Ivan Wolffers*, Rika Subarniati Triyoga**, Endang Basuki***, Didik Yudhi****, Walter Devillé*, Rachmat Hargono**

* Health Care and Culture, Faculty of Medicine, Vrije Universiteit, Van der Boechorststraat 7, 1081BT Amsterdam, The Netherlands
** School of Public Health, Surabaya, Indonesia
*** Department of Community Medicine, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia
**** Hotline Surya, Surabaya, Indonesia

There are big differences between sex workers in terms of income, gender, places where they work, ways to get clients, reasons to enter sex work and career development. Yet, STD and HIV/AIDS intervention programmes and the majority of research projects often do not respect these differences. There is a need for research that is more concerned with the perspectives of the sex workers themselves. We have tried to demonstrate this by describing the relationships of female sex workers in Surabaya and Jakarta. These different relationships lead to different behaviours with regards to cleaning rituals, risk perception, prevention behaviour and the use of condoms. Data were collected in a research programme in which 1486 female sex workers in Jakarta, Surabaya and Bandung (Indonesia) joined a cohort study. For this article we have concentrated on the material from Surabaya and Jakarta. Among others KABPs (Surveys on Knowledge, Attitudes, Behaviour and Practices) were done and with a selection of the sex workers, Focus Group Discussions and in-depth interviews were held. Analysis showed that the concept of multiple identities was useful to understand how sex workers keep different aspects of their lives separated. Sex workers have different relationships (with clients, regular clients, boyfriends and steady relationships) in which role expectations are different and behaviour changes. In terms of risk perception the fact that a new client is considered dirty (kotor) while if one is more familiar with a person he is not seen as dirty (tidak kotor) leads to different cleaning rituals and different attitudes towards condom use. Appropriate interventions aimed at sex workers should not only approach them on one dimension of their multiple identities, but understand the complexities of these multiple identities and approach them as complete human beings, who are involved in more than sex transactions.

Key words:
Sex workers, Indonesia, HIV/AIDS prevention, condom use

Since the public health campaigns to control the HIV-epidemic identified sex workers and their clients as populations to be targeted, an avalanche of research on sex workers and review papers have been produced (Estebanez et al 1993, Koenig 1989, de Zalduondo 1991, Woolley et al. 1988, Day 1988, Day et al 1988 and 1993, Siraprapasiri 1991, Padian 1988, Wilson et al 1989, Cohen 1987 and Carovano 1991). Most of the research on prostitution is applied research, because health-care workers had to understand more about sex work in order to develop or improve interventions. It has resulted in a growing number of publications on condom use (Vanwesenbeeck et al. 1993a and 1993b, Spina et al. 1992, Worth 1989, Lamptey 1990, Feldblum et al 1988, Langer et al 1994, Brien et al 1994, Catania et al 1992, Zenilman et al 1995, Weller 1993, Weinstock et al 1993, Moatti et al 1991, Fox et al 1995 and Asamoah-Adu et al 1994), on peer education and other education and awareness activities (Wilson et al 1989, Gillies et al 1992, Tchupo et al, 1993, Fopumena et al 1993, Garcia 1994, Kywe et al 1996, Asthana et al 1996 and Evans and Lambert 1997) and on improving STD facilities in order to lower thresholds for sex workers to make use of them (Laga 1997, Sanchez et al 1998). Underlying a lot of the research is the view that sex workers are a potential hazard for society and a multiplier in HIV-dissemination (Lawless, Kippax and Crawford, 1996). Sex workers are often mainly viewed in the context of how their frequent change of sex partners contributes to HIV transmission (Wawer et al 1996). This reinforces the patriarchal attitude of protecting men from HIV infection (Downe 1997), while in fact women are far more vulnerable to be infected (de Bruyn 1992, Sacks 1996). Female sex workers have a high risk for being infected (Campbell 1991, Sacks 1996), but relatively little research is exclusively directed at their protection.
Compared with the massive amount of such applied research, relatively little research is done on the conditions of prostitution, the way sex workers think about their work, how they survive, give meaning to their daily activities or how they see themselves and their partners. Earls and David claim that little of all that literature appears to be useful in arriving at a general understanding of prostitution or in a guiding social policy (Earls and David 1989). This may be an illustration of the ambiguous relation between prostitution and society. Research on prostitution is often only acceptable as long as it respects the concept that prostitution is a problem, that the researcher looks for solutions of these problems and while doing so it often victimizes those working in prostitution or stigmatizes them. Barbara de Zalduondo has stressed the fact that there are many different kinds of sex workers and that it is important to understand differences and details of sex work (de Zalduondo 1991), which gives importance to a more fundamental kind of research on prostitution. She has stressed the value of a holistic, ethnographic view of the cultural and economic context of gender relations for understanding sexual behaviour and to depict the interlocking system of internalised (learned) values and beliefs, and environmental opportunities and constraints (De Zalduondo 1995, 159).

In this article we describe different relationships of female sex workers, the meaning given to these relationships, and how the relationships are distinguished from each other. In that sense it fits into De Zalduondo=s advocated approach of prostitution research (De Zalduondo 1995), because it focuses on the insights, feelings and interpretations of sex workers themselves. Honesty demands to explain that the data for this article were collected in the framework of an applied research project that was primarily focusing on HIV/AIDS interventions in three cities in Indonesia.
However, within this research project the point of view has always been that interventions can only be successful if they fit within the conditions that are decisive for prostitution and if they reflect insights and views of the sex workers themselves. That is why it was thought essential to collect data on prostitution to understand self-image, identity and behaviour of sex workers and not only to study how condom use and STD-clinic visits could be increased. For instance, research was conducted on the way women are recruited to become sex workers, what pushing factors may have been involved in them making the decision to enter prostitution, how they see themselves and others, what strategies they develop to maintain an acceptable level of self esteem under the pressure of societal disapproval and what relationships they have.

