High condom use but low HIV testing uptake reported by men who purchase sex in Bali, Indonesia

ABSTRACT

Men who purchase sex (MWPS) have long been considered as one of the population groups at risk of HIV transmission. However, while HIV-related interventions have been targeted towards this group, few studies have directly recruited MWPS to measure the impact of such interventions. This study aimed to fill the gap for Indonesia by identifying the level and predictors of condom use and HIV testing among MWPS, to inform prevention strategies. A cross-sectional study was conducted by surveying 200 MWPS in Bali, Indonesia in 2015. A structured questionnaire was administered to collect the data. Self-reported condom use on the occasion of last paid sex was very high (88.5%), while a history of HIV testing was low (8.1%). None of the variables identified in this study were associated with condom use at last paid sex. Men were more likely to report a history of HIV testing if they: perceived themselves to be at high risk of HIV, had a higher level of HIV-related knowledge, reported a history of genital ulcers or urethral discharge in the past 12 months, or were aware that confidential HIV testing was available. Implications and limitations of this study are discussed.

KEYWORDS:

• HIV test
• condom use
• clients of sex workers
• men who purchase sex
• Indonesia

Acknowledgment

This study was a collaboration of Udayana University, Bali and the Kirby Institute at UNSW, with funding from Udayana University International Collaboration Research Grant (Skim Riset Kerjasama Luar Negeri). This study is also part of Luh Putu Lila Wulandari’s PhD thesis, undertaken with the support of the Australia Awards Scholarship and funding from the Australian Department of Foreign Affairs and Trade. John Kaldor is the holder of an NHMRC Research Fellowship. We acknowledge Yayasan Kerti Praja, field workers and participants involved in this study. We also acknowledge the role of UNSW Research Training Statistical Consulting Services for their advice on the quantitative analysis of this study.

Disclosure statement

No potential conflict of interest was reported by the authors.

ORCID

Luh Putu Lila Wulandari http://orcid.org/0000-0002-3397-3648