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ABSTRAK Tingkat penggunaan kondom pada kelompok Waria sebesar 39% pada tahun 2007 terjadi sedikit peningkatan sebesar 36% tahun 2011 (Kemenkes 2011), tetapi masih dibawah target (60%) (KPAN, 2010). Penggunaan kondom pada seks komersial dipengaruhi oleh kemampuan penjaja seks untuk menawarkan pemakaian kondom ketika berhubungan seks kepada pelanggannya. Dari penjaja seks yang tidak pernah menawarkan penggunaan kondom kepada pelanggannya ternyata pemakaian kondom pada seks komersial terakhir cukup rendah, hanya sekitar 10–20%. Determinan yang diduga berhubungan dengan perilaku Waria dalam menawarkan penggunaan kondom kepada pasangan seks antara lain : umur, tingkat pendidikan, pengetahuan pencegahan HIV/AIDS, riwayat IMS, kemudahan memperoleh kondom, lama melakukan seks komersil, kontak dengan petugas, konsumsi alkohol/napza sebelum berhubungan seks. Tujuan penelitian ini untuk mengetahui determinan perilaku Waria dalam menawarkan penggunaan kondom kepada pasangan seks. Penelitian ini menggunakan data STBP tahun 2011 yang dilakukan di 5 kota besar di Indonesia, dengan desain studi Cross Sectional. Jumlah data yang dapat dianalisis sebanyak 684. Hasil menunjukan bahwa proporsi Waria yang menawarkan penggunaan kondom kepada pasangan seks sebesar 81,3%. Determinan yang berhubungan signifikan adalah kontak dengan petugas (p=0,000), OR = 3,847 (95% CI= 2,507– 5,902) dan kemudahan memperoleh kondom (p=0,000), OR = 3,010 (95% CI= 1,934–4,685). Umur, tingkat pendidikan, pengetahuan pencegahan HIV/AIDS, riwayat IMS, lama melakukan seks komersil dan konsumsi alkohol/Napza sebelum melakukan hubungan seks tidak berhubungan. Berdasarkan hasil penelitian tersebut, maka saran yang dapat diberikan adalah peningkatan frekuensi kontak petugas dengan Waria baik petugas dari pemerintah maupun dari LSM yang peduli terhadap masalah HIV/AIDS dengan Waria untuk membahas risiko tertular HIV dan cara pencegahannya terutama tentang pentingnya menggunakan kondom dalam hubungan seks berisiko dan menjamin agar kondom selalu tersedia dan terjangkau dalam jumlah cukup terutama di dalam tempat kerja Waria.
ABSTRACT Levels of condom usage on MTF transgender group was found 39% at 2007, there was a increase of 36% in 2011 (Ministry of Health, 2011), still below the target (60%) (KPA, 2010). Condom usage in commercial sex is influenced by the ability to negotiation sex workers condom usage to sex patner. At sex workers who do not ever negotiation to sex patner of condom usage turns was found condom usage at last sex is quite low, only about 10-20%. Determinants related to MTF transgender behavior in condom usage negotiation to sex partner among others: age, level of education, knowledge of HIV/AIDS, STI history, ease of obtaining condoms, old of commercial sex, contact with the officer, the consumption of alcohol/drugs before sex. The purpose of this study to knowing determinants of MTF transgender behavior in condom usage negotiation to sex partner. This study uses producted IBBS conducted in 2011 in 5 major cities in Indonesia, with a cross-sectional study design. The amount of data that can be analyzed as many as 684. Results showed that the proportion of MTF transgender behavior in condom usage negotiation to sex partner was 81.3%. Determinants significantly related are contact with the officer (p = 0.000), OR = 3.847 (95% CI = 2.507 to 5.902) and the ease of obtaining condoms (p = 0.000), OR = 3.010 (95% CI = 1.934 to 4.685). Age, level of education, knowledge of HIV / AIDS, STI history, the old of commercial sex and alcohol / drugs before sex are not related. Based on these results, the suggestions can be given are to increase the frequency of contact of the officers with MTF transgender both officers of the government and NGOs concerned with the problem of HIV/AIDS with MTF transgender to discuss the risk constracting HIV and how to prevent it, especially about the importance of condom usage in unsafe sexual behavior; and affordable in sufficient quantities, especially in the workplace MTF transgender.
