Vulnerability and sexual risks: Vagos and vaguitas in a low income town in Perú

Abstract

Young people constitute a priority for sexual health research, policy and planning. Many studies, however, regard youth as a homogeneous group defined by developmental stages and their problems as inherent rather than factors resulting from structural vulnerability. Ethnographic data from this study provided strong evidence of the inappropriateness, in prevention interventions, of the concept of ‘young people’ as a group defined only by age and gender. When incorporating social resources and support into the analysis, specific segments of youth with diverse sexual practices and health seeking behaviours emerge. Thus, although most young people in urban areas show a similar level of HIV/STI knowledge, their exposure to risk varies according to their living conditions. Two population segments – “street guys” and “fast girls” – identified as vulnerable for sexual risk, are characterized. Both groups hang out on the streets, and most are involved in using alcohol and drugs, and/or practicing transactional sex. This study provided evidence for the need of various approaches according to level of poverty and social vulnerability in order to develop more effective HIV/AIDS and STI prevention programs to meet the needs of young men and women in low‐income areas.

Keywords:

• Youth
• vulnerability
• social exclusion
• poverty
• sexual risk
• HIV/AIDS
• STI

Notes

Poverty in Perú is associated with migration to urban areas and the subsequent concentration of the population in those areas. For example, eight out of ten people living on Perú's coast live in urban areas (INEI 1999).

The HIV/AIDS epidemic is primarily concentrated in large cities; this is also true in Perú where, the capital city, Lima, had the majority (66.5%) of reported AIDS cases in 2004 (OGE 2004).

According to Bourdieu (1997), the State exercises symbolic violence as constituent of their “field” of power, understood as the field where the relations of power between agents possessing one of the various kinds of capital (economic or cultural) take place. By virtue of such capital, they are able to dominate their respective fields. In this sense, “symbolic violence” equates to the concept of “ideology”.

See Bandura 1977, 1986, 1990, 1994, Becker 1974, Rogers 1983, Salovey and Wegener 2000.

This is a randomized community intervention trial, testing an intervention based on the Theory of Diffusion of Innovations (Rogers 1983). In the intervention, community opinion leaders (or leaders of community social networks) agree to be trained to promote change in the social norms influencing the sexual behaviour of individuals and groups with the goal of reducing transmission rates of STIs and HIV among young people.

Many areas of Chiclayo were visited and evaluated in order to develop a geographic map of the neighborhoods. Interviews were conducted in selected neighbourhoods with: key personnel in primary care establishments; community members (storekeepers, pharmacists, hairdressers, members of mothers' clubs); and groups of young men and women. Additionally, secondary documents were reviewed, including: socio‐demographic, epidemiological, anthropological and similar studies, for each of the chosen areas. After this pre‐ethnographic work and a detailed evaluation, five communities were selected for in‐depth ethnographic work. Criteria were defined as existence of the existence of risk behaviors among young people, similar socio‐economic characteristics, and area/population size. Simón Bolivar was randomly selected from the five.

Survival is here defined not only in economic terms, but also with regard to the lack of caring and support.

Compensated sex is characterized by sex in exchange for clothes, money, or alcohol depending on the environment.

According to the National Institute of Statistics in Perú (INEI 2005) 50% of youth between 15 and 29 years‐old live in poverty. There are no statistics regarding social exclusion because this is still a theoretical concept. Poor people are socially excluded, but social exclusion is also related to disadvantaged positions with regard to ethnicity, age, gender and sexuality.