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Kata kunci: Pedesaan, Perilaku Seksual Remaja, Perkotaan.
The most important risk factor as a primary driver of HIV infection in transgender population is risky sex behavior such as duration of anal sex, consistency of condom use, number of partner sex and selling sex. This study was aimed to investigate association between risky sex behavior and HIV among transgender population in Indonesia 2018-2019. This study was done as secondary data analysis from a national cross-sectional study, namely the Intergrated Biological and Behavior Survey (IBBS) 2018-2019, done by the Ministry of Health of Republic of Indonesia. In this IBBS, Time Location Sampling (TLS) dan Simple Random Sampling (SRS) were used. All of eligible population were to be study participants of this study. Risky sex behaviors was assessed through guided interview, while HIV infection was determined by series of rapid serologic test. Association, between risky sex behavior and HIV, using PR (prevalent ratio), was analyzed using chi-square test and cox regression model. This study found that transgenders with high risk sex behavior were 1.45 times more likely (95% CI 1,16-1,81) to get HIV infection as compared to transgenders with low risk sex behavior.
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
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.
