Female Sex Workers In Indonesia Research Articles

Risk Factors of Syphilis Infection among Female Sex Workers (FSW) in Indonesia 2018/2019: A Cross Sectional Study

Background: Syphilis is one of the most common causes of curable bacterial sexually transmitted infection (STI) worldwide. Female sex workers (FSW) are the key population to be affected by STI. in Indonesia, little is known about syphilis infection in most at risk population. This study aimed to know the risk factors of syphilis among FSW in Indonesia 2018-219.Methods: This research uses Cross Sectional study design. This study used secondary data based on the Integrated Biological and Behaviour Survey (IBBS) 2018-219. The study population was 5,816FSWs who registered in the IBBS 2018-2019 in 16Districts/Municipalities in Indonesia. The study sample was derived from an eligible population that met the inclusion criteria=5,647 respondents.Results: The results show the prevalence of Syphilis among FSW was 1.3%. Syphilis infection is associated tocondom consistent (OR=1.7 ; 95%CI=1.094– 2.853 and STI Information (OR=1.7; 95%CI=1.115–1.788).Conclusion: FSWs who do not use condoms consistently and correctly when having sex with customers and those who do not receive health information about syphilis are at higher risk of syphilis infection. For this reason, FSWs must use condoms consistently and correctly every time they have sex with customers.

The short-term effects of COVID-19 on HIV and AIDS control efforts among female sex workers in Indonesia

BackgroundThe COVID-19 pandemic has raised concerns as to its impact on other health programs. One program that appears particularly vulnerable is HIV and AIDS. We undertook an assessment of COVID-19 impact on HIV control efforts in Indonesia for a sub-population that has received little attention in the global literature—female sex workers (FSW).MethodsThe study was undertaken in 23 National AIDS program priority districts. Four sources of monthly data during January–July 2020 were considered. COVID-19 infection data were extracted from national and district surveillance systems. Combination prevention program outputs were reported by civil society organizations (CSOs) providing community support services to FSW. These organizations also undertook monthly scans of levels of commercial sex activity and HIV testing availability. We also considered data from an ongoing HIV community screening trial. The primary mode of analysis entailed comparisons of levels and trends of indicators from the four data series.ResultsCommercial sex activity was severely curtailed in April–May in many districts. While recovering to pre-COVID-19 levels in “Localization” areas, the number of active FSW in July was one-third below that in February. HIV testing service availability declined by 50% at health facilities before recovering slowly, while mobile clinic services largely ceased during April–June. Numbers of FSW reached, condoms distributed, FSW tested for HIV, HIV cases detected, and FSW starting treatment all declined precipitously in April/May but had largely recovered to pre-COVID-19 levels by July. We found only a temporary dip in treatment initiation rates among HIV positive FSW and no discernible impact on treatment retention. The HIV community screening trial data revealed significant demand for HIV testing among FSW that was not being met even before the onset of COVID-19.ConclusionsCOVID-19 has had at least short-run economic effects on FSW and the national response to HIV and AIDS targeting FSW. However, the effects appear to have been cushioned by community-based services and support in study districts. The findings make a compelling case for the expansion of community-based services irrespective of the future trajectory of COVID-19. As COVID-19 has not yet been contained, the trajectory of economic activity and service delivery is uncertain.

Web-Based Multifaceted Approach for Community-Based HIV Self-Testing Among Female Sex Workers in Indonesia: Protocol for a Randomized Community Trial.

