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ABSTRAK Nama : Marta Butar Butar Program Studi : Epidemiologi Judul : Prediktor Kejadian Infeksi Sifilis Pada Populasi Lelaki Suka Seks dengan Lelaki (LSL) di 10 Kabupaten/Kota Di Indonesia (Analisis Data STBP 2015) Latar Belakang : Berdasarkan angka kejadian sifilis pada kelompok LSL yang tercatat pada STBP Tahun 2011 cenderung meningkat sebesar 9 % (dari 4% menjadi 13%) dibandingkan STBP Tahun 2007. Tujuan penelitian ini adalah menganalisis prediktor kejadian sifilis pada populasi LSL yaitu umur, tingkat pendidikan, status HIV, penggunaan kondom, konsumsi Napza/Napza suntik, konsumsi alkohol, jumlah pasangan seks dan pemeriksaan IMS. Metode : Desain Penelitian cross sectional menggunakan data sekunder dari STBP 2015. Data di analisis dengan Cox regresion. Populasi penelitian yaitu kelompok LSL yang berasal dari 10 kabupaten/kota dengan jumlah sampel responden yaitu 1495 orang. Hasil : Proporsi infeksi Sifilis pada kelompok LSL pada 10 kabupaten/kota di Indonesia adalah 15,7%. Ada hubungan yang bermakna antara status HIV (PR 2,05 (95% CI 1,58-2,66), Umur (20-24 tahun (PR 2,45, 95% CI 1,07-5,64), 25-29 tahun (PR 3,01, 95% CI 1,30-6,95), > 30 tahun (PR 2,42, 95% CI 1,04-5,65) dibandingkan LSL umur 15-19 tahun) dengan kejadian infeksi sifilis pada LSL dan ada interaksi antara alkohol dan pendidikan (LSL berpendidikan rendah yang minum alkohol (PR Interaksi 0,47 95% CI 0,23-0,96), LSL berpendidikan rendah tidak minum alkohol (PR Interaksi 1,34 95% CI 0,94-1,90) dan LSL berpendidikan tinggi yang minum alkohol (PR Interaksi 1,4 95% CI 1,03-1,90) dibandingkan LSL yang berpendidikan tinggi yang tidak minum alkohol) dengan kejadian infeksi sifilis pada LSL sedangkan penggunaan kondom, Napza/Napza suntik, jumlah pasangan seks lelaki dan pemeriksaan IMS tidak berhubungan secara statistik dengan nilai p > 0,05 dengan kejadian sifilis. Kata kunci : Prediktor, sifilis, Lelaki Suka Seks dengan Lelaki
ABSTRACT Name : Marta Butar Butar Program Major : Epidemiology Title : Predictors of Syphilis Infections In Population of Male Who Have Sex With Men (MSM) in 10 Districts / Cities In Indonesia (Data analysis STBP 2015) Background : Based on the incidence of Syphilis in delayed groups of MSM in STBP 2011 the symptoms increased by 9% (from 4% to 13%) compared to STBP Year 2007. The purpose of this study was predictors of syphilis infection in MSM population, age, education level, HIV status, Condoms, intake / drug consumption, alcohol consumption, number of sex partners and STI examination. Method: The cross sectional study design used secondary data from STBP 2015. The data were analyzed by Cox regression. The population of the study were MSM group from 10 districts / cities with 1495 respondents Results: The proportion of Syphilis infections in MSM in 10 districts / cities in Indonesia was 15.7%. There was a significant relationship between HIV status (PR 2.05 (95% CI 1.58-2.66), Age (20-24 years (PR 2.45, 95% CI 1.07-5.64), 25 29 years (PR 3.01, 95% CI 1.30-6.95),> 30 years (PR 2.42, 95% CI 1.04-5.65) compared with men aged 15-19 years) with syphilis infection in MSM and there is an interaction between alcohol and education (low educated MSM who drink alcohol (PR Interaction 0.47 95% CI 0.23-0.96), low educated MSM who not drink alcohol (PR Interaction 1.34 95 % CI 0.94-1.90) and high educated MSM who drink alcohol (PR Interaction 1,4 95% CI 1.03-1.90) than high educated MSM who not drink alcohol with syphilis infection in MSM while condom use, drug/ injecting drug, number of male sex partners and STI examination were not statistically correlated (p> 0,05) with syphilis infection. Keywords: Predictors, syphilis, Men Sex With Men
Kata Kunci : STBP, Lelaki suka Seks dengan Lelaki, HIV-AIDS
ABSTRAK
Latar belakang: Epidemi HIV secara global masih merupakan masalah kesehatan masyarakat yang serius. Pada tahun 2011 terdapat 2.5 juta (2.2 – 2.8 juta) kasus baru infeksi HIV di seluruh dunia, dengan kamatian karena AIDS mencapai 1.7 juta jiwa. Penularan infeksi HIV di Indonesia saat ini terutama melalui hubungan seks heteroseksual terutama terjadi dari WPS kepada pelanggan seks komersial, yaitu kelompok lelaki berperilaku risiko tinggi. Populasi ini merupakan jembatan penularan infeksi HIV (bridging population) dari populasi risiko tinggi ke populasi umum. Data menunjukkan jumlah laki-laki di Indonesia yang menjadi klien WPS lebih banyak dibandingkan pengguna napza suntik dan kelompok MSM (men who have sex with men). Prevalensi HIV pada kelompok LBT meningkat 7 kali lipat dari 0.1% (STBP 2007) menjadi 0.7% (STBP 2011). Keberadaan IMS meningkatkan kemudahan seseorang terkena infeksi HIV. Sebagian besar IMS akan menimbulkan peradangan dan kerusakan jaringan kulit/selaput lendir genital yang memudahkan masuknya HIV. Infeksi menular seksual dengan gejala ulkus genital, misalnya sifilis, menyebabkan kemudahan terkena infeksi HIV meningkat 4 – 6 kali. Penelitian ini dilakukan untuk melihat pengaruh faktor perilaku seks yang berhubungan dengan infeksi HIV dengan mempertimbangkan penyakit sifilis sebagai efek modifikasi, pada populasi LBT 12 kabupaten/kota di Indonesia.