Kata Kunci:Waria, determinan, HIV
HIV and AIDS is a public health problem that requires serious attention. Waria askey populations, the prevalence needs to be controlled to not spread to the generalpopulation. Based on the Integrated Biological and Behavioural Surveillance(IBBS) 2007 and 2011, the prevalence of HIV on the transgender has notdemonstrated a significant reduction (24% in 2007 and 22% in 2011). The aim ofthis study is to discuss the determinants of HIV on transgenders in 5 cities inIndonesia using data Integrated Biological and Behavioral Surveillance (IBBS) in2011. This study is a quantitative study with a cross-sectional study designfollowed the design of the study on IBBS 2011. The results showed that thedeterminant of HIV status on transgender in 5 cities in Indonesia, are age, durationinvolved sex work, education, history of STIs, job as a sex worker, number of analsex clients, consistency use of condoms and lubricants, HIV testing, and STIclinic visits. Results of this study indicate transgender job is the greatest riskfactor of HIV status on transgender in 5 cities in Indonesia (OR = 2.36).
Key words:Transgender, determinants, HIV
Hasil penelitian menunjukkan proporsi penggunaan kondom pada saatberhubungan seks sebesar 18% pada pasangan tetap, 17% pada pasangan tidaktetap, 17% membeli seks dan 5% menjual seks. Determinan penggunaan kondompada 4 pasangan berbeda, namun tidak memiliki kondom selalu ada pada semuajenis pasangan. Determinan penggunaan kondom pada pasangan tetap adalahtidak memiliki kondom, tidak merasa berisiko, pengetahuan rendah, tidakmengakses LASS, tidak menikah dan merasa kondom tidak bermanfaat dalammencegah HIV merupakan determinan dari perilaku penggunaan kondom Penasunpada pasangan tetap. Determinan penggunaan kondom pada pasangan tidak tetapadalah tidak memiliki kondom dan tidak menikah merupakan determinanpenggunaan kondom Penasun pada pasangan tidak tetap. Determinan penggunaankondom pada Penasun yang membeli seks adalah tidak memiliki kondommerupakan determinan penggunaan kondom Penasun saat membeli seks.
Kata Kunci : Penasun, Penggunaan Kondom
Consistent condom use in IDUs remains low. According to the report IBBS2013, the consistent use of condoms in 17% IDU steady partner, 17% of couplesare not fixed and 16% commercial partner. This study aims to look at thedeterminants of condom use among IDU in four cities in Indonesia. This studyuses IBBS IDU 2013. How sampling IBBS IDU is Respondent Driven Sampling(RDS). Analysis of univariate, bivariate and multivariable.
The results showed the proportion of condom use during sex by 18% on aregular partner, 17% on casual partners, 17% and 5% purchase sex sell sex.Determinants of condom use on four different couples, but does not have acondom always exist in all types of couples. Determinants of condom use on aregular partner is not having a condom, do not feel at risk, low knowledge, noaccess LASS, not married and feel condoms are not useful in preventing HIV is adeterminant of condom use behaviors of IDUs in couples staying. Determinants ofcondom use in casual partners is not to have condoms and abstaining frommarriage is the determinant of condom use in casual partners of IDUs. The Determinants of condom use among IDU who buy sex is not having a condom is a determinant of the use of condoms when buying sex IDU.
Keywords: IDU, Condom Use
Kata Kunci : LSL, Penggunaan Kondom Konsisten, Pulau Jawa, Indonesia
Men Who Have Sex with Men (MSM) are population at high risk for HIVinfection. Promoting consistent condom use (CCU) is a key risk reduction strategyfor HIV prevention among MSM. This thesis reports the factors associated withCCU among MSM with their regular, casual, client, and sex worker partners. Thisthesis used cross-sectional design from Integrated Biological and BehaviourSurveillance for MSM in Java Island in 2011. Binary logistic regression analyseswere conducted to assess the determinants of CCU with socio-demographic,perceived, cues to action, and past condom use factors. CCU ranged from 37 to49% with male partners and 28% with female partner. Multivariate analysesshowed that MSM who had a single status, comprehensive knowledge, no STDsymptoms, and past condom use were likely to be consistent condom users. HIVinterventions among MSM need to increase comprehensive knowledge of HIVand promote CCU with all types of sex partners.
