Online Program

Social and structural constraints on disclosure and informed consent with female sex workers and their managers in the Philippines

Tuesday, November 5, 2013 : 8:30 a.m. - 8:50 a.m.

Lianne Urada, PhD, MSW, LCSW, Department of Medicine, Division of Global Public Health and Center on Gender Equity and Health, University of California, San Diego, La Jolla, CA
Janie Simmons, EdD, National Development and Research Institutes, Inc., New York, NY
This qualitative research explored the experiences of female sex workers (FSWs) participating in behavioral HIV prevention research, including their process of consent to research, their knowledge of research ethics, barriers to disclosure of sensitive topics, and the necessary conditions for their involvement in interventions. Individual interviews were conducted with 20 FSWs and 10 establishment managers working in night clubs, karaoke bars and spas/saunas in the Philippines, using semi-structured interview guides. In addition, four community advisory board meetings were conducted to collect feedback on the study design and assist with the interpretation of findings (N=12 individuals). Emergent themes included FSW issues with trust (e.g. research in general, interviewers), especially around confidentiality/privacy, intrusiveness of survey questions, sense of being forced by government to do surveys, and the belief that nothing would happen as a result of the research. FSWs expressed desire to actively participate in intervention design/implementation, learn new skills (e.g. job training), and receive compensation equivalent to their pay while away from work. Both FSWs and managers expressed frustration with government support (e.g. their inability to stop police raids, and unaffordable fees for registration/clinic services). The results suggest the need to improve HIV prevention research practices with FSWs by: 1) addressing barriers to respect, trust, and/or disclosure stemming from risks in the structural environment and/or the research process itself; and by; 2) developing a more transparent and participatory approach to HIV prevention research that engages FSWs in the research process in order to reduce perceived and actual risks to participants.

Learning Areas:

Assessment of individual and community needs for health education
Conduct evaluation related to programs, research, and other areas of practice
Ethics, professional and legal requirements
Planning of health education strategies, interventions, and programs
Public health or related research
Social and behavioral sciences

Learning Objectives:
Identify social and structural contextual factors that influence female sex workers' consent to participate in non-governmental survey interviews involving highly sensitive topics. Name one social factor that constrains disclosure of sensitive topics in survey interviews. Identify two factors that influence female sex workers' decisions to forgo participation in socio-structural HIV prevention interventions.

Keyword(s): Women and HIV/AIDS, Sex Workers

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal investigator of multiple grants focusing on the epidemiology of HIV risk factors and ethical issues in conducting HIV prevention intervention research with female sex workers in the Philippines. Among my scientific interests has been the development of social and structural strategies for preventing HIV and STIs in female sex workers in low and middle income countries.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.