Metode: cross sectional, analisis data hasil STBP 2011.
Hasil: Prevalensi HIV pada LBT sebesar 0.7%, LBT dengan perilaku seks berisiko rendah sebesar 91.5%. Perilaku seks risiko tinggi terdapat pada 6.6% LBT dan 1.9% di antaranya berperilaku seks risiko sedang. Prevalensi LBT yang mengaku setia pada pasangan sebesar 49.8%. Kejadian infeksi HIV berhubungan secara signifikan dengan riwayat hubungan seks dengan WPS, setia pada pasangan, jumlah WPS dalam 1 tahun terakhir, penggunaan napza suntik, serta keluhan IMS. Keberadaan sifilis tidak memodifikasi efek perilaku seks terhadap infeksi HIV, karena kejadiannya kecil. Pada analisis multivariat didapat perilaku seks yang berisiko untuk tertular HIV adalah pernah berhubungan dengan WPS memiliki risiko tertular HIV dengan OR 2.113(0.883-5.052) dan pernah berhubungan dengan casual partner memiliki OR sebesar 1.347(0.506-3.589) setelah dikontrol dengan variabel penggunaan napza suntik dan keluhan IMS.
ABSTRACT
Background: Global HIV epidemic still reveal serious public health issue. In 2011 there was 2.5 million (2.2 – 2.8 million) HIV new cases worldwide with mortality reach 1.7 million people. Heterosexual transmission of HIV in Indonesia mainly occurs from FSW to their clients, which is identifying as high risk men (HRM). HRM population is HIV transmission bridging population from high to low risk population. Data shows FSW’s clients amounted much more than the IDUs or MSM. HIV prevalence in HRM had been increased 7 times from 0.1% (IBBS 2007) to 0.7% (IBBS 2011). The presence of STD increases risk of HIV infection, so that STD is believed as HIV infection cofactor. Most STD caused inflammation and genital mucosa/skin damage which make HIV infection easier. Genital ulcer disease, such as syphilis, raised HIV infection 4-6 times. This study aims to see sexual behavior effect on HIV infection with regard of syphilis as modification effect on HRM population in 12 districts in Indonesia.
Method: Cross sectional. The IBBS 2011 data analyses.
Result: HIV prevalence among HRM amounted 0.7%. Of 91.5% HRM have low risk of sexual behavior, 1.9% medium risk, and 6.6% experience high risk sexual behavior. 49.8% HRM was faithful. There was significant association between HIV infection and having sex with FSW, faithfulness, the amount of FSW in 1 year, injecting drug user, and the presence of STI symptoms. The presence of syphilis has not modified the association between sexual behavior and HIV infection, statistically. Multivariate analyses founded that having sex with FSW and/or casual partner were risky sexual behavior with OR of being infected by HIV were 2.113(0.883-5.052) and 1.347(0.506-3.589) respectively, after being controlled with variables injecting drug user and the presence of STI symptoms.
