Why seafarers remain
a very high risk group to HIV
1University of the Philippines, College of Medicine, Manila, Philippines, 2Cardiff University, School of Social Sciences, Cardiff, United Kingdom
Background: Seafarers have always been historically seen as vulnerable
to sexually transmitted infections because of many factors including mobility.
The first cases of HIV in the history of AIDS were traced to seafarers. There have been an increasing number of
seafarers infected since the early part of the epidemic until
the present prompting various AIDS programs in the maritime industry as early
as the 80s. Yet decades after, there seems to be a steady increase of
infections despite the high level of awareness. Why the continued risky
Methods: In-depth interviews and focus group discussions with international
seafarers were conducted in a number of ports.
Seafarers with HIV were also interviewed. Ethnographic studies in the bars frequented
by seafarers in Brazil and South Africa were conducted.
Results: Ports all over the world are known to have bars catering to seafarers. Many risk factors were identified: economic
capability, psychosocial needs, social organization and occupational
determinants. Some of these factors are
related to temporality and liminality. Distorted
knowledge remains one major determinant despite exposure to many information. This
changes their perception of risk leading to non-use of condom. The group has
developed its own 'knowledge culture' such as the concept of 'suction effect' (withdrawal
in the middle of ejaculation), various criteria of 'cleanliness' of sex workers,
regular HIV testing and negative results leading to continued risky behaviour,
rationale for sexual engagements, etc.
'Relationships' with sex workers still remains the defining factor in condom
use. Frequency (temporal) of sex decreases
the likelihood of condom use.
Conclusions: Seafarers remain a high risk group due to a variety of risk
factors. Their risky behaviour is shaped by their 'knowledge' and risk perception. AIDS programs need to be 'repackaged' to make
them more effective. Continuous monitoring of the various issues of the problem
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