Psychological, Economic, and Structural Barriers to PrEP Uptake Among Female Sex Workers: An Interpretative Phenomenological Analysis in Pangkalpinang, Indonesia
DOI:
https://doi.org/10.26630/jk.v17i1.5587Keywords:
Female sex workers, Health policy, HIV, Interpretative phenomenological analysis, Pre-exposure prophylaxisAbstract
PrEP infrastructure in Pangkalpinang City has been available since March 2024, but uptake among female sex workers (FSW) remains critically low. This study employed Interpretative Phenomenological Analysis (IPA) to examine the lived experiences and systemic barriers affecting implementation. Seventeen participants, consisting of FSW, healthcare workers, and cross-sectoral stakeholders, were involved in individual interviews and focus group discussions. Analysis identified seven key themes: psychological barriers, economic survival tradeoffs, body-based perceptions, structural hurdles, the role of peer educators, provider-patient disparities, and incoherent policies. Despite technical readiness, only one FSW initiated PrEP, reflecting a profound gap between service supply and community demand. Access is hindered by economic vulnerability, anticipated stigma, and policies that prioritize criminalization over health considerations. The study concludes that technical preparedness is inadequate without interventions that target psychological and economic barriers. Success requires peer-delivery strategies and coherent policies that genuinely address the social realities faced by marginalized groups in HIV control programs.
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