Articles

Trends in HIV Prevalence, Condom Use and Associated Factors among Female Sex Workers in Denpasar, Bali, Indonesia

Dewa Nyoman Wirawan , Emily Rowe, Made Suarjaya, Luh Putu Sri Armini

Dewa Nyoman Wirawan
Udayana University. Email: wirawandewa48@gmail.com

Emily Rowe
Kerti Praja Foundation

Made Suarjaya
Bali Province Health Department

Luh Putu Sri Armini
Denpasar City Health Department
Online First: July 01, 2014 | Cite this Article
Wirawan, D., Rowe, E., Suarjaya, M., Armini, L. 2014. Trends in HIV Prevalence, Condom Use and Associated Factors among Female Sex Workers in Denpasar, Bali, Indonesia. Public Health and Preventive Medicine Archive 2(1): 2-11. DOI:10.15562/phpma.v2i1.115


Objectives: The purpose of this paper is to review trends of HIV prevalence, condom use and associated risk factors among the female sex workers (FSW) in Denpasar, Bali. 

Methods: To analyze trends of HIV prevalence, surveillance data from 2000-2013 was used. Survey data from 2007 to 2013 was referenced for analysis of condom use trends. Data on associated risk factors was taken from 2012 integrated HIV and behavior survey.

Results and conclusion: HIV prevalence among direct FSW in 2000 was as low as 1.6% (95%CI: 0.05-3.15) and continued to rise, reaching a prevalence peak of 22.5% (95%CI: 16.4-26.6) in 2010.  HIV prevalence began to decline in 2011, 2012 and 2013. Analysis unearthed similar prevalence trends among indirect FSW albeit with a much lower prevalence of 0.25% in 2001, rising to 7.2% in 2010 and declining to 2.2% in 2013. The proportion of direct FSW reporting to always wear condoms in the last working week increased from 38% in 2007 (95%CI: 33.3-42.7) to 65% in 2013 (95%CI: 60.4-69.6). Multivariate analysis with logistic regression indicated that the significant risk factor with HIV prevalence was the specific grouping of FSW, in that low/mid-price are more at risk in comparison to high price with OR=4.37 (95%CI: 1.42-13.38). Risk factors associated with condom use was also the specific group of FSW, high price reported higher condom use with OR=4.04 (95%CI:2.03-8.04) and greater role of sex work site ‘pimps’ in encouraging their FSW to reject clients refusing to wear condoms with OR=2.06 (95%CI: 1.29-3.30). HIV prevalence among indirect and high-price direct FSW was much lower compared to prevalence in low/mid-price direct FSW. HIV prevalence and condom use among direct FSW population are significantly associated with group price range and the role of ‘pimps’.

References

Wirawan DN, Fajans P, Ford K. AIDS and STDs. Risk behavior patterns among female sex workers in Bali, Indonesia. AIDS CARE 1991; 5: 289-303.

Ford K, Wirawan DN, Fajans P, Muliawan P, MacDonald K, Thorpe L. Behavioral interventions for reduction of sexually transmitted disease/HIV transmission among female commercial sex workers and clients in Bali, Indonesia. AIDS 1996; 10: 213-222.

National AIDS Commission. Republic of Indonesia Country Report on the Follow up to Declaration of Commitment on HIV/AIDS Reporting Period 2010-2011. Jakarta: 2012.

Direktorat Jenderal Pengendalian Penyakit dan Penyehatan Lingkungan Kementerian Kesehatan Republik Indonesia. Laporan Triwulan Situasi Perkembangan HIV&AIDS di Indonesia Sampai Dengan 31 Maret 2010. Jakarta: 2011.

Direktorat Jenderal Pengendalian Penyakit dan Penyehatan Lingkungan Kementerian Kesehatan Republik Indonesia. Surveilans Terpadu Biologis dan Perilaku 2011. Jakarta: 2012.

Guy M, Robert M, Agus N, Liesbeth B and Dyah EM. Is the Bed Capture Enzyme Immunoassay useful for surveillance in concentrated epidemics? The case of female sex workers in Indonesia. Southeast Asian J Trop Med Public Health 2011; 42(3): 634-642.

Auvert B, Taljaard D, Lagarde E, et al. Randomized, controlled intervention trial of male circumcision for reduction of HIV infection risk: the ANRS 1265 Trial. PLoS Med 2005; 2(11): e298.

Bailey C, Moses S, Parker CB, et al. Male circumcision for HIV prevention in young men in Kisumu, Kenya: a randomized controlled trial. Lancet 2007; 369:643-56.

Gray H, Kigozi G, Serwadda D, et al. Male circumcision for HIV prevention in young men in Rakai, Uganda: a randomized trial. Lancet 2007; 369:657-66.

Gray RH, Kiwanuka N, Quinn TC, et al. Male circumcision and HIV acquisition and transmission: cohort studies in Rakai, Uganda. AIDS 2000; 14:2371-81.

Weiss HA, Quigley M, Hayes R. Male circumcision and risk of HIV infection in sub-Saharan Africa: a systematic review and meta-analysis. AIDS 2000; 14:2361-70.

National Family Planning Coordinating Board. Indonesia Demographic Health Survey 2007. Jakarta: 2008.

National Family Planning Coordinating Board. Indonesia Demographic Health Survey 2012. Jakarta: 2013.

Direktorat Jenderal Pengendalian Penyakit dan Penyehatan Lingkungan Kementerian Kesehatan Republik Indonesia. Surveilans Terpadu Biologis dan Perilaku 2007. Jakarta: 2008.

Wirawan DN, Rowe E, Silfanus F, Pidari P, Satriani A and Suyetna D. Long-term trends in Neisseria gonorrhoeae and Chlamydia trachomatis prevalence among brothel-based female sex workers in Denpasar, Bali, Indonesia. Public Health and Preventive Medicine Archive 2013, 1(2):106-112.

Pemerintah Kota Denpasar. Peraturan Daerah Nomor 1 Tahun 2013 tentang Penanggulangan HIV dan AIDS. Denpasar: 2013.


No Supplementary Material available for this article.
Article Views      : 332
PDF Downloads : 128