BackgroundNew HIV infections in Indonesia continue to be concentrated among key populations, including female sex workers (FSWs). However, increasing HIV testing among this subpopulation remains a challenge, necessitating exploration into alternative testing modalities.ObjectiveThis study aims to assess whether the addition of an oral fluid testing option in community settings would increase the rate of HIV case identification among FSWs. Because the study was implemented early in the outbreak of COVID-19 in Indonesia, a secondary objective is to assess approaches and tools for implementing both community outreach and community HIV screening for FSWs during pandemic conditions.MethodsWe undertook a community-based randomized trial in 23 national priority districts in which community outreach services were being provided. Community-based screening using an oral fluid-based rapid test was added to the community outreach standard of care in intervention districts with clients having the option of performing the test themselves or being assisted by outreach workers. A web-based system was created to screen for eligibility and collect participant data and test results, facilitating the process for both unassisted and assisted participants. Participants with reactive screening results were encouraged to undergo HIV testing at a health facility to confirm their diagnosis and initiate antiretroviral treatment as needed. Multiple means of recruitment were deployed including through outreach workers and social media campaigns.ResultsOf the 1907 FSWs who registered, met the eligibility criteria, and gave consent to participate, 1545 undertook community oral fluid test (OFT) screening. Most (1516/1545, 98.1%) opted for assisted screening. Recruitment via social media fell far short of expectations as many who registered independently for the OFT because of the social media campaign did not identify as FSWs. They were eventually not eligible to participate, but their interest points to the possibility of implementing HIV self-testing in the general population. The successful recruitment through outreach workers, facilitated by social media, indicates that their roles remain crucial in accessing FSW networks and improving HIV testing uptake.ConclusionsThe addition of HIV self-testing to the standard of care supported by a web-based data collection system was able to increase HIV case identification among FSWs in intervention districts. The high satisfaction of OFT users and the interest of the general population toward this alternative testing modality are promising for scaling up community HIV screening nationally.Trial RegistrationClinicalTrials.gov NCT04578145; https://clinicaltrials.gov/ct2/show/NCT04578145International Registered Report Identifier (IRRID)RR1-10.2196/27168

Corrigendum to: A strengths-based analysis of social influences that enhance HIV testing among female sex workers in urban Indonesia

Background: HIV prevalence among female sex workers in Indonesia remains high and large proportions of female sex workers have never been tested for HIV. International research highlights the importance of community-led strategies to increase HIV testing in this population. Little qualitative research has been conducted to address these issues in Indonesia or other Asia-Pacific countries. This paper documents social influences that enhance HIV testing among female sex workers in urban Indonesia. Methods: This was an interpretive qualitative study in Yogyakarta, Denpasar and Bandung. In total, 57 female sex workers participated in 11 focus group discussions, and four participated in individual semi-structured interviews. Deductive and inductive thematic analysis techniques were used to identify narratives of strengths pertaining to uptake of HIV testing. Results: Participants described supportive relationships with peers, community-based organisations and 'bosses'. Participants reported trusted networks with peers within which to share information about HIV testing and receive emotional support. Relationships with community outreach workers facilitated HIV testing through reminders, accompanied visits, and emotional/informational support. Community-based organisations worked with health services to facilitate mobile, community-based testing to overcome employment- and family-related constraints that inhibited women's clinic attendance. 'Bosses' employed a variety of practices to encourage HIV testing among their workers. Conclusions: Relationships, practices and action in community- and workplace-based settings outside formal health service spaces enhanced HIV testing among female sex workers. Community- or workplace-based HIV testing with outreach support from health services, peer-led HIV testing within existing social and work-based networks, and working with bosses to implement HIV prevention strategies can address low HIV testing rates in this key population.

The Determinants of Sexually Transmitted Infections (STIs) among Female Sex Workers (FSWs) in Indonesia: The Literature Review

STIs is the 10 biggest serious disease in many developing countries, primarily among FSWs (female sex workers). Additionally, the Ministry of Health Indonesia in January-March 2017 reported Female Sex Worker is the highest risk population (8.765 cases) regarding to syndrome approach and laboratory examination to have STIs with diagnosing outcome. The objective of this study is to conduct a literature review and to examine the determinants of STIs among FSWs as found in the published papers. The subject of this study is female sex workers in Indonesia. This study used literature review from six internet data based (Scopus, Medline, Google Scholar, ProQuest, CINAHL, and PubMed). It got 183 scientific articles and selected 17 based on inclusion criteria. The articles chronicled by inclusion criteria in the revised PRISMA flow diagram of article review and inclusion and review by Social Cognitive Theory (SCT). The selected articles were published between 1997 to 2016. Variables which reviewed consist of: cognitive/personal factors which were found are age (14 of 17), education (7 of 17), duration of sex work (7 of 17), behaviour factors which found condom use (8 of 17), number of client (7 of 17), past symptoms (3 of 17), environmental factors which found sex venue (2 of 17), place of origin (2 of 17), and protection (1 of 17). Strongly determinants related to STIs among FSWs in Indonesia are age, education, duration of sex work, condom use, number of clients, past symptoms, sex venue, place of origin, and protection.

