title: An ethnographic study of HIV/AIDS among Ayoreo sex workers: cultural factors and risk perception.
abstract: OBJECTIVE
  To describe and understand Ayoreo sex workers' perceptions of HIV/AIDS and to identify factors that may affect the prevention of risk behaviours.
  
  
  BACKGROUND
  According to recent HIV/AIDS incidence reports, being female, indigenous and a sex worker means belonging to a maximum-risk group, left in the background in terms of strategies for the fight against HIV. Although there has been research into intervention models in these populations, it is important to detail the perceptions of the problem from the perspective of sex workers from the affected ethnic groups.
  
  
  METHODS
  This study used an ethnographic methodology that included participant observation and semi-structured interviews.
  
  
  METHODS
  The research was conducted in two phases. First, participant observation was chosen to access and observe the behaviour of Ayoreo sex workers. The second phase was a semi-structured interview with sex workers and key informants. The interviews, together with the field notes, were transcribed and analysed, following inductive strategies to find emerging themes.
  
  
  RESULTS
  Here, we present the results related to four emerging themes: the cultural acceptance of sex work as a useful economic activity; the lack of concern for sexually transmitted illnesses and the stigmatisation of people who are HIV seropositive; external factors that increase vulnerability such as difficulties in using a condom; and conflictive and unbalanced relationships between the Ayoreo people and the health system and health professionals.
  
  
  CONCLUSIONS
  The health- and sexual reproduction-related culture, the knowledge and attitudes of sex workers, external factors, and relationships with the health system and health professionals continue to place Ayoreo sex workers in high-risk conditions in relation to sexually transmitted diseases and HIV/AIDS.
  
  
  CONCLUSIONS
  Employing cultural care as its base, nursing could develop programmes and interventions culturally adapted for the prevention of disease and the promotion of health in these populations.
authors.affiliation: High Guadalquivir Public Hospital, Andújar, Jaén, Spain.
authors.forename: Olga M
authors.initials: OM
authors.lastname: López-Entrambasaguas
authors.forename: José
authors.initials: J
authors.lastname: Granero-Molina
authors.forename: Cayetano
authors.initials: C
authors.lastname: Fernández-Sola
mesh_terms: D000884:Anthropology, Cultural; D001838:Bolivia; D003466:Cultural Characteristics; D005260:Female; D006801:Humans; D012307:Risk Factors; D011477:Sex Work
keywords: HIV; culture; ethnology; minority groups; sexual and reproductive health; sexual behaviour