Keywords : MSM, Consistent condom use, Java Island, Indonesia
Kata kunci:Waria, faktor, HIV, IMS
HIV and sexually transmitted infections (STI) are public health problem that veryimportant to be considered. As key population of HIV transmissions, Transgender needto be given special intention so its transmission to the general population can beprevented. Based on the Integrated Biological and Behaviour Survey (IBSS) 2011 and2015, the prevalence of STI such as syphilis, clamidia, and gonorrhea on Transgender hasdecreased, while HIV prevalence has increased from 22% to 25%. This study discussesthe factors related to the incidence of HIV and STI among Transgender in 5 cities inIndonesia using data Integrated Biological Behavioral Surveillance (IBBS) in 2015. Thisstudy is a quantitative study with a cross sectional study design followed the design ofthe study on IBBS 2015. The result showed that factors related to HIV dan STI onTransgender in 5 cities are age, education, employment, comprehensive knowledge,consistency of use of condoms, consistency of the use of lubricant, number of anal sexpartners, use of injectable drugs, use of silicone injections, alcohol consumption beforesex, HIV tests, and visits to STI services. The results of the this study showed that the useof silicone injections was the most influential factor on the status of HIV on Transgenderin 5 cities in Indonesia (OR = 1.68).
Key words:Transgender, factors, HIV, STI.
Kata kunci : Konsistensi, kondom, WPSL, WPSTL.
Sudah lebih 25 tahun, sejak pertama ditemukan lahun 1981, berbagai bangsa di dunia berupaya untuk menanggulangi HIV/AIDS, tetapi penyakit ini terus berkembang dengan peningkatan yang cepat dan mengkhawatirkan. Estimosi jumlah penderita HIV/AIDS di seluruh dunia pada tahun 1990 adalah 7,8 juta dan pada akhir Desember 2007 sudah mencapai 33,2 juta, dimana 90% berasal dari negara berkembang (WI-IO&UNAIDS, 2007). Perkembangan epidemi HIV/AIDS di Indonesia termasuk dalam kelompok tercepat di Asia, fase epidemiknya telah berubah dari “low” menjadi “concentrated” . Sampai akhir September 2007 ,secara kumulatif jumlah pengidap infeksi HIV adalah 5904 dan kasus AIDS adalah 10384, yang tersebar di 33 provinsi. Rate kumulatif kasus AIDS Nasional sebesar 4,57 mf 1oo.ooo pcnduduk (1:>n.Jen PPM&PL, 2007). Papua mempunyai proporsi kasus AIDS tertinggi dibandingkan dengan provinsi Iainnya di Indonesia dan penularannya telah merambah ke masyarakat umum dengan prevalensi cukup tinggi yaitu lebih I persen. Bila dibandingkan dengan populasi penduduk maka cafe rare kasus/jumlah penduduk x 100.000) dl Papua adalah 60,93 per 100.000 penduduk dan merupakan 15,39 kali Iebih tinggi dibandingkan dengan rate nasional (3,96). Penularan HIV di Papua 90 persen disebabkan Oleh hubungan heteroseksual (BPS & Depkes RI, 2007). Tigginya penyebaran HIV/AIDS di Papua dikarenakan rendahnya penggunaan kondom pada kelompok risiko tinggi, rendahnya pengetahuan dan minimnya informasi tentano HIV/AIDS. Informasi mengenai hubungan antara ringkat keterpapamn infonnasi HIV/AIDS dengan perilaku kelompok