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Kata kunci : GSEM, Penasun, Perilaku Seks Berisiko
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.
Adolescents are part of the nation's next generation who have a big role in the progress of a nation. Characteristics of adolescents tend to have high curiosity, want to be recognized for their existence and unstable emotions, easily influenced by friends, prioritizing group solidarity, causing adolescents to be vulnerable to risky sexual behavior. This study aims to determine the effect of reproductive health knowledge on premarital sexual behavior of adolescents aged 15-24 years in Indonesia using the 2017 IDHS data. The design used in this study was cross sectional with a sample of 12,903 respondents who met the study inclusion criteria. The results showed that 44% of respondents who are currently or have been dating who have ever engaged in premarital sexual behavior and respondents who have low knowledge are 40.9%. The results of the multivariate analysis of the effect of knowledge of reproductive health on premarital sexual behavior found that respondents who had knowledge of low reproductive health had a risk of engaging in premarital sexual behavior by 0.8 times compared to those who had high knowledge after being controlled by peer influence.
The progression of Human Immunodeficiency Virus (HIV) infection in theworld is very progressive. Since found in 1981 until 2016 the number of cases hasreached tens of millions of lives. The number of new HIV infections in CirebonRegency has the same as the condition of the world. In 2017 the number of new casesincreased by 50% compared to 2009. The spread of HIV infection is still concentratedin the key population with the main transmission pattern through unsafe sex. Primaryprevention undertaken are early detection of a HIV status and counselling of riskfactors through Voluntary Counseling and Testing (VCT) activities. This study aims todetermine the magnitude of the association between risky sexual behavior with HIVinfection on VCT Clients in Cirebon Regency.This was cross sectional study using secondary data of VCT in 2017. Thepopulation is clients who visit VCT clinic, doing pre-test counselling, HIV test andpost-test counselling. Clients are key populations (gay / MSM, customer sex workers,IDUs, sex workers, transgender, and prisoners), TB patients and legaly sex partner.Logistic regression analysis was used to estimate association between risky sexbehavior and HIV infection after controlled covariate variables.Nearly 3.0%. (85/2,858) of tested clients were positif HIV and 80.4%(2,299/2.858) client had risky sexual behavior. There was a significant associationbetween risky sex behavior and HIV infection on VCT clients in Cirebon Regency(Adjusted POR=2.23 (1.019-4.899) after controlling to gender.The proportion of risky sex behaviors in VCT clients is very high, VCT clientswho engage in sex-risk behaviors had a risk of 2.23 times for HIV infection comparedto VCT clients who do not engage in risky sexual behavior. It is recommended to theCirebon Health Office to improve promotive and preventive programs to enhancingcommunity knowledge and skills in preventing HIV infection, conducting outreachtraining in terms of regulatory and advocacy techniques, increasing the frequency ofVCT and improving the duration and quality of counselling in VCT.Key words:HIV, VCT, Risky sexual behavior, Cirebon Regency.
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
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.