Prostitution in Indonesia
In Indonesia there is a wide variety of sex transactions and depending on point of view these can be defined as sex work. Epidemiologists may define these exchanges of sexual favours for economic benefits as sex work, while the persons involved in these transaction will never define it as sex work. Like in most other countries, dominant groups in Indonesian society will define prostitution as a negative phenomenon (Wolffers 1997) and this will add to the importance of the difference between self-defined identity and the identity as defined by others. In addition, women who identify themselves, as being sex workers will see certain relationships as sex work, while others that are also based on an exchange of sexual favours for economic benefits as not being sex work.
A negative conception of prostitution is expressed in the Indonesian word for sex worker. This is perampuan tuna susila, meaning woman without morals or pelacur, meaning a person with incorrect sexual behaviour.
Officially prostitution is not allowed in Indonesia and sex workers caught soliciting can be sent to a rehabilitation camp, but in some areas of the big cities, brothels are tolerated. In Jakarta prostitution is tolerated in the harbour town Tanjung Priok and in Surabaya, the biggest port of Indonesia and host to the Indonesian navy, this is among others in Tambak Asri and Bangunsari. Authorities have regulated sex work in these areas, including health facilities and certain restrictions during religious events. During the Ramadhan period for instance the sex workers have to start their work at a later time and work shorter hours to show respect to this religious event by not offering sex services during the fasting hours. Soliciting in the streets is not allowed in Indonesia and sex workers are completely dependent on the attitude of the police towards them. This is not very different from the situation in Kuala Lumpur in Malaysia (Wolffers and Bevers 1997) and some other Asian countries. The societal disapproval of prostitution creates an extra reason for sex workers to keep their identities well separated from each other. Their multiple identity provides them with a means to survive the complexity of their different relationships.

Multiple identities
Indonesian sex workers have various relationships with all kinds of people that are defined by their context. They are colleagues and competitors of other sex workers. They have an employee-employer relationship with their pimps. There is a business relationship with their clients. They have emotional relationships with their lovers or partners. If they have children, they have a parental relationship to them. If they are still living with their families, they are somebody's daughter and somebody's sister. All these different relationships imply different roles to play and thus different identities. It was thought that understanding the behaviour of sex workers in these different contexts implies understanding the way they see themselves and how their identities are created. The concept of multiple identities as introduced by post-structuralist and post-modern anthropologists and feminists appears to be a useful tool to analyse sex workers behaviour. Henrietta L. Moore describes it as follows: Individuals are multiple constituted subjects, and they can, and do, take up multiple subject positions within a range of discourses and social practices. Some of these subject positions will be contradictory and will conflict with each other. This set of multiple and contradictory positionings and subjectivities is held together by the subjective experience of identity, the physical fact of being an embodied subject and the historical continuity of the subject (Moore 1994, 55).
The emphasis here lies on the fact that multiple identities are defined by the context and that these identities are not always shared, but can exist in competition, because the person has competing loyalties (Moghadam 1994). It also gives room to the fact that identities are shaped and reshaped by external forces with their own agendas. Hann Papanek provides three examples of how certain ideals of womanhood are propagated as indispensable to the attainment of an ideal society. These ideals apply to women's personal behaviour, dress, sexual activity, choice of partner and reproductive options (Papanek 1994). It will be obvious that the ideology of the ideal woman will be in conflict with the identity of the sex worker, but both are part of the multiple identity of the woman who is doing sex work and she will be continuously on her guard to identify the lines between them. The creation of an identity must be seen as a process of understanding the limitations and marking between the self and the other(s). The result is not a fixed and unchangeable identity but a reflexive project made and remade by the person in terms of his or her biographical experience (Giddens 1991). To stress the fact of the dynamics it might be better to use flexible terms to describe the activity of multiple identities: identification and differentiation. Apart from these mainly feminist writers, authors writing about sexuality have come up with similar concepts and ideas. Attention has shifted from sexual actions to the cultural and social context in which they take place (Parker and Gagnon 1995), while medical epidemiology, however, is still caught in its quantitative quest for description of the sexual act of sex workers: with whom, how often, how and why? In this way it decontextualizes sex, and in our case prostitution, while making stereotypes of the sex workers by focusing on only one dimension of their identities. The post-modern, post-structuralist approach proposed here clarifies the competition between values, the domination of certain ideologies in a society (Wolffers 1997) and helps us to understand how effective identities are in maintaining self esteem and reaching personal goals. According to Jeffrey Weeks sexuality is woven into the web of all our identities (Weeks 1995). Dennis Altman discusses social construction of the sex worker identity and observes that the relationship between money and sex is complex and fluid and the demarcation of prostitution correspondingly vague (Altman 1995, 95). In this article we will see for instance how a client relationship changes into a regular client relationship and may even develop into a lover relationship. In all these roles the man will pay for the sex services.
In this light it is essential to understand the difference between the way sex workers themselves define their identities and the way outsiders do this. The independent young woman going on weekend days to a bar to pick up a man she likes, who will support her with the cost of daily life, does not see herself as a sex worker, while the epidemiologist will put her in that category for the sake of the research and interventions. This implies a conflict between self-defined identity and identities as defined by others. In our research we have focused on sex workers who identify themselves as being sex workers.
Sex workers are moving from one identity to another and in doing that they are supported by certain rituals and codes. Dress and make up mark the role change from mothers, sisters, wives into sex workers. Some sex workers will keep the area where they live far away from that where they do their work. This is partly because of the fear of discovery, but also to keep their different lives apart from each other: in one life they have the identity of the sister and in the other that of the sex worker. Part of the importance of these rituals is based on the need to maintain self-esteem through defining the own identity versus letting your identity being defined by the others.
Another important code of conduct for sex workers is their emotional involvement. In their role as lovers or wives they are supposed to be emotionally involved, while in their role as sex workers they prefer to keep emotional distance. Sex workers for instance often refuse to kiss the client. Mixing these identities and the accompanying behaviours can be confusing for the sex workers, but in their work, conditions may arise that put the sex worker suddenly from one identity into another. An example is the entrance of a family member in the brothel. Another example is the gradual transition of a casual client into a regular client and in some cases finally into a lover. The latter example will be used in this article to describe the transition from one role into another, from one kind of behaviour into another and thus from one identity into another. How does this process of change of relationship and thus of identity develop and what are the typical sets of behaviour that come along with it?