risiko Linggi, seperti peianggan WPS dalam penggunaan kondom scks komemial sangat berguna sebagai masukan bagi pembuat kebijakan untuk membuat program penoegahan dan penanggulangan penyakit HIV/AIDS yang iebih efektif dan efisien, khususnya di Papua. Tujuan penelitian ini adalah diketahuinya hubungan tingkat ketcrpaparm informasi HIV/AIDS dengan perilaku penggunaan kondom pada pelanggan WPS di Papua seteiah dipadankan oleh variabel umur, status perkawinan, tingkat pcndidikan, tingkat pengetahuan dan riwayat mengalami gejala IMS yang berpcmn sebagai confounder, dcngan menggunakan modelling Propensity Score Matching_ Penelitian ini menggunakan data sckunder Survei Surveilans Perilaku HIV/AIDS 2004/2005 dari PZMPL Depkes Rl dan desain penelitian ini adalah cross sectional. Sampel pada penelitian ini adalah tukang ojek dan tukang bongkar muat pelabuhan di Papua, yang selanjutnya disebut dengan pelanggan WPS. Hasil penelitian menunjukkan bahwa responden yang konsisten menggunakan kondom saat berhubungan scks dmngan WPS muih sangat rendah (|9?l4%). Hasil analisis bivariat menunjukkan variabel umur (p=0,650), status perkawinan (p=0,403) tidal: berhubungan dengan perilaku penggunaan kondom pada pelanggan WPS, sodangkan variabel tingkat pcndidikan (p=0,000l), tingkat pengetahuan (p=0,000),dan riwayat mengalami gejala IMS (p=0,000) menunjukkan hubungan yang sigtifikan dengan periiaku penggunann kondom pada pelanggan WPS. Pada analisis mukivasiat modelling Propensiry Score Marching baik dengan nearest neighbor maupun caliper, variabel umur dan status perkawinan hams dikeluarkan dari model, karena reduksi biasnya lebih rendah sebelum dipadankan daripada setelah dipada-nkan. Hmil akhir analisis PSM pada model fit didapatkan nilai yang sama antara kedua algoritma baik nilai OR maupun nilai T-stat. 'Nilai odds ratio (OKI adalah 2,3 (95%Cl=I,2-4,5), ini artinya pelanggan WPS yang Hngkat ketcrpaparan infonnasi HIV/AIDS cukup memiliki peluang 2,3 kali untuk menggtmakan kondom sccara konsisten dibandingkan dengan yang tingkat kCl¢l'P8P&l'|-ll infonnasi HIV/AIDS kurang dan nilai T-stat didapat 0,85(p>0,05), artinya tidak ada hubungan yang bcnnaknu antara tingkat keterpaparan infomaasi HIV/AIDS dengan perilaku penggunaan kondom pads pelanggan WPS di Papua. Berdasarkan hasil penelitian ini, maka disarankan kepada pengelola program HIV/AIDS baik di pnsat maupun daemh agar lebih meningkatkan intensitas dan kedalaman informui HIV/AIDS terutama bagi kelompok nusyanakat yang mempunyai risiko tinggi terhadap penyakit HIV/AIDS, meningkatkan pemn tenaga kesehatan dan membangun kcmitraan dengan tokoh agama, tokoh adat/masyamkat, LSM, dunia usahalswasta dan Iembaga pendiclikan formal untuk kepentinan penyeharan informasi yang akurat dan benar tcntang HIV/AIDS, melibatkan pakar komunikasi dan mendorong perusahaan komunikasifmedia lebih berperan dulam upaya pencegahan dan penanggulangan HIV/AIDS dan sosialisasi kondom, pemberdayaan kelompok risiko tinggi(pecr group) dalam pcnyebaran infomuui HIV/AIDS dan menetapkan pttraturan daerah penggunaan kondom 100%.
