Condom Use Among Men Who Have Sex With Men and Male-to-Female Transgenders in Jakarta, Indonesia.

This article examined differences in condom use during anal intercourse among men who have sex with men (MSM) and male-to-female transgender women in Jakarta, Indonesia. A cross-sectional design, structured interviews, and hierarchical linear modeling were used to examine condom use among MSM recruited from entertainment places (EPs; e.g., discotheques/dance clubs/karaoke bars), massage parlors (MPs), and among transgender women who congregated and/or sought sexual partners on streets/parks (S/P). The sample consisted of 91, 97, and 114 of MSM-EP, MSM-MP, and transgender-S/P, respectively. Respondents reported on 641 unique sexual partner encounters, which were "nested" within 302 respondents. Reported condom use was high, 66%, 84%, and 83% for MSM-EP, MSM-MP, and transgender-S/P, respectively, and varied across type of respondent. At the individual level, depressive symptoms and history of physical abuse during childhood and adulthood were associated with lower condom use (p < .05). By contrast, having a higher level of education was associated with more condom use (p < .05). At the partner level, condom use was associated with type of partners and the use of club drugs before sex. HIV-prevention efforts should take into account the multilevel determinants of condom use within these populations.

Studying alcohol use prior to sexual intercourse among female sex workers in eastern Indonesia.

Researching female sex workers (FSWs) in Indonesia, where commercial sex tends to be hidden or undercover, is challenging but possible. This is even more challenging when it involves investigation of sensitive behaviors, such as their alcohol use, a known disinhibitor to risk behavior. The adoption of effective strategies is needed to increase response rates and improve data quality. This article describes procedures used to research FSWs' alcohol use during commercial sex in the Eastern part of Indonesia. Challenges, lessons learned, and recommendations for best practices are discussed.

Sex work venue and condom use among female sex workers in Senggigi, Indonesia.

This paper examines the structural influence of sex work venues on condom use among female sex workers in the Senggigi area of Lombok, Indonesia. A cross-sectional design employing ethnographic observation, structured interviews and hierarchical linear modelling was used to examine condom use among female sex workers who solicited clients at three types of sex work venues: (1) freelance locations, (2) brothels and (3) entertainment places (karaoke bars and massage parlours). The sample consisted of 115 women 'nested' within 16 sex work venues drawn from the three venue types. Rate (39%) of condom use varied across sex work venues. Perceived management style, HIV/AIDS-related policies and risk-reduction services differed by venue, but this variation did not explain differences in condom use. At the individual level, higher condom use was associated with female sex workers having ever been married. At the client level, condoms were more likely to be used with foreign rather than domestic/local Indonesian clients. Low rates of condom use among Indonesian female sex workers during commercial sex suggests the need for increased HIV-prevention efforts that acknowledge sex worker characteristics and relationships with clients that place them at risk. Future research into the effects of social context on HIV risk should also be considered.

A venue analysis of predictors of alcohol use prior to sexual intercourse among female sex workers in Senggigi, Indonesia.

BACKGROUND: Female sex workers' (FSWs') use of alcohol, a known disinhibitor to risk behaviour, has been largely understudied. Knowledge of how various sex work venues influence FSW's alcohol consumption before engaging in commercial sex is even rarer. Our analysis identifies those factors across three types of sex-work venues that predict alcohol use among FSWs prior to paid sexual intercourse with clients. Our data were collected through structured interviews with FSWs engaging in commercial sex in Senggigi Beach, Lombok Island in the eastern Indonesian province of West Nusa Tenggara. METHODS: Employing a cross-sectional and multilevel design, three categories of venues where FSWs meet clients in