The research projects "Support for STD and HIV/AIDS control and prevention among high risk populations in Jakarta, Surabaya and Bandung" (EC no B7.5046/94/015) and "Community intervention study on female Commercial Sex Workers in Surabaya Indonesia" (EC TS3-CT94-0332) were based on exploratory and descriptive research to develop interventions to better protect female sex workers and their clients from STDs and HIV-infection (1996-1997). In the three cities in Indonesia samples of female sex workers in brothel areas were selected as cohorts (Jakarta 486, Bandung 342 and Surabaya 658) in order to understand HIV-infection among them. In Surabaya the research was done in Tambak Asri and Bangunsari (together a total population of approximately 1800 sex workers): a random cluster sample of brothels was taken from the brothels from which no women joined the Peer Education Programme to reach a number of about 500 sex workers. All brothels with peer health educators were included in a second stratum. In Jakarta the research was done in Kramat Tunggak in Tanjung Priok (with a total population of approximately 1500 sex workers): here also a cluster sampling of brothels was used to reach a sample of 500 sex workers.
The sex workers were checked on a two monthly basis for clinical and laboratory signs of STDs and each half year they were tested for HIV-infection. During the period of the research project no HIV-infections were found in these cohorts (Ieven et al. 1997). In Surabaya and Jakarta 120 sex workers were followed during three weeks with condom diaries in order to monitor condom behaviour and interviews were done about failed condom use by trained sex workers.
In addition to clinical and laboratory data, a team of social scientists collected social-economic data. The instruments used were quantitative data collection on risk behaviour and sexuality (KABPs and condom diaries) and qualitative data collection (6 focus groups discussions of 2,5 hours and 12 life histories) on reasons for certain behaviours and 'sexual careers'. An extra factor in Surabaya was the research to understand the potential and constraints of peer education among female sex workers. This resulted in a wide variety of information on female sex workers in Jakarta, Bandung and Surabaya (Basuki et al. 1997, Devillé et al. 1997, Wolffers et al. 1997). This article is mainly based on the qualitative research, though where appropriate the data collected through the KABPs will be presented in order to give a more comprehensive description. However, the KABPs were done among brothel-based sex workers, while the in-depth interviews also included other categories of sex workers. Where this is important this difference will be stressed in this article. For this article we used the data from Surabaya and Jakarta because from those cities we had the most complete data sets.

Demographic results
The mean age of the brothel-based sex workers in Surabaya is 27.58 (SD 5.52) and in Jakarta 23.86(SD 5.3) and mean age at which they started to do sex work was 25.63 (SD 5.20) in Surabaya and 22.1 (SD 5.1) in Jakarta. The mean age of the sex worker population in Surabaya is relatively old compared to Jakarta, since in Surabaya older sex workers who have only one or a few regular clients often keep on living in the brothels? Of the brothel-based sex workers 22.0% in Surabaya and 9.7% in Jakarta has no education, 34.5% in Surabaya and 38.1% in Jakarta went to primary school (sekolah dasar) but did not finish it, 30.1% in Surabaya and 39.7% in Jakarta finished primary school and 9.6% in Surabaya and 10.4% in Jakarta has more education than only primary school.
Table 1: Level of education of sex workers in Jakarta and Surabaya Surabaya Jakarta No education 23 % 10 % Primary school not finished 36 % 40 % Primary school finished 31 % 40 % More education than primary School 10 % 10 % Almost 80% of the brothel-based sex workers in Surabaya have been married or still are. Their mean number of children is 1.09 (SD 1.05). Table 2: Marital state of brothel-based sex workers in Surabaya and Jakarta Surabaya Jakarta Number percentage Number percentage Not yet married 31 5.0 60 12.4 Married 523 85.5 425 87.4 Widow 58 9.5 1 0.2
The identity of the female sex worker
In the life of women who go into prostitution there is a moment where they may have to accept their identity as a sex worker. The process is often gradual. The women may start as free-lancers who are working as assistants in barbershops and who will accompany a client or who are hanging out in discos and bars, where occasionally they may pick up a client. They see themselves in the first place as independent women and not as sex workers. When the man pays something after having had sex it only seems normal in a culture where giving presents and favours to each other plays an important role.
T., a 36-year-old brothel-based sex worker from Surabaya tells how she was drawn into prostitution: When my husband left me because of another woman I became frustrated. I went to several discotheques in the hope that I would meet a musician and that he would become my lover. However, when I met one he was already married. We got really close. We loved our intimate moments together. We went to restaurants and several times we had sex in a hotel. He always gave me some money afterwards. I never saw it as sex work, but as a token of sympathy because of my bad luck. After the affair was over the step to go into sex work seemed relatively easy to T.
K., a 40-year-old woman renting a house for herself in the brothel area Tambakasri in Surabaya, also did not perceive herself in the first place as a sex worker. She makes a living as a tukang pijit (someone skilled in massage) and doing laundry. When I do massage and the client asks me to have sex with him, I will do it if I like him. When I have no special feeling for him I will refuse his offer. After having had sex the client will give some money as a present.
Depending on how dependent the sex workers have become on this kind of income the moment comes closer where they will admit to themselves that they are sex workers and accept the identity. This moment of acceptance comes closer when they are in sex work already for a longer period of time.
First my best friend's sister asked me to stay in her house during the weekend. Then she asked me to go out with her. We went to a five-star hotel where she introduced me to her friend. He was a young, generous gentleman. I got used to living glamorously and taking ecstasy pills. For that lifestyle I needed the money. When the gentleman did not like me anymore, my friends sister offered me to become an upper-class sex worker in order to be able to pay her back the money I borrowed from her to buy the ecstasy pills, tells 21 year old D. from Surabaya. D. rents a room in the brothel area but prefers to pick up her clients in shopping malls, restaurants or discos and take them to a hotel.
On the other hand, those who are working from brothels and in the streets have to accept the sex worker identity.
Formerly I did not know that this place was a brothel. I came to the city to find a job, but a strange guy trapped me. He locked me up for three days in a room and raped me three times a night. When I was freed and met the other girls working here as a sex worker, I realized what place it was. I was ashamed to return home without money. I was raped and no longer a virgin. I felt worthless and had the impression that people would look at me and see it. So I decided to become a sex worker, tells 16 year old I. from Surabaya. And 25-year-old widow N. tells: When my friend took me to this place to get a job, I knew that it was brothel. I refused to work as a sex worker. So I did the laundry for the sex workers here. But later on, when my family in the village needed more money and realizing that my income was so small, I decided to try it when the pimp asked me to work as a sex worker.