Barriers to HIV testing among male clients of female sex workers in Indonesia

BackgroundFrequent engagement of men in sexual encounters with female sex workers (FSWs) without using condoms places them at a high risk for HIV infection. HIV testing has been noted to be among important strategies to prevent HIV transmission and acquisition. However, it is known that not all men willingly undertake an HIV test as a way to prevent HIV transmission and/or acquisition. This study aimed to identify barriers to accessing HIV testing services among men who are clients of FSWs (clients) in Belu and Malaka districts, Indonesia.MethodsA qualitative inquiry employing face to face open ended interviews was conducted from January to April 2017. The participants (n = 42) were clients of FSWs recruited using purposive and snowball sampling techniques. Data were analysed using a qualitative data analysis framework.ResultsFindings indicated three main barriers of accessing HIV testing services by clients. These included: (1) personal barriers (lack of knowledge of HIV/AIDS and HIV testing availability, and unwillingness to undergo HIV testing due to low self-perceived risk of HIV and fear of the test result); (2) health care service provision barriers (lack of trust in health professionals and limited availability of medication including antiretroviral (ARV)); and (3) social barriers (stigma and discrimination, and the lack of social supports).ConclusionsThese findings indicated multilevelled barriers to accessing HIV testing services among participants, who are known to be among key population groups in HIV care. Actions to improve HIV/AIDS-related health services accessibility are required. The dissemination of the knowledge and information on HIV/AIDS and improved available of HIV/AIDS-related services are necessary actions to improve the personal levelled barriers. System wide barriers will need improved practices and health policies to provide patients friendly and accessible services. The societal levelled barriers will need a more broad societal approach including raising awareness in the community and enhanced discussions about HIV/AIDS issues in order to normalise HIV in the society.

Perceptions of Determinants of Condom Use Behaviors Among Male Clients of Female Sex Workers in Indonesia: A Qualitative Inquiry.

This study aimed to explore perceived determinants of condom use behaviors among male clients of female commercial sex workers (FCSWs) in Belu and Malaka districts, Indonesia. One-on-one in-depth interviews guided by the Health Belief Model (HBM) were used to collect the data from participants (n = 42). The Framework analysis for qualitative data was employed to analyze the data. Results demonstrated several factors associated with lack of and inconsistent condom use among the participants. They included self-perceived risk of contracting HIV infection, knowledge of the severity of HIV illness and its impacts, and condom use: its benefits and its influencing factors. Additionally, factors including reduced sexual pleasure and the lack of knowledge of how and where to access condoms were important perceived barriers to condom use among participants. Having seen images of HIV-/AIDS-positive people, knowing friends and relatives suffering from HIV, and knowing FCSWs as a high-risk group for HIV infection were the cues to using condoms among several participants. Likewise, self-efficacy was also associated with condom use behaviors among the participants. The findings indicate the needs for HIV/AIDS interventions that include dissemination of HIV/AIDS knowledge, condom promotion, and improvement in the availability of condoms for both FCSWs and their clients.

The Risk Factors Analysis Occurrence of Chlamydia Infection to Direct Female Seks Workers (DFSW) in Indonesia

Chlamydia infection is one of the most common sexually transmitted infections worldwide. Based on data of IBBS 2015 in Indonesia, the highest prevalence of chlamydia occurred in direct female sex worker group (32.21%). This study a STIs to determine the risk factors for chlamydia infection in direct sex workers. This research uses Cross-Sectional study design. The population of this study were all direct female sex workers as many as 3,789 people with samples in accordance with inclusion and exclusion criteria as many as 3.114 people. The prevalence of direct female sex workers with chlamydia infection was 1.018 (32.4%). The result of the analysis showed that there was a relationship between age (PR: 0.541 95% CI: 0.456-0.643) and length of work as FDSW (PR: 1,.60, 95% CI: 1.087-1.512) chlamydia infection in female sex workers in Indonesia. most dominant variable has an effect on the incidence of chlamydia infection that is long working as FDSW after controlled by age (PR 1.282 95% CI: 1.087-1,.12). It is expected for the government to improve the implementation of prevention program of chlamydia not only among female sex worker but also proactive to customer.

HIV susceptibility among clients of female sex workers in Indonesia: a qualitative inquiry.

