STAGES OF BEHAVIORAL CHANGE IN HIV/AIDS PREVENTION AMONG ONLINE SEX WORKERS

Abstract

Online sex workers connect with clients through digital platforms such as social media and messaging applications, yet sexual encounters still occur in person, placing them at high risk for HIV/AIDS transmission. This descriptive qualitative study explores the stages of behavioral change in HIV/AIDS prevention among online sex workers in Semarang City using the Transtheoretical Model (TTM), which includes stages of change, self-efficacy, and decisional balance. Four main informants were purposively selected and interviewed in depth. Data were analyzed thematically and deductively based on the TTM framework. The findings show that all informants had reached the contemplation stage, with progression varying across preparation, action, and maintenance stages. However, behavioral implementation in the action stage remained limited, especially when condom negotiation was challenged by client pressure. In terms of VCT utilization, most informants stayed at the contemplation stage, with relatively low self- efficacy. Conversely, self-efficacy related to condom use was higher among informants who could assert boundaries with clients. Regarding decisional balance, informants experienced a dilemma between self- protection and economic needs. Although they acknowledged the benefits of VCT, this awareness had not yet led to consistent preventive actions. These findings underscore the need for interventions tailored to behavioral readiness, enhanced self-efficacy, and strengthened social and economic support to sustain effective HIV/AIDS prevention behaviors among online sex workers.