Though most women accept this identity, they do not feel that they are sex workers 24 hours of the day. And here is where their other identities become important. There are different ways for the sex workers to keep these identities separated. For those who work far away from home, this is relatively easy. They physically travel from one identity to the other.
The fact that many are mothers provides them with this other identity. From the KABPs among the brothel-based sex workers in Surabaya we know that of those who are or have been married 73.5% have children, while of those not married 71% have.
Table 3: Number of children of brothel-based sex workers in Surabaya Number percentage No children 213 32.8 1 child 255 39.2 2-3 children 161 24.8 More than children 21 3.1

Bu P. (bu is short for ibu, meaning mother, which is used for older women) is 37 years old has been working for almost eight years in a brothel in Surabaya. Presently she is the mistress of a truck driver and considers leaving the brothel. She told: My son is eight years old and stays with my mother in the village. I have told him that I work in a bookstore. I regularly send him money for daily expenses and bring him a monthly visit. I am very happy to have a son that gives me expectations for the future and the motivation to make enough money to quit from this kind of work. S., 33 years old, told: I have an eighteen-year-old girl who stays with me in my house in the city. She is studying at a private university. My late husband was with the navy and from his pension I could raise my daughter. When I feel lonely and need some money I come here to pick up a man. I told my daughter that I am doing small business to cover my daily expenses. My daughter and my neighbours do not know that I am a sex worker. M., a 30 years old street sex worker with two children wants to stop doing sex work as soon as her son is 19 years old. She said: When I come home from my work and I see the children at home, I feel happy and proud to be a mother. My tiredness disappears and I feel good.
Brothel-based sex workers mostly also live in the brothels and they do not have the possibility to travel to the other identity. They may see going to work as having to play another role, where they are using another aspect of their personality. During the day the women dress casually, wear old clothes and have no make up. They talk quietly and relaxed with us, researchers, also with the male researchers. Some women have their children living in the area where they work, but most of the children are staying with the grand parents. At night they dress up and put on their make up. For that reason there are many beauty salons in the area. Their behaviour towards men is radically different when they are working. They take on a tempting and provoking attitude.

Confusion of the roles that sex workers have to play
In each sex workers career there are moments when the different identities cannot easily be kept apart. This may be due to the sexualised role she must play in her work. Soliciting for instance demands from the sex worker to be tempting in order to convince the potential client to make use of her services. She has to fulfil the stereotypical expectations about femininity that their male clients have which may be in strong contrast with the way they want to be seen by, for instance, their family members and neighbours. Of course, apart from their work there are also other situations in daily life where women use their skills to convince men to give them certain favours, but in the sex work situation the rules for this seduction are different. If, while soliciting, the sex worker is confronted with someone she knows from her other life, she is in a rather confusing situation. A sex worker, for instance, will not give her work address to her family, but instead she will give the address of a friend. Sometimes this other address is not even in the same city. The friend will refer the mail to her work address. I am afraid that my parents will find out what I am doing and not accept me as their daughter anymore, 18 year old Y. from Tambakasri in Surabaya said.
Sex workers in both Surabaya and Jakarta try hard to keep these different worlds apart: My husband passed away several years ago, and I had to sustain my four children. They do not know I work here every day. I told them that I work at a restaurant. Sometimes the family members know about the work of their daughters or sister. A sex worker from Jakarta told: Some mothers come to Kramat Tunggak regularly to ask money from their daughters. However, more frequently the two worlds are strictly separated.
The shame of being discovered doing this work is exactly the result of the incompatibility of the two identities: that of the daughter or the girl in the village for instance, and that of the sex worker. The sex workers in Surabaya, working in brothels and also living there will often rent a room in another part of town, where they can receive their families from the villages. As they do this collectively, the cost is bearable. It is one of the ways to keep the worlds in which the two identities belong apart. However, sometimes the two worlds cannot be separated.
One day, 29 years old A., a brothel-based sex worker in Tambakasri in Surabaya, saw her former fiancée, a cousin who got married to another woman, show up in the brothel. Initially she was surprised and very embarrassed. She tried to hide, but because she needed money and still loved him, she made love with him.
Another situation where the different identities can no longer be separated is that of the sex worker dealing with a client and that of the woman who is in need of warmth and companionship.