A qualitative inquiry using one-on-one in-depth interviews was conducted in the Belu and Malaka districts of Indonesia from January to April 2017. The study participants (n =42) were the clients of FSWs recruited using the snowball sampling technique. The inclusion criteria were: being a client of FSWs and being aged 18 years or more. Data were analysed using a framework analysis. Findings were grouped into two main emerging themes that included behavioural and socioeconomic factors. Behavioural factors that mediated HIV susceptibility among clients of FSWs were: frequent engagement in unsafe sex with multiple sex workers; low perceptions of the relevance of available HIV and AIDS services and limited access to these services; and HIV stigma or fear of being labelled as HIV positive. Socioeconomic factors included: participants' economic situation; and individuals' household responsibility and ability to afford FSWs services. The study results indicate the need to reformulate and improve HIV and AIDS-related services, including increasing the level of availability of HIV service points and the dissemination of knowledge and information about HIV and AIDS and condom use and making them accessible to both FSWs and their clients in Belu and Malaka districts.

FACTORS AFFECTING THE UTILIZATION OF VOLUNTARY COUNSELING AND TESTING (VCT) SERVICE AMONG FEMALE SEX WORKERS IN INDONESIA: A SYSTEMATIC REVIEW

Human Immunodeficiency Virus - Acquired Immuno Deficiency Syndrome (HIV-AIDS) is one of depressing urban health encountered by the Indonesian citizen. Female sex workers are group at risk and one of the key of HIV transmission. During sexual intercourse, female sex workers didn’t pay attention to the status of customer that infected with HIV / AIDS or not. This review present to identify factors and the most influence factors in the utilization of voluntary counseling and testing (VCT) service among female sex workers in Indonesia The method use online database such as journal.fkm.ui.ac.id, journal.ugm.ac.id, ejournal.undip.ac.id, jornal.unair.ac.id, portalgaruda.id and google scholar. The keywords to search article in database online is fact or VCT or HIV-VCT or female sex workers. There are four eligible articles to review after filtered by inclusion criteria. Result from this review, factors in utilization of VCT services by female sex workers is perception of vulnerability of HIV/AIDS, perception of severity of HIV/AIDS, perception of benefits of VCT, VCT obstacle perception, motivation of VCT, knowledge of HIV/AIDS and VCT, attitude of HIV/AIDS and VCT, facilities, support by councelor, beliefs about VCT, value of knowing their HIV status and motivation to comply other’s support. The most influence factor is level of knowledge about VCT. Based on the result of this review and the description of articles, utilization of VCT Service among Female Sex Workers in Indonesia influenced by knowledge of VCT. For the next research can investigate about comparing the methods in the utilization of services in the female sex workers and other high-risk populations. Article DOI: https://dx.doi.org/10.20319/lijhls.2016.23.3947 This work is licensed under the Creative Commons Attribution-Non-commercial 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc/4.0/ or send a letter to Creative Commons, PO Box 1866, Mountain View, CA 94042, USA.

FEMALE SEX WORKERS’ ATTITUDES TOWARD HIV TESTING: A STUDY AMONG INDIRECT SEX WORKERS IN BANTUL, YOGYAKARTA, INDONESIA

Background: HIV prevalence among female sex workers in Indonesia is among the highest in Asia after Papua New Guinea and Malaysia. Indirect sex workers posed a heightened risk of HIV infection compared to direct sex workers because they usually earn less than their direct counterpart and have lower bargaining power in condom use.
 Objective: This study aims to examine the factors influencing indirect sex workers’ attitudes toward HIV testing.
 Methods: This study employed a quantitative method with a cross-sectional approach involved 67 indirect sex workers from massage parlors and beauty salons in Bantul district. Descriptive analysis of respondents’ attitude, perceive threat and expectation was drawn from Health Belief Model Theory.
 Results: The majority of indirect sex workers had positive attitude towards HIV testing. They are aware to the importance of condom in every commercial sex works, but the majority believe themselves were not susceptible to HIV-AIDS due to their preference to healthy-looking clients to serve sex. Personal expenses to visit the health center for HIV testing are less considered compared to public opinion and discrimination. Peers encouraged the workers to get tested. Disseminating HIV/AIDS information to sex workers through media and mobile phone are not successful.
 Conclusion: The findings of the study carrying an expectation that when individuals’ attitudes toward HIV testing are positive, the likelihood of getting themselves tested would also be higher. Since the perception is driven by information as stimulus, it is important to provide continuous information to create stimulus which eventually will influence their perception.

Increasing HIV Prevalence among Female Sex Workers in Indonesia: How is it Presented in the Media and in Scholarly Journals?

Within different target audiences, the media and scholarly journals have significant roles in enhancing the awareness and influencing the development of HIV prevention-related policies. However, particularly in developing and poor countries, the media seem to affect policy development in contradictory ways. Thus, it is interesting to investigate how the increasing prevalence of HIV among female sex workers (FSWs) in Indonesia is represented in the media and to compare this representation with those in scholarly articles.Using three types of newspaper and peer-reviewed scholarly articles, this paper found that the media tend to frame the problem and its risk factors as merely a health problem produced by unsafe behaviours that are inappropriate to the local culture and belief. Efforts to challenge dominant values through the involvement of local media should encourage local journalists to be aware of the consequences of their chosen media template. Furthermore, given the fact that the majority of scholarly articles included in the analysis focused more on the biological and behavioural factors of HIV infection, more social research is needed. Keywords: media, HIV, and policy

Transactional Sex Risk across a Typology of Rural and Urban Female Sex Workers in Indonesia: A Mixed Methods Study

Context-specific typologies of female sex workers (FSWs) are essential for the design of HIV intervention programming. This study develops a novel FSW typology for the analysis of transactional sex risk in rural and urban settings in Indonesia. Mixed methods include a survey of rural and urban FSWs (n = 310), in-depth interviews (n = 11), key informant interviews (n = 5) and ethnographic assessments. Thematic analysis categorises FSWs into 5 distinct groups based on geographical location of their sex work settings, place of solicitation, and whether sex work is their primary occupation. Multiple regression analysis shows that the likelihood of consistent condom use was higher among urban venue-based FSWs for whom sex work is not the only source of income than for any of the other rural and urban FSW groups. This effect was explained by the significantly lower likelihood of consistent condom use by rural venue-based FSWs (adjusted OR: 0.34 95% CI 0.13–0.90, p = 0.029). The FSW typology and differences in organisational features and social dynamics are more closely related to the risk of unprotected transactional sex, than levels of condom awareness and availability. Interventions need context-specific strategies to reach the different FSWs identified by this study's typology.

Sexual risk behaviours, HIV and other sexually transmitted infections among female sex workers in Indonesia

ObjectivesTo assess the HIV/AIDS epidemic situation among female sex workers (FSW) in Indonesia using data from the 2007 Integrated Biological-Behavioural Surveillance (IBBS).MethodsBehavioural data were collected from time–location samples of 5947...

Syphilis among female sex workers in Indonesia: need and opportunity for intervention

ObjectiveTo study the prevalence and factors associated with syphilis among female sex workers (FSWs) in Indonesia.MethodsDirect and indirect FSWs were sampled in 10 major cities in Indonesia. A behavioural survey...

Addressing the high prevalence of gonorrhoea and chlamydia among female sex workers in Indonesia: results of an enhanced, comprehensive intervention

ObjectivesThe authors developed a comprehensive STI-control programme to decrease gonorrhoea and chlamydia prevalence, and increase consistent condom use among brothel-based sex workers in Indonesia.MethodsThe STI-control programme for brothel-based sex workers...

Pacar and Tamu: Indonesian women sex workers' relationships with men

There are major differences between female sex workers in Indonesia in terms of income, places of work, ways of contacting clients, reasons for entering sex work and career progression. Yet, STD and HIV/AIDS intervention programmes and the majority of research projects often do not respect these differences. This paper describes relationships between female sex workers and clients and other male partners in Surabaya and Jakarta. Different relationships were associated with different attitudes to self cleansing, risk perception, preventive behaviour and the use of condoms. The concept of multiple identities is useful in understanding how sex workers negotiate their relationships with occasional clients, regular clients and boyfriends. Differences in relationship are moreover reflected in differences in role expectations and behaviours. In particular, perceptions of dirtiness ( kotor ) and non-dirtiness ( tidak kotor ) influence sex workers' behaviour with clients. Intervention programmes should address the complexities of these multiple identities and relationships, and should acknowledge sex workers as human beings involved in more than sexual transactions.