It has been more than 25 years, since the first time the HIV/AIDS we found in 1981, there are many different programs have been developtxl by countries around the world in attempt to control the growth and spreading of HIV/AIDS. But unfortunately, the uncontrolable growth of this disease has attracted more serious attentions. The estimated number of sufferes litom the disease has increased dramatically from about 7,8 million people in 1990 to approximately 33,2 million sufferes in late December 2007. There was 90% of the total sufferers fiom developing countriw (WHO&UNAlDS, 2007). The growth of the HIV/AIDS epidemic in indonesia has been recorded as the fastest among Asian countries. It has progressed fiom “low” to “eoncentrated". Untill late September 2007, the total number of people infected by HIV cumulativcly reached 5904 and the number of AIDS cases was l0384, that found within 33 provinces of Indoneia. The national cumulative rate of the AiDS cases in Indonesia was 4,57 per 100.000 people (Dit.Jcr1 PPM&PL, 2007). The highest proportion of the I-HV/AIDS found in Indonesia is in Papua where the spread of the infectious disease has reached its most eomunities with the prevallance of the cases is more than l%. If this value is being compared with its population of the province in general, the case rate will be 60,93 per l00.000 peoples. This rate is 15,39 times higher than the national rate which is only 3,96. The most common cause of the spreading process of the disease in Papua is through heterosexual behaviours which is up to 90 percent (BPS & Depkes RI, 2007). The increased number of HIV/AIDS in Papua is also led by the usage of condom at high risk group still low, a lack of infomation and education about HIV/AIDS. The information about relationship between infomation exposed about HIV/AIDS with behavior in condom use among the consumer of FSW is necessary to be considered by public health policy makers as 2 sugestion to prevent and control ilu: growth ofHlV/AIDS effectively and effecient in Papua. This research is aimed to identify the relationship between the infomation exposed about HIV/AIDS with behavior in condom use among the consumer of FSW in Papua by focussing on ages, marital status, educational level, infomation level and the story of suffering from Sexual Transmited Infection symptoms which act as corrfounder, and using Pmpensity Score Marching Analysis. This research uses secondary data of Behavioral Surveillance Survey(BSS) of HIV/AIDS in 2004/2005 from P2MPL, Health Department of indonesia and the design of this research is cross sectional. The samples used in this research are the consumers of FSW. They are tukang ojelc (motorcycle taxi drivers) and tukang bongkar muat pelabuhan (workers loading goods in Papua’s harbour. Further they will be mentioned as the FSW consumers. The results of this research show that the number of respondents who are consistent to use condoms in conducting their sexual intercourses with FSW is still remaining low (l9,l4%). By bivariate analysis, the result shows that the variable age (p=0,650), marital status (p=0,403) have not significantly with the consumer of FSW behavlor’s in condom use. Meanwhile, the variable educational level (p=0,000l). knowledge level (p=0,000), and the history of suffering from IMS symptoms (p=0,000) have showed the significant relation with the behaviours of using condoms among FSW consumers. The multivariate analysis with Propensiry Score Marching, either nearest neighbor or caliper show that varlabel age and marital status have to be excluded hom the model because the reductive bias before matching process is lower than after the match. The final result of the analysis of PSM on a fit model is found the same value for both algoritma either OR value or T-stat value. The value of odds rario (OR) is 2,3 (95%Cl=l,2-4,5). This means that the FSW consumers with adequate exposed information of HIV/AIDS have 2,3 times of possibilities to use condoms consistently compared with the other ones, who do not have enough exposed infonnation of HIV/AIDS, and T-stat value is 0,85(p>0,05) which means the relationship between the level of exposed infomation of HIV/AIS and the behavior of condom use among FSW consumers in Papua have not significant. Based on the results of this research, it is suggested that the managers of the HIV/AIDS programs either in the centre or in district areas to improve the intensity and the depth of relevant infomation of HIV/AIDS for high risk community groups, to develop the roles of health workers, and to build a good relationships and supports with religionists, traditional/ cultural values, NGO‘s, local businesses and formal educational institutions in order to be able to spread and share accurate, adequate and proper information about HIVIAIDS. It is also suggested to involve communication experts and encourage companies and electronic medias of communication to be more active in anticipation and controling the spreads of HIV/AIDS and the socialisation of using condoms, empowering the high risk groups (peer group) to take in part of HIV/AIDS infomation spreading, and the local policy makers are suggested to make l00% condom policy.
Kata kunci : GSEM, Penasun, Perilaku Seks Berisiko
