Objectives To assess the HIV/AIDS epidemic situation among female sex workers (FSW) in Indonesia using data from the 2007 Integrated Biological-Behavioural Surveillance (IBBS).
Methods Behavioural data were collected from time–location samples of 5947 FSW in 10 cities in late 2007. HIV, syphilis, gonorrhoea and chlamydia test results were obtained for 4396, 4324, 3291 and 3316 FSW, respectively. Trends in HIV prevalence were assessed via linkage with sentinel surveillance data. Factors associated with HIV, gonorrhoea and chlamydia infection were assessed using multivariable logistic regression.
Results HIV prevalence averaged 10.5% among direct and 4.9% among indirect FSW, and had increased steadily among direct FSW from 2002 to 2007. Prevalence of chlamydia, gonorrhoea and active syphilis averaged 35.6%, 31.8% and 7.3%, respectively, among direct FSW, and 28.7%, 14.3% and 3.5% among indirect FSW. Being a direct FSW, younger age and having current infection with syphilis and gonorrhoea and/or chlamydia were associated with a higher likelihood of HIV infection. Number of clients in the past week and consumption of alcohol before having sex were associated with a higher likelihood of gonorrhoea and/or chlamydia infection, while having received a STI clinic check-up in the previous 3 months and/or periodic presumptive treatment for sexually transmitted infections (STIs) in the past 6 months were associated with reduced likelihood of infection.
Conclusions The HIV/AIDS epidemic among FSW in Indonesia appears to be expanding, albeit unevenly across provinces and types of FSW. High STI prevalence is conducive to further expansion, but recent efforts to strengthen STI control appear promising.
- Female sex workers
- risk behaviours
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Funding Primary financial support for this research was provided by the US Agency for International Development (USAID) and the Indonesian Partnership Fund. Additional financial support was provided by WHO and the Australian Agency for International Development (AusAID) through the Indonesian HIV/AIDS Prevention and Care Project (IHPCP).
Competing interests None.
Ethics approval This study was conducted with the approval of the ethics committee of the Indonesian Centre for Biomedical and Pharmaceutical Research, Ministry of Health, as well as the Protection of Human Subjects Committee (PHSC), Family Health International.
Provenance and peer review Not commissioned; externally peer reviewed.