The tamu
The client of the sex worker is called tamu, meaning guest or visitor. There is no emotional relationhip of the sex worker with the tamu and the interaction between sex worker and tamu is characterized by behaviour that stresses this emotional distance. The sex worker will demand from the tamu that he cleans himself before the sexual act. Inspecting the sexual organ of the tamu and washing his genitals is often part of the interaction. This is because the stranger is potentially kotor, meaning dirty. B. (18), a brothel-based sex worker from Surabaya said: When I have a tamu, I always look at his appearance and check his odour. When he looks dirty and smells bad, he may have a disease. To check this I squeeze his sexual organ to see whether there is any discharge. If there is discharge I suggest him to use a condom. And if he does not want to use a condom, I ask him to bathe carefully before having sex.
It looks as if the concept of kotor helps the sex worker to keep the emotional distance towards the client. After the sexual act the sex worker will have to clean herself from this kotor-ness by washing her vagina with a sirih leaf (folia bettel) decoction (a traditional herbal remedy), with Dettol (a cleaning agent) or Odol (an Indonesia tooth past brand) or with an aseptic soap (sabun Asepso). O., a 34-year-old sex worker who dropped out of university told: I feel secure because when I wash myself with toothpaste my vagina becomes pedes (hot) and that will kill the germs and bacteria. In addition to a hygienic measure this also has the effect of a purification rite: a ritual to protect yourself because one has transgressed from safe, familiar and clean to strange, threatening and kotor.
Condom use is another part of behaviour that may play a role in keeping the emotional distance to the tamu. Though still many clients refuse to use condoms during their sexual intercourse with the sex workers, and though many sex workers still do not dare to refuse unprotected sex if the client does not want to use a condom, most sex workers will try to negotiate condom use with new clients. Sex workers from Jakarta told: I try to frighten my clients that they might get AIDS if they do not use condoms. Or: I always say to my clients that we should take care of our health, to prevent ourselves from disease. Or: I said to my clients who refused to use condoms that they should try first. If they do not like it they can take it off.
Condom use has often become similar to professional behaviour of sex workers and they can be very frustrated if they do not succeed to convince the client to use one. A good example of this is brothel-based 23 years old P., who is involved in peer education activities of the local Non Governmental Organisation Hotline Surya. Before she got in touch with Hotline Surya, she did not use condoms consistently, but once she was working with Hotline Surya she understood the importance of condom use and now she tries to use a condom every time she has sex. However, often there are clients who refuse using condoms. In these situations P. is ashamed to not use a condom as she knows it is not wise. She will check the client to see if he is clean and will try to find out if he has been going with girls in areas of town that are considered as being more kotor or dirty. Then depending on how bad she needs money, P. will decide about condom use with that client. Sukarti, from Tambakasri explains that condom use also depends on the clients. Most of her clients are regulars and she already knows if she can use a condom with him or not. With what she calls abnormal clients she will not use a condom. These are clients with slow erection, because condom use will make it even worse and the act will take too long. Another category of abnormal clients are those with quick ejaculation, because there will be no time to put on a condom and if the client comes before the sexual act he will not pay.
As Jakarta and Surabaya are big ports, part of the clients are sailors from other countries. The sex workers are well aware that the sailors go to different ports and have different relationships with all kinds of women. Non-Indonesian men are less near and the sex workers see these foreigners as different because they eat different food. Using different food is essential to distinguish between pribumi (people form the same land and thus using the same food) and foreigners. Because their food is different, their sweat is also different from ours. So if we have sex with them, we may get a disease, told one of the sex workers in Jakarta. When asked what they mean with foreigners the sex workers answered: People who originally come from other countries, like Chinese, Malaysian. It is striking that though Indonesia has a population of three million Chinese, most Indonesian sex workers also considers Chinese clients as being different and non-pribumi. On the other hand, according to the sex workers, Chinese clients often appear with condoms themselves. Brothel-based 23 years old G., one of the peer educators in Surabaya, told that she had the impression that the Chinese clients are better educated about condoms and their role in STD prevention. From the condom diary research in Jakarta and Surabaya we have the following information:

Table 4: Relationship between type of client and condom use in Jakarta and Surabaya Jakarta Surabaya Type of client Condom use (%) Condom use (%) Indonesian 405/732 (55.3%) 719/1630 (44.1%) Chinese Indonesian 60/68 (88.2%) 109/145 (75.1%) Foreigner 5/5 (100%) 3/7 (42.8%) Table 4 does not only reflect the wish of the sex workers to use condoms, but also that of the clients.

Langganan or pelanggan
The group of people that sex workers in the brothels meet and which may eventually become more intimate with them is often limited to the realm of their work. These are acquaintances of their pimps; men who do small jobs for the brothel owners and the clients who become regulars. The regular client is a langganan or pelanggan meaning long-time customer. When the brothel-based sex workers were asked if they had any regular clients, 47.5% in Surabaya and 41.0% in Jakarta answered that they had not, while 52.5% in Surabaya and 59.0% in Jakarta told that they had one or more langganan. Interviewed for the KABPs 26.1% of the brothel-based sex workers in Surabaya and 36.8% in Jakarta told that on the previous night they had received a langganan.
If tamu come frequently they become langganan and it is interesting to see that by becoming more familiar to the sex workers they also become less kotor. They are tidak kotor (the word tidak means not). It is also more or less proven to the sex workers, because they have had several times sex with him and they have not experienced ill health or disease. The sex workers start feeling safe. The sex workers will not discuss condom use with the client anymore and will leave the choice to the client, because their identities as female friends become more important. That means that the women will probably be more submissive and willing to adapt to role expectations related to how Indonesian women should behave. With a new client I will ask to use a condom, but if I know him, I do not use. Nothing can happen, said brothel based 26 years old W. from Surabaya. However, some of the older regular clients will insist to use a condom and even bring one themselves. When the sex workers are asked why they do not insist on condom use themselves when having sex with a langganan, the only reason they can give is that they know him. By knowing a person, he has become more familiar, has come nearer and is therefore less kotor. This often makes the relationship more emotional and is less likely defined as a business transaction. The sex worker may cross a line from the professional sex worker identity to a person who becomes personally involved because of her other needs as a woman. The normal Indonesian woman is looking for a boyfriend or pacar, because without a male partner one is seen as incomplete in Indonesian culture. The consequence of this is that it will happen at the cost of their negotiating power and thus have a negative impact on their potential for autonomous decision making.

