Sexual risk behaviours, HIV and other sexually transmitted infections among female sex workers in Indonesia

• Published in: Sexually transmitted infections Vol. 86; no. 5; pp. 393 - 399
• Main Authors: Magnani, Robert, Riono, Pandu, Nurhayati, Saputro, Eko, Mustikawati, Dyah, Anartati, Atiek, Prabawanti, Ciptasari, Majid, Nurholis, Morineau, Guy
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd 01.10.2010; BMJ Publishing Group; BMJ Publishing Group LTD
• Subjects: Acquired immune deficiency syndrome; Adolescent; Adult; AIDS; Biological and medical sciences; Chlamydia; Condoms - utilization; Disease transmission; Drug use; Female; Female sex workers; General aspects; Gonorrhea; Health Knowledge, Attitudes, Practice; HIV; HIV Infections - epidemiology; HIV Infections - psychology; HIV/AIDS; HSV-1; Human immunodeficiency virus; Human infectious diseases. Experimental studies and models; Human viral diseases; Humans; Indonesia; Indonesia - epidemiology; Infections; Infectious diseases; Medical sciences; Patient Acceptance of Health Care - psychology; Patient Acceptance of Health Care - statistics & numerical data; Prevalence; Prevention and actions; Public health. Hygiene; Public health. Hygiene-occupational medicine; risk behaviours; Risk Factors; Sex industry; Sex Work - psychology; Sex Work - statistics & numerical data; Sexual Partners; Sexually transmitted diseases; Sexually Transmitted Diseases - epidemiology; Sexually Transmitted Diseases - psychology; STD; STIs; Surveillance; Syphilis; Unsafe Sex - statistics & numerical data; Vagina; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Womens health; Young Adult; Asia; Indonesia; United Kingdom > UK; United States > US; Immunopathology; Sexual behavior; Retroviridae; AIDS; Immune deficiency; Lentivirus; Infection; Virus; Prostitution; Sexually transmitted disease; Viral disease; Female; Human immunodeficiency virus
• ISSN: 1368-4973; 1472-3263
• DOI: 10.1136/sti.2009.038059

ObjectivesTo assess the HIV/AIDS epidemic situation among female sex workers (FSW) in Indonesia using data from the 2007 Integrated Biological-Behavioural Surveillance (IBBS).MethodsBehavioural data were collected from time–location samples of 5947 FSW in 10 cities in late 2007. HIV, syphilis, gonorrhoea and chlamydia test results were obtained for 4396, 4324, 3291 and 3316 FSW, respectively. Trends in HIV prevalence were assessed via linkage with sentinel surveillance data. Factors associated with HIV, gonorrhoea and chlamydia infection were assessed using multivariable logistic regression.ResultsHIV prevalence averaged 10.5% among direct and 4.9% among indirect FSW, and had increased steadily among direct FSW from 2002 to 2007. Prevalence of chlamydia, gonorrhoea and active syphilis averaged 35.6%, 31.8% and 7.3%, respectively, among direct FSW, and 28.7%, 14.3% and 3.5% among indirect FSW. Being a direct FSW, younger age and having current infection with syphilis and gonorrhoea and/or chlamydia were associated with a higher likelihood of HIV infection. Number of clients in the past week and consumption of alcohol before having sex were associated with a higher likelihood of gonorrhoea and/or chlamydia infection, while having received a STI clinic check-up in the previous 3 months and/or periodic presumptive treatment for sexually transmitted infections (STIs) in the past 6 months were associated with reduced likelihood of infection.ConclusionsThe HIV/AIDS epidemic among FSW in Indonesia appears to be expanding, albeit unevenly across provinces and types of FSW. High STI prevalence is conducive to further expansion, but recent efforts to strengthen STI control appear promising.