The HIV epidemic in Indonesia is concentrated in certain groups that are at high risk of HIV and one of them is the MSM (Men Sex with Men) group. Based on several studies in other countries, circumcision (sunat) is an effort to prevent HIV transmission in men, and circumcision has been carried out by the majority of Indonesia's population who are predominantly Muslim. However, in Indonesia, circumcision has not been included in the HIV AIDS prevention and control program and there is still a lack of research related to circumcision on HIV in the MSM group. The purpose of this study was to determine the relationship between circumcision and HIV status in MSM in Indonesia 2018/2019. This study used secondary data from the Integrated Biological and Behavioral Survey (IBBS) for HIV AIDS 2018/2019 with a cross-sectional design study and a sample size of 4,284 MSM in 19 selected IBBS districts/cities. The results showed that MSM who never performed circumcision had a 1.27 times higher risk of being HIV positive compared to MSM who had circumcised after being controlled with the consistency of condom use and education variables. The collaboration between the government and CSOs (Civil Society Organizations) to make circumcision easy, cheap, and safe as part of efforts to prevent HIV transmission is expected to complement other existing prevention programs
Globally, every year there are 6 million new cases of syphilis estimated in people aged 15 to 49 years. Syphilis is a risk factor among men who have sex with men (MSM) and other groups that tend to have multiple sex partners. As is known, people who suffer from syphilis have a greater risk of contracting and transmitting HIV to others. This is because the mode of transmission of syphilis and HIV have in common. A cross sectional study: The Integrated Biological and Behavioral Survey (STBP) in 2018-2019 was conducted by the Ministry of Health as part of an evaluation of the HIV AIDS program in Indonesia. The study was conducted in 24 selected city/district with a total sample of 3,941 MSM, behavioral data collection was carried out by interview while syphilis and HIV biological data were carried out by laboratory examination of blood samples. Study showed that syphilis was a risk factor for HIV with PR = 4.1 (95% CI: 3.4-4.9). Respondents with syphilis have an incidence of HIV 4.5 times greater than respondents without syphilis. The combination of syphilis, primary occupation and the use of condoms when buying sex increases the risk to 4.5 (95% CI: 2.03-10.03). There is association between syphilis and HIV. Syphilis increases the risk of HIV up to 4 times among MSM. The involvement and strengthening of the technical capacity of the GWL Community Based Organization (CBO) in promoting safe sex and the utilization of services for MSM communities and the acceleration of STI-friendly programs for key populations (officers and tools) will be a driven of MSM for regular service access. Prevention as a more effective approach can be done simultaneously considering that both syphilis and HIV can be prevented in the same way. Syphilis among MSM needs special attention because if not treated immediately the impact will go to a larger heterosexual population.
Kata kunci: Lelaki Seks Lelaki (LSL), perilaku seksual berisiko, pengetahuan HIV/AIDS
Sexual risk behavior HIV/AIDS among MSM can be influenced by prevention and misconception knowledge of HIV/AIDS. This study aims to determine the relations about knowledge of HIV/AIDS and sexual risk behavior HIV/AIDS among MSM in 3 cities (Yogyakarta, Tangerang, Makassar) in Indonesia on 2013. This study used cross sectional design by using data IBBS 2013. Samples in this study were 343 MSM in 3 cities in Indonesia meet the criteria inclusion and exclusion and analyzed by univariate, bivariate, and stratification. Form the result, the percentage were 16% MSM have high risk of sexual risk behavior, 30.9% MSM have prevention and misconception knowledge less, 52.5% MSM >24 years, 48 % MSM less participate in the health services HIV/AIDS, 51% MSM less of source information. Based on analysis bivariate relationships with sexual risk behavior HIV/AIDS less having knowledge HIV/AIDS (PR = 2.0; 95%CI 1.2-3.2), age ≤ 24 years (PR= 1.7; 95%CI 1.0-2.7), less participate in the health program (PR= 2.0; 95%CI 1.2-3.4), less get media source information (PR= 0.6; 95%CI 0.4-1.0). Stratification results of the strata on the variables of covariate variable have higher PR on MSM aged >24 years (PR= 2.14; 95%CI 0.98-4.66), MSM less follow the program health service (PR = 2.10; 95%CI 1.17-3.77), and MSM got a better media source information (PR= 2.05; 95%CI 1.11-3.77). It is therefore advisable to improve program IPP back, give education in according by age, and provide a source of information that is more effective and massive.
Keywords: Men Who Have Sex with Men (MSM), sexual behavior risk HIV/AIDS, knowledge of HIV/AIDS
Kata Kunci: perilaku seks berisiko HIV/ AIDS, usia muda, LSL
The projection in 2030 is decreased number of deaths from infectious diseases in the world's population, while diseases caused by HIV / AIDS will increase is influenced by public accessibility to ARV treatment and efforts to prevent transmission of HIV / AIDS. The most vulnerable group vulnerable to HIV infection are young people. Many young people engage in risky sexual behavior because of risky behaviors decision in this group. Among young MSM, high rates of HIV infection are caused by risky sexual behavior. The purpose of this study is to determine the factors of risky sexual behavior of HIV/ AIDS in young MSM age 15-24 years. Risk factors include age, education, knowledge, exposure to health information, age of first sex, HIV testing service, other health service, alcohol consumption, and drug consumption. The study utilize secondary STBP 2018 data. The research design use cross sectional with univariate and bivariate analyzes with chi square test α = 0.05. The results show that there are significant relationship between knowledge (p value=0,001; PR=1,4; CI=1,3-2,5); HIV test service (p value=0,000; PR=1,7; CI=2,0-3,4), other health service prevention (p value=0,000; PR=1,6; CI=1,9-3,2), and alcohol consumption (p value=0,009; PR=1,2; CI=1,1-1,8) with risky sexual behavior of HIV / AIDS.
Keywords: HIV/ AIDS risky sexual behavior, young age, MSM
