| Table of contents |
Foreword ................................................................................................................................. i
Table of Content .................................................................................................................... v
List of Figues .......................................................................................................................... ix
List of Tables .......................................................................................................................... xiii
List of Abbreviation .............................................................................................................. xv
Table of Key Indicators ........................................................................................................ xxiii
Introduction ............................................................................................................................ 3
Background ...................................................................................................................... 3
Survey Methodology ...................................................................................................... 4
1. Risk of HIV Spread ....................................................................................................... 5
The HIV/AIDS Epidemic and Dynamics of High Risk Behavior............................ 5
The HIV/AIDS Epidemic in Indonesia ....................................................................... 7
A. Transmission Through Commercial Sex .......................................................... 8
High Risk Sex and Mobility .................................................................................. 9
Background of Commercial Sex Workers and Their Clients ........................... 11
Types of Employment Among Sex Workers' Clients ....................................... 12
Trends in the Commercial Sex Industry.............................................................. 13
Frequency of Commercial Sex Contacts .............................................................. 14
The Price of Sex ....................................................................................................... 15
B. Transmission among Injecting Drug Users...................................................... 16
Circle of Friends ..................................................................................................... 16
“Shooting up” Together ........................................................................................ 17
Length of Addiction .............................................................................................. 17
Buying Drugs Together.......................................................................................... 18
Preferred Locations for Shooting Up .................................................................. 19
Injecting Frequency................................................................................................. 19
Access to Clean Needles/Syringes ...................................................................... 19
Mobility of Injecting Drug Users .......................................................................... 20
Mobility of Injecting Drug Users .......................................................................... 20
2. High Risk Behavior and Trends ................................................................................ 23
A. High Risk Behavior among Sex Workers and Their Clients......................... 23
Sexual Behavior Trends ......................................................................................... 23
Sexual Behavior Among High Risk Males .......................................................... 26
Influence of Alcohol and Drugs on Non-Use of Condoms During
Commercial Sex ..................................................................................................... 29
Risk Perceptions among High Risk Individuals ................................................ 31
B. High Risk Behavior among Injecting Drug Users .......................................... 32
Frequency of “Berbagi Basah” .............................................................................. 32
Influence of Purchasing Drugs Together on “Berbagi Basah” ......................... 33
Sharing of Needles/Syringes in the Last Week ................................................. 35
Injecting Behavior .................................................................................................. 35
Borrowing/Lending of Needles/Syringes ......................................................... 36
Preferred Locations for Sharing Needles/Syringes .......................................... 36
Incorrect Sterilization ............................................................................................. 36
Sexual Behavior....................................................................................................... 37
3. HIV Prevention Behavior ............................................................................................ 39
A. Risk-Reduction Behavior among Commercial Sex Workers and
Their Clients........................................................................................................... 39
Appropriate behavior for preventing the spread of HIV includes
abstaining from sex, monogamy, the use of condoms during high risk sex,
and not sharing needles/syringes........................................................................ 39
Condom-Use Behavior During Anal Sex ............................................................ 41
Use of Lubricant During Anal Sex ....................................................................... 42
Condom Use in Commercial Sex According to Awareness, Access,
Availability and Willingness to Suggest Condom Use ..................................... 43
Principal Reasons for Not Using Condoms ........................................................ 46
B. Risk Reduction among Injecting Drug Users ................................................. 47
Using Own Needles/Syringes ............................................................................. 47
Not Sharing Needles/Syringes ............................................................................ 48
Correct Sterilization of Needles/Syringes .......................................................... 49
Participation in Rehabilitation Programs ........................................................... 50
Reducing Risks from Sexual Behavior ................................................................ 51
Outreach and Intervention ................................................................................... 51
4. Treating Sexually Transmitted Infection (STI) and HIV Testing ....................... 53
Erroneous Knowledge about How to Prevent HIV................................................... 53
Trends in Seeking Treatment for Sexually Transmitted Infection (STI) ................ 55
HIV Infection Can Only Be Confirmed by a Blood Test .......................................... 59
HIV Testing ..................................................................................................................... 60
5. High Risk Behavior among Young People ............................................................... 63
Outreach and Education on Sexual Abstinence and the Dangers of Drugs .......... 64
HIV/AIDS Awareness ................................................................................................... 65
Sexual Behavior .............................................................................................................. 68
Drug Use .......................................................................................................................... 69
Influence of Outreach Activities on High Risk Behavior among Young People .. 71
6. Prevention Programs and Their Impacts .................................................................. 73
Prevention Programs ..................................................................................................... 73
Outreach Programs ........................................................................................................ 74
Condom Distribution ..................................................................................................... 75
Program Impacts ............................................................................................................ 77
7. PMobility among High Risk Subpopulations and Relations Between High
Risk Subpopulations .................................................................................................... 83
A. Mobility of High Risk Subpopulations ........................................................... 83
Mobility of female commercial sex workers ...................................................... 84
Client Mobility ........................................................................................................ 85
Mobility of Transsexual Commercial Sex Workers ........................................... 86
Mobility of Male Prostitutes ................................................................................. 86
Injecting Drug User Mobility ............................................................................... 87
B. Transmission of HIV between High Risk Subpopulations ......................... 88
8. Conclusions .................................................................................................................... 89
Appendix ........................................................................................................................... 95
A. Behavior Surveillance Survey (BSS) ................................................................. 97
B. Survey Methodology ............................................................................................ 99
Survey Targets ........................................................................................................ 99
Results of Listing .................................................................................................... 102
Sample Size ............................................................................................................. 105
C. Characteristics of Respondents ......................................................................... 107
Age .......................................................................................................................... 107
Marital Status .......................................................................................................... 109
Education ................................................................................................................ 109
Mobility Patterns ................................................................................................................... 111 |
