Socio-cultural Construct of Sexuality: Knowledge, Attitudes and Practices of the Population at Risk of HIV in Bangladesh

Abstract

This research explored the sexuality of the particular sub-group (e.g., Prostitutes) and their clients (e.g., Drug users, Truckers etc.).Those clients are maintained as the bridge of communication to the general population. Sex and sexuality might be considered as private issues but it was influenced by social context and socially constructed meanings. In developing countries HIV is a sexual disease because almost in sixty percent cases the infected were transmitted by it through heterosexual route. So, concern about sex and sexuality will make proper implementation of HIV/AIDS prevention program. This was the subversive objective of this research plan. But as an academic research the specific objectives are to understand sexuality through historical, religious and social context, to understand the perceived vulnerability, severity and self-efficacy against the risk, to find out the gap between Knowledge, attitudes, and practices, the role of passionate love and safety beliefs against the risky sex, to explore the nature of individual behavior change by the impact of social and psychological determinants and to understand the women vulnerability and their lack of power to negotiate for safe sex. 60 quantitative respondents were selected, 23 clients of the sex workers were selected from the various occupational groups (i.e., Truckers, Rickshaw-puller, Snatcher, Paper collector, Vegetable seller, Motor mechanic, Chatpatiwala, Hotel boy, Small businessmen, Unemployed youth and Agricultural labor), and 37 hotel and street based sex workers were selected. Population was selected by using convenience and respondent-driven sampling due to lack of accurate sampling framework of this hidden population. To find and recruit the hidden group members, sometimes street approached and time-space sampling techniques were used. In-depth interview through the check-lists, FGD sessions, PRA session with 106 respondents were ensued. Several public and private gathering points were selected. These included streets, parks, embankments, mazars, railway, bus and truck terminals, clinics, DIC centers of the several NGOs, university campus and residential hotels. Discussion and interview focused on basic socio-demographic information, paying and non-paying sexual history, beliefs about partner safeties, passionate love towards partner, information about first sex partner and criteria of partner choice. Sexual scripts included traditional, romantic, recreational and utilitarian-predatory scripts; the normative values and religious affiliation were also included. Sexual scripts also included the aspects of romance and pleasure (filtration phase to sexual phase). Questions included the HIV transmission, prevention and misconception, attitudes and practices of safe sex, perceived vulnerability, severity, barrier, self-efficacy, perceived behavioral control the safer sexual intentions and the cue stimulus to safe sex. Heterosexual abnormality is not uncommon in the sphere of the patriarchal social formation in Bangladesh. Sexuality was severally formed; the effects of romance of love, the oriental religions were also closely linked to sex (mostly it allows male dominancy and several restriction impose to women). In Bangladesh Prostitution was illegal both legally and morally but it has a history and role which is closely linked with the development of urbanization. Homosexuality has another passion and reality in the Muslim context in Bangladesh. Although Bangladesh has initiated lots of programs against HIV/AIDS but the risk and misconceptions are high. According to the traditional cultural-religious scripts extra-marital sex is sin but the respondents were engaged in it due to passion, dominance and the influence of friends, peers and digital pornographies. Male clients consider condom as a barrier due to their high perceived severity and susceptibility; on the other hand, female commercial sex workers face several structural problems to use it frequently. Knowledge, attitudes and practice of the behavior are not consistent in these two groups. Condom inconsistencies with paying and non­paying clients were high among both of the groups; but the clients vulnerability were high because they have power to exploit and force. Even they can kill anyone if they consider it as a barrier for their pleasure, and they were more diversified. So, prevention program should be more concentrated in the whole society; not only in the particular sub-groups and it has needed to develop a uniform program network for HIV/ AIDS, malaria and population control jointly.