commitment on HIV/AIDS (UNGASS) Reporting Period 2008-2009,” National AIDS Commission Republic of Indonesia, 2009.
[25] S. Weller and K. Davis, “Condom Effectiveness in Reducing Heterosexual HIV Transmission (Cochrane Review),” The Cochrane Library, No. 4, 2003.
[26] E. Pisani, Dadun, P. K. Sucahya, O. Kamil and S. Jazan “Sexual Behavior among Injection Drug Users in 3 Indonesian Cities Carries a High Potential for HIV Spread to Noninjectors,” Journal of Acquired Immune Deficiency Syndromes, Vol. 34, No. 4, 2003, pp. 403-406.
http://dx.doi.org/10.1097/00126334-200312010-00007
[27] C. Spooner, A. M. I. Saktiawati, E. Lazuardi, H. Worth, Y. W. Subronto and R. S. Padmawati, “Women Who Inject Drugs and HIV Risk in Central Java, Indonesia,” International HIV Research Group, Sydney, 2010.
[28] A. Persson and W. Richards, “Vulnerability, Gender and ‘Proxy Negativity’: Women in Relationships with HIVPositive Men in Australia,” Social Science & Medicine, Vol. 67, No. 5, 2008, pp. 799-807.
http://dx.doi.org/10.1016/j.socscimed.2008.05.010
[29] A. E. Miranda, N. C. Figueiredo, W. McFarland, R. Schmidt and K. Page, “Predicting Condom Use in Young Women: Demographics, Behaviours and Knowledge from a Population-Based Sample in Brazil,” International Journal of STD & AIDS, Vol. 22, No. 10, 2011, pp. 590-595.
http://dx.doi.org/10.1258/ijsa.2009.009104
[30] L. Norman, C. Garriga and L. Cintron, “Condom Use Patterns among Women Who Live in Public Housing Developments in Ponce, Puerto Rico,” Journal of Health Care for the Poor and Underserved, Vol. S22, No. 4, 2011, pp. 122-145.
http://dx.doi.org/10.1353/hpu.2011.0160
[31] L. DePadilla, M. Windle, G. Wingood, H. Cooper and R. DiClemente, “Condom Use among Young Women: Modeling the Theory of Gender and Power,” Health Psychology, Vol. 30, No. 3, 2011, pp. 310-319.
http://dx.doi.org/10.1037/a0022871
[32] L. Callegari, C. C. Harper, A. van der Straten, M. Kamba, T. Chipato and N. S. Padian, “Consistent Condom Use in Married Zimbabwean Women after a Condom Intervention,” Sexual Transmitted Diseases, Vol. 35, No. 6, 2008, pp. 624-630.
http://dx.doi.org/10.1097/OLQ.0b013e31816b3208
[33] J. T. F. Lau, J. Gu, L. Zhang, F. Cheng, Y. Zhang, J. Zhang, et al., “Comparing Prevalence of HIV-Related Behaviors among Female Injecting Drug Users (IDU) Whose Regular Sexual Partner Was or Was Not IDU in Sichuan and Yunnan Provinces, China,” AIDS Care, Vol. 21, No. 7, 2009, pp. 909-917.
http://dx.doi.org/10.1080/09540120802612790
[34] I. Abdullah, “Sangkan Paran Gender,” Pustaka Pelajar, Yogyakarta, 1997.
[35] Koentjaraningrat, “Javanese Culture,” Oxford University Press, Singapore City, 1985.
[36] N. J. Ford, Z. Shaluhiyah and A. Suryoputro, “A Rather Benign Sexual Culture: Socio-Sexual Lifestyles of Youth in Urban Central Java, Indonesia,” Population Space and Place, Vol. 13, No. 1, 2007, pp. 59-76.
http://dx.doi.org/10.1002/psp.443
[37] M. Burke, M. Rajabu and J. Burke, “Maximizing Male Participation in Prevention of Mother to Child Transmission Programs in Tanzania,” Proceedings of Tenth XVII International AIDS Conference, Bangkok, 2004.

Copyright © 2024 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.