Pacar or kiwir
Most sex workers have relationships with pacar (in Indonesian language) or kiwir (in Javanese language): boyfriends. In traditional Asian culture a woman is only fully a woman if she has a man who is taking care of her. Traditional values for women are to please and find a man and if she has not succeeded to do so before her 23rd or 24th birthday she is becoming a perawan tua, meaning an old spinster. The status of women according to traditional values is strongly related to having a partner and in relation to that, having children. Of course, in a quickly modernizing society and especially in cities, this is changing gradually, but the first question that young women are asked is if they have a boyfriend yet. These values are equally important for sex workers. Some of the sex workers even do the work and save money to later be able to buy and maintain a decent lover that can be a father for their children that may presently be staying with their grand parents.
The boyfriends are often a bit younger than the regular clients are, but there can be overlap. The pacar or kiwir is not kotor. Therefore, the cleaning rituals are not necessary and condom use is most of the times not even thought about. The condom is for working with the tamu and not for the pacar or kiwir, unless he would insist on it himself. A sex worker from Jakarta said: If with my boyfriend I prefer not to use condom, because we know our cleanliness; usually foreigners ask for condom..

Steady relationships
A category of brothel-based sex workers, especially the older ones, will try to create a situation in which they will serve only a limited number of regular clients. They are looking for langganan. Emotionally and financially it is the most stable situation for the sex workers.
There are two categories of steady relationships of brothel-based sex workers. Sex workers tell that they need a pacar, to make them feel at home and to satisfy their own feelings. They will go shopping together and will spend part of their free time together. Though the sex worker has a pacar she will still work and see many clients because it means a substantial contribution to the money the two have to spend. The sex workers will often support the pacar or kiwir financially. The pacar or kiwir are generally younger or have the same age as the sex workers. Part of them is mainly interested in the money of the sex workers. Such pacar are usually called gendak. The sex workers discuss personal problems with him, because they live away from home and need a person to turn to.
Some of the younger women do not want to have a partner, though, because they consider time spent with a partner as wasted. In that time they cannot work and they need the money badly.
A second category of steady relationships are the older ones who generally have more feelings for the sex workers and if they are rich enough they even may want to support them or take them as a second wife. Sometimes, when the sex worker needs money she may borrow this from him.
The relationship with a langganan may finally even develop into the woman becoming an isteri simpanan, which can best be translated with a secret wife. In that case they marry without permission of the first wife. Another possibility is not marrying, but becoming a simpanan or gundik, meaning mistress. As a secret wife or mistress, the sex worker will continue to live in the brothel, but she will not serve other clients anymore. Many brothel-based sex workers consider this as the ideal situation if a regular marriage is not possible. The women get a regular income, though it is small, but suffcient for simple daily expenses. When she wants to visit her children in her village, she can ask for more money. Because she has only one sexual relationship she feels safe with regards to STDs and HIV/AIDS. And in addition, she does not have to work so hard anymore. Though most of them will remain in an isolated position, because the community will shut them out, some will take part in community life and even join the PKK (Perkumpulan Kesjahteraan Keluarga, the Indonesian organisation of family health, and a semiformal welfare organisation). Being a secret wife or a mistress may give them some opportunity to take part in community activities like visits to orphanages, religious gatherings, joining arisans (a lottery to save money for social activities). In the interviews the sex workers told that in this way they feel like a normal housewife and they can save money as preparation for when they will be old.

Sexual identity of sex workers in Indonesia (and especially those working in brothels) has to be understood in relation to their different roles and expected behaviours. Part of the professional attitude of the sex workers is based on keeping their different identities strictly separated and for doing this, the sex workers have a set of rules of behaviour that help them drawing lines between these identities. Dress, make up, gestures and mimics help to go from one identity to the other. However, it is difficult to always maintain this strict separation. This is due to social pressure on the sex worker, gender roles and personal needs of the sex workers. This can be well observed when looking at the different relationships of sex workers. In the relationship with new clients the professional code of behaviour - including negotiation about condom use - is easily maintained and the most powerful tool for the sex worker to do that is the concept that the other is dirty. However, as soon as the client become closer, and more familiar, he becomes not dirty and the division between new client and regular client disappears. Javanese men eat the same food, have the same sweat and their personality is so familiar for the sex workers that they will quicker accept them as near and not dirty, but Chinese and foreigners can only very rarely come so close. The regular client can even become a boyfriend or lover and the final result may be a steady relationship in which the sex worker has become a second wife, which is hard to distinguish from what the sex workers themselves call, a normal housewife.
The importance of this for HIV/AIDS and STD programmes is that information- and awareness campaigns for sex workers in order to give them the tools to protect themselves against HIV-infection and AIDS, should not only be targeted at them as being sex workers. In their identity as sex workers the women are rather good in keeping professional standards and for the more assertive sex workers condom use is one of them. Of course, if the clients in the Indonesian male-dominated society refuse to use condoms, it becomes difficult for sex workers to insist on condom use.
Unfortunately, Indonesian authorities have not launched any general condom campaign, fearing religious and cultural sensitivities. However, even if national campaigns in Indonesia would guarantee that also clients would understand the importance of condom use and that this constraint would be out of the way, there would still be the issue of the other identities of the sex workers. We have to look at whom these women are when they are not working in the brothels or soliciting in the street and how they see themselves. In the first place we see this with the free-lance sex workers who work from bars or discos and do not see themselves primarily as sex workers. They are not reached by information targeted at sex workers. In the second place, we see that clients can become regular clients with whom it is more difficult to have only a professional attitude and they finally can become boyfriends with whom a professional attitude is even impossible. Yet, in these relationships the risks involved for the women themselves are as serious.
The importance of targeting sex workers as women with multiple identities is probably valid for other countries too. It also underlines the need for research on prostitution that goes beyond the interaction between sex workers and their casual clients. There is a need to understand how sex workers see themselves and their clients and what tools they use to maintain their self esteem with regards to the stigmatization by society.

D. Altman
Political Sexualities: Meanings and Identities in the Time of AIDS. In: Conceiving Sexuality; Approaches to Sex Research in a Postmodern World. Edited by R.G. Parker and J.H. Gagnon. New York: Routledge. 97-108

A. Asamoah-Adu, S. Weir, M. Pappoe et al
Evaluation of targeted AIDS prevention intervention to increase condom use among prostitutes in Ghana. AIDS 8: 239-246

S. Asthana and R. Oostvogels
Community participation in HIV prevention: problems and prospects for community-based strategies among female sex workers in Madras. Social Science and Medicine 43: 133-148

E. Basuki, N. Erlaimi, D. Luhpuri, R. Hargono. N. Susessen, I. Wolffers, W. Deville
Reasons for not using condom among Commercial Sex Workers in Indonesia. Oral abstract A(O)007 at the 4th International Congress on AIDS in Asia and the Pacific. Manila

T.M. Brien, D.L. Thombs, C.M. Mahoney, L. Wallnau
Dimensions of self-efficacy among three different groups of condom users. Journal of American College Health 42: 167-174

C.A. Campbell
Prostitution, AIDS and preventive health behaviour. Social Science and Medicine 32: 1367-1378

K. Carovano
More than mothers and whores: redefining the AIDS prevention needs of women. International Journal of Health Services 21: 131-142

J.A. Catania, T.H. Coates, S. Kegeles et al
Condom-Use in Multi-Ethnic neighbourhoods of San Francisco: the populatyio-base AMEN (AIDS in multi-ethnic neighbourhoods) Study. American Journal of Public Health 82: 284-287

E. Cohen
Sensuality and venality in Bangkok: the dynamics of cross-cultural mapping of prostitution. Deviant Behaviour 8: 223-234

S. Day
Prostitute women and AIDS: anthropology. AIDS 2; 421-428

S. Day, H. Ward, J.R.W. Harris
Prostitute women and public health. British Medical Journal 297: 1585

S. Day, H. Ward, L. Perrotta
Prostitution and risk of HIV: male partners of female prostitutes. British Medical Journal 307: 359-361

M. de Bruyn
Women and AIDS in developing countries. Social Science and Medicine 34: 249-262.

W. Deville, I. Wolffers, E. Susanti, R. Hargono, H. Lumintang, S. Luwayan, S. Hanafi
Peer education among commercial sex workers: Who are educated - an example from Surabaya. Oral Abstract B(O)048. 4th International Congress on AIDS in Asia and the Pacific. Manila

B.O. de Zalduondo
Prostitution viewed cross-culturally: Toward recontextualization sex work in AIDS intervention research. Journal of Sex Research 28: 223-248

B.O. de Zalduondo and J.M. Bernard
Meanings and Consequences of Sexual-Economic exchange: Gender, Poverty and Sexual Risk Behavior in Urban Haiti. In: Conceiving Sexuality; Approaches to Sex Research in a Postmodern World. Edited by R.G. Parker and J.H. Gagnon. New York: Routledge. 157-182

P.J. Downe
Constructing a complex of Contagion: The perception of AIDS among working prostitutes in Costa Rica. Social Science and Medicine 42: 1575-1583

C.M. Earls and H. David
Male and female prostitution: a review. Annals of Sex Research 2: 5-28

P. Estebanez, K. Fitch, R. Najera
HIV and female sex workers. Bulletin of the World Health Organizaton 71 (3/4): 397-412.

C. Evans and H. Lambert
Health-seeking strategies and sexual health among female sex workers in urban India: implications for research and service provision. Social Science and Medicine 44: 1791-1803

P.J. Feldblum, J.A. Forthey
Condoms, Spermacides and the transmission of human immunodeficiency virus: a review of the literature. American Journal of Public Health 78: 52-54.

A.J.C. Foumena, Betimaj, A. Boupda et al
Training of sex workers as peer educators. Poster session PO-D13-3766 at the IXth International Conference on AIDS in Berlin.

L.J. Fox, P.E. Bailly, L. Kazu et al
Condom-use among high-risk women in Honduras: evaluation of an AIDS prevention programme. AIDS Education and Prevention 5: 1-10

R. Garcia
Training female sex workers as peer counsellors for health care and human rights awareness. Poster session PD0472 at the Xth International Conference on AIDS in Yokohama

Modernity and Self-Identity. Cambridge: Polity Press.

P. Gillies, R. Slack, M. Newman et al
Researching health needs and HIV-related preventive practices among prostitutes. Poster PoD5628 at the VIIIth International Congress on AIDS, Amsterdam.

