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HIV is still a global health problem. FSW customers are one of the key populations spreading HIV. Consistent condom use is an effective way of preventing HIV and STI in this group. The consistency rate of condom use in this group is still low, namely: 35.82% in category 1 consistency (always or often using condoms), and 21.10% in category 2 consistency (always using condoms). The consistency of condom use is influenced by several factors, one of which is the perception of risk of contracting HIV. In the group of known customers who have a perception of feeling at risk of contracting HIV is 45.37%. This study is a quantitative cross-sectional design study to determine the relationship between perception of risk of contracting HIV with consistency of condom use in FSW customers using IBBS data 2018-2019, carried out in 24 regencies/cities in 16 provinces in Indonesia from 2018 to 2019 with a total sample of 4743 people. The results showed: in the consistency of category 1 condom use, there was a significant relationship between the perception of risk of contracting HIV and the consistency of condom use where FSW customers who had a perception of feeling at risk of contracting HIV had a 1.60 times higher tendency to consistently use condoms during sex than those who had a perception of feeling no risk after being controlled by the age variable of first intercourse sex and knowledge of condom effectiveness (PR=1.60, 95% CI=1.28-1.99). Meanwhile, in the consistency of category 2 condom use, there was a significant relationship between the perception of risk of contracting HIV and the consistency of condom use where FSW customers who had a perception of feeling at risk of contracting HIV had a 1.46 times higher tendency to consistently use condoms during sex than those who had a perception of feeling no risk after being controlled by age variables for the first time having sex and knowledge of condom effectiveness (PR=1.46, 95% CI=1.10-1.94). The implementation of mandatory condom localization bylaws with strict sanctions accompanied by synergistic cooperation between cross-sectors, updating the periodic mapping of unreached localizations accompanied by counseling on HIV/AIDS and condom effectiveness, dissemination of information to form risk perceptions and consistent behavior using condoms, the implementation of condom provision management in localization needs to be considered to reduce the incidence of HIV especially in FSW customer groups.
Prevalensi HIV pada LSL terus meningkat dari tahun ke tahun, 8% pada 2007 menjadi 17% pada 2011. Tingginya prevalensi HIV pada populasi ini disebabkan oleh pratek perilaku seks aman berupa penggunaan kondom secara konsisten yang masih rendah, 32% pada 2007 dan 24% pada 2011. Tujuan penelitian: Diperolehnya informasi yang mendalam tentang faktor-faktor pendukung dan penghambat perilaku penggunaan kondom secara konsisten pada pekerja seks laki-laki panti pijat serta situasi dan pola penggunaan kondomnya. Desain penelitian: Kualitatif menggunakan rapid assessment procedures. Sebanyak 30 informan dipilih melalui ?stratified? purposive sampling dari 15 panti pijat laki-laki, diwawancarai secara mendalam menggunakan structured open-ended question, ditranskrip dan matriks dibuat untuk memilah data sesuai tema-tema yang muncul. Observasi situasi di panti pijat dan analisis dokumen dilakukan untuk melengkapi wawancara mendalam. Analisis-interpretasi data dilakukan berdasarkan 5 level Socio Ecological Model. Hasil: Sebagian besar faktor-faktor pada level individual (pengetahuan, motivasi dan kesiapan menggunakan kondom, niat, keputusan menggunakan kondom, keterampilan, dan selfefficacy) dalam situasi yang memadai dan menjadi faktor pendukung penggunaan kondom secara konsisten. Namun pengaruh faktor-faktor ini tidak langsung dan sangat dipengaruhi oleh faktor-faktor interpersonal terutama klien, atasan/manajer panti pijat, teman dan pasangan tetap serta oleh faktor-faktor situasi organisasi panti pijat seperti aturan organisasi, mekanisme rantai suplai distribusi dan promosi kondom, struktur dan budaya organisasi. Faktor-faktor pada level komunitas tidak mendukung tetapi juga tidak menghambat secara langsung karena jejaring, kapasitas, kepemimpinan, partisipasi dan sumber daya komunitas masih embrional dan belum kuat. Faktor-faktor pada level kebijakan publik mendukung perilaku penggunaan kondom informan karena memungkinkan ketersediaan dan distribusi kondom serta program HIV berjalan di panti pijat. Namun karena adanya kontradiksi antara beberapa kebijakan publik, pengaruhnya menjadi terbatas. Ditemukan juga ada 3 pola umum penggunaan kondom pada informan yang merupakan model sederhana dari stage of change model, health believe model, precaution adoption process model dan social cognitive theory. Kesimpulan/rekomendasi: semua informan telah menggunakan kondom tetapi hanya sebagian kecil informan, sekitar 30%, yang penggunaan kondomnya konsisten. Faktor pada level interpersonal dan organisasional adalah faktor yang paling mempengaruhi penggunaan kondom informan dibandingkan faktor-faktor pada level individual, komunitas dan kebijakan publik. Disarankan agar intervensi pencegahan HIV menyasar lebih dalam faktor-faktor pada kedua level tersebut.
Background: HIV prevalence among MSM increase time to time, 8% in 2007 to 17% in 2011. High HIV prevalence among this population caused by low unsafe sex practices in form of consistent condom use, 32% in 2007 and 24% in 2011. Study purpose: to acquired insight of consistent condom use suporting and inhibiting factors among massage parlor-based male sex workers as well as situation and patterns of condom use behavior. Study design: qualitative approach using rapid assessment procedure method. Thirty informans were select through ?stratified? purposive sampling from 15 massage parlors, interviewed using structured open-ended questions, trancripted and matrix developed for data sorting to captured any emerged themes. Documents and secondary data analysis and observation carried out to suplement indepth interview. Data analysis and interpretation done based on 5 levesl of Socio Ecological Model. Results: Most of factors at individual level (knowledge, motivation and readiness to use condom, behavioral intention, deicion about acting, condom use skill, self-efficacy) were adequate and as supporting factors for consistent condom use practices. However influences of these factors was indirect and greathly influenced by interpersonal factors particularly by clients, massage parlor managers, peers and steady partners as well as by organizational factors such as massage parlor work regulation, condom supply chain management and promotion, organizational culture and structure. Factors at community level were neither support nor inhibit directly to consitent condom use practices. These are mainly caused by inadequate and embryonic stage of community networking, capacity, leadership, participation, and resources. Factors at public policy level support informant?s consistent condom use practices since these factors enabled condom availability and distribution and presence of HIV prevention program inside the massage parlors as well. However due to contradiction among those existing public policy, the influences were narrow. This study found 3 general patterns of informant?s condom use practices which are served as simple model of social cognitive theory, stages of change model, health believe model and precaution adoption process model. Conslusion/recommendation: All informants had used condom but only few of them, about 30%, had used it consistently. Factors at interpersonal and organizational level were the most influencing factors for consistent condom use practices among informants compared to factors at individual, community and public policy level. It is recommended to have deeper and more intensive intervention at those two levels.