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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.
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.