M. Ieven, A. Idajadi, Y. Rosana, S. Sudigdoadi, A. Renton, A. Meheus, N. Suesen
HIV: Still not a major problem in Commercial Sex Workers (CSW) in Java, Indonesia Toronto-ICAAC Conference, September 1997

E.R. Koenig
International prostitutes and transmission of HIV. Lancet 333: 782-783

B. Kywe, N Nyunt, K. Nu Nu et al
HIV prevention among commercial sex workers using peer education and outreach strategies; Myanmar. Oral presentation Th.D.460 at the XIth International Conference on AIDS in Vancouver

M. Laga and G. Dallabetta
Sexually Transmitted Diseases: Treating the whole syndrome. Lancet 350 (suppl III): 25

P.R. Lamptey
Barrier contraceptives and the interaction between HIV and other sexually transmitted diseases. In: Heterosexual Transmission of AIDS. Edited by N. Alexander, H. Gabelnick and J. Spieler. New York: Alan R Liss Inc. 255-265

L.M. Langer, R.S. Zimmerman, R.J. Cabral
Perceived versus actual condom skills among clients ate Sexually Transmitted Disease Clinics. Public Health Reports 109: 167-174

S. Lawless, S. Kippax and J. Crawford
Dirty, diseases and undeserving: the positioning of HIV positive women. Social Science and Medicine 43: 1371-1377

J-P. Moatti, N. Bajos, J-P. Durbec et al
Determinants of condom use among French heterosexuals with multiple partners. American Journal of Public Health 81: 106-109

V.M. Moghadam
Women and Identity Politics in Theoretical and Comparative Perspective. In: Identity, Politics and Women. Cultural Reassertion's and Feminism's in International Perspective, Edited by V.M. Moghadam. Boulder: West View Press, 3-26.

H.L. Moore
A Passion for Difference. Cambridge: Polity Press.

N.S. Padian
Prostitute women and AIDS: epidemiology. AIDS 2: 413-419

H. Papanek
The ideal woman and the ideal society: Control and autonomy in the construction of Identity. In: Identity, Politics and Women. Cultural Reassertion's and Feminism's in International Perspective. Edited by V.M. Mohgadam. Boulder: West View Press, 42-75.

R.G. Parker and J.H. Gagnon
Conceiving Sexuality; Approaches to Sex Research in a postmodern world. New York: Routledge.

V. Sacks
Women and AIDS: An analysis of media misinterpretation. Social Science and Medicine 42: 59-73

J. Sanchez, E. Gotuzzo, J. Escamilla, C. Carillo, L. Moreyra, W. Stamm, R. Ashley, P. Swenson, and K.K. Holmes
Sexually Transmitted Infections in Female Sex Workers: Reduced by condom use but not by a limited periodic examination programme. Sexually Transmitted Diseases 25: 82-89.

T. Siraprapasiri, S. Thanprasertsuk, A. Rodklay, S. Srivanichakorn, P. Sawanpanyalert, J. Temtanarak
Risk factors for HIV among prostitutes in Chiengmai, Thailand. AIDS 5: 579-582

M. Spina, D. Serraino and U. Tirelli
Condom use and high-risk sexual practices of female prostitutes in Italy. AIDS 6: 601-602

J.P. Tchupo, T. Manchester, M.M. Lobe, R. Buschel
The importance of peer distribution of condoms to prostitutes. Oral presentation WS-D10-4 at the IXth International Conference on AIDS in Berlin.

I. Vanwesenbeeck, R. de Graaf, G. van Zessen, C.J. Straver, J.H. Visser
Condom use by prostitutes: Behavior, factors and considerations. Journal of Psychology & Human Sexuality 6: 69-91

I. Vanwesenbeeck, R. de Graaf, G. van Zessen, C.J. Straver and J.H. Visser
Protection styles of prostitutes= clients: Intentions, behavior, and considerations in relation to AIDS. Journal of Sex Education and Therapy 19: 79-92

M.J. Wawer, C. Podhista, U. Kanungsukkasem, A. Pramualratana and R. McNamara
Origins and working conditions of female sex workers in urban Thailand: Consequences of social context for HIV Transmission. Social Science and Medicine 42: 453-462

J. Weeks
History, Desire and Identities. In: Conceiving Sexuality; Approaches to Sex Research in a Postmodern World. Edited by R.G. Parker and J.H. Gagnon. New York: Routledge. 33-50

H.S. Weinstock, C. Lindan, G. Bolan et al
Factors associated with condom use in a high-risk heterosexual population. Sexually Transmitted Diseases 20: 14-20

S.C. Weller
A meta-analysis of condom-effectiveness in reducing sexually transmitted HIV. Social Science and Medicine 36: 1635-1644

D. Wilson, P. Chiroro, S. Lavelle, C. Mutero
Sex workers, client sexual bahaviour and condom use in Harare, Zimbabwe. AIDS Care 1: 269-280

I. Wolffers
Culture, media, and HIV/AIDS in Asia. Lancet n349: 52-54

I. Wolffers, W. Devillé, Y. Barakbah, R. Subarniati Triyoga, D. Yudhi, S. Luwayan, S. Hanafi
Methodological challenges with regard to research among commercial sex workers - an example from Surabaya, Indonesia. Oral Abstract C (O) 039. 4th International Congress on AIDS in Asia and the Pacific. Manila

I. Wolffers and M Bevers
Sex Work, Mobility and Aids in Kuala Lumpur, Malaysia. CARAM Kuala Lumpur.

P.D. Woolley, C.A. Bowman, G.R. Kinghorn
Prostitution in Sheffield: differences between prostitutes. Genitourinary Medicine 64: 391-393

J.M. Zenilman, C.S. Weisman, A.M. Rompalo et al
Condom Use to prevent incident STDs: The validity of self-reported condom use. Sexually Transmitted Diseases 22: 15-21