Abstract

Objectives: This article reports new surveillance data on prevalence of sexual risk taking, HIV and other sexually transmitted infections (STIs) among four occupational groups of Indonesian men thought to be at elevated risk of infection.

Methods: Behavioral survey data were collected from 3,008 men in 11 cities, among whom 2,158 men were tested for HIV and syphilis and 1,950 for gonorrhea and Chlamydia. Risk factors for STIs were assessed using multivariable logistic regression.

Results: Thirty-six percent of men had sex with a female sex worker in the previous year and 20% with non-marital female partners. Consistent condom use was low with both sex workers (17%) and other non-marital partners (13%). HIV prevalence was 2% in Papua and <1% elsewhere, but was for the first time detectable in a non-core transmitter male population outside of Papua. STI rates were high for a non-core transmitter group, especially syphilis. Truck drivers were the most at risk. Multivariable analyses revealed exposure to female sex workers and inconsistent condom use, along with geographic location (Papua vs. non-Papua) and unobserved factors associated with certain occupational groups, to be key risk factors for STI infection.

Conclusions: The results confirm that men in the four occupational groups are reasonable proxies for “high-risk men” for surveillance purposes in Indonesia. Although HIV prevalence was low, the extent of sexual risk taking and the moderately high levels of STIs among these men, along with rising HIV rates among female sex workers, indicate potential for HIV/AIDS transmission in Indonesia to accelerate.