Abstract
A qualitative inquiry using individual interviews explored determinants of unprotected sexual behaviours favouring HIV transmission among Men who Have sex with Men (MSM) in Yogyakarta, Indonesia. The study was conducted in July 2015 with 24 MSM participants recruited using convenience sampling technique. Data were analysed using a qualitative data analysis framework, with the Social Cognitive Theory (SCT) employed as the study conceptual framework. Findings were grouped into a reciprocal triadic relationship involving behavioural, personal (cognitive) and environmental determinants. Behavioural determinants comprised having multiple casual sex partners, engagement in group sex and transactional sex practices. Environmental factors associated with unprotected sexual behaviours included influence of unsafe sex from regular partners and lack of access to HIV-related services. Personal (cognitive) determinants favouring unprotected sexual behaviours identified were lack of knowledge of condom and HIV/AIDS, individuals’ expectation of pleasurable sexual intercourse, and low self-efficacy to discuss condom use and HIV status with casual sex partners. As effort to address HIV in MSM in Indonesia is still at its infancy, the findings of the current study are insightful and will inform the development of evidence-based programs in addressing HIV/AIDS problem in MSM populations in Yogyakarta and other similar settings.
Highlights
Over the past ten years, Indonesia has experienced a fast growing number of people living with HIV/AIDS (PLWHA)
The 2017 national AIDS report and several studies in Indonesia have indicated that Men who have Sex with Men (MSM) populations are highly susceptible to HIV infection due to their frequent engagement in such behaviours (Kementrian Kesehatan RI, 2017; Morineau et al, 2011; Pisani et al, 2004; Prasetyo, et al, 2014)
Consistent with the results of several previous studies (El-Sayed, IA, & El-Gueniedy, 2008; Mimiaga et al, 2009; Morineau, et al, 2011; Poon, et al, 2013), the current study confirms that having multiple casual sex partners was one of the behavioural determinants strongly associated with HIV-risk sexual practice among the participants
Summary
Over the past ten years, Indonesia has experienced a fast growing number of people living with HIV/AIDS (PLWHA). The number of PLWHA increased from 6,093 in 2005 to 88,719 in 2010, 268,185 in 2015, and 319,103 in 2016, with corresponding rise in prevalence of HIV/AIDS from 0.05% in 2011, to 0.06% in 2012, 0.08% in 2013, 0.10% in 2014, 0.11% in 2015, and 0.13% in 2016 (Kementrian Kesehatan RI, 2017). The 2017 national AIDS report and several studies in Indonesia have indicated that Men who have Sex with Men (MSM) populations are highly susceptible to HIV infection due to their frequent engagement in such behaviours (Kementrian Kesehatan RI, 2017; Morineau et al, 2011; Pisani et al, 2004; Prasetyo, et al, 2014). The same report shows that the HIV prevalence among MSM in the country has steadily increased from 2.0% in 2011 to 3.1% in 2012, 5.0% in 2013, 6.4% in 2014, 7.6% in 2015, and 11.8% in 2016 gjhs.ccsenet.org
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