Room for Conversation: The Salience of Space in Mother Child Sexual Health Communication
Children of sex workers (SW) are at high risk for HIV because they initiate sex at young ages and live in conditions marked by poverty (Sahini & Dasgupta, 2009). Mother-child sexual health communication (SHC) has been found to reduce adolescent sexual risk behaviors. Children of SW often do not leave the risk environments inhabited by their mothers, hence the manner in which SW shape their children’s risk behaviors is crucial to their health. The space of the red light districts has the potential to play a significant role in mother-child relationships. However, there is limited understanding about the salience of space in sex workers and their children’s lives. This study aims to identify the relationship between space and mother-child SHC.
Methods:
In partnership with DMSC, we conducted in-depth semi-structured qualitative interviews with 35 SW (with children ages 10-18). Durbar Mahila Swamanya Committee (DMSC) is a sex workers’ collective in Kolkata, India that emerged out of a community based, structural intervention in the wake of the HIV epidemic in 1992. Participants were recruited using convenience sampling from the Durbar member list. Members were then asked to identify sex worker mothers who would be interested in the study. Interviews elicited information about mother-child relationships and sexual health communication. Interviews were translated into English and transcribed verbatim. Elements of constructivist grounded theory were used both in the data collection and analysis phases of the project (Charmaz, 2006). Dedoose qualitative software was used to analyze the data.
Results:
The results indicate that mothers’ beliefs and attitudes about SHC with their children was influenced by physical and subjective spaces their children occupied.
1) Physical Space: a) The red-light district’s physical space, marked by exchanges with clients and the presence of community health clinics, often provided mothers’ with an opportunity to initiate SHC. b) For some mothers whose children resided in boarding schools, the physical distance from their children inhibited SHC. 2) Subjective Space: a) Mothers’ perception of the red-light district, as corrupting or protecting children, ultimately guided their impetus to discuss sexual health. b) For children living in boarding schools, their mother’s perception of such sanitized spaces, far removed from sex work, discouraged them from SHC.
Conclusion:
While social work intervention research has highlighted the importance of structural factors like poverty, stigma, policy, the importance of physical space and the meaning it hold for participants has not been addressed. This study found that both physical space and subjective space shape sex worker mothers’ attitudes toward SHC. Health education interventions that promote mother-child SHC must take physical and subjective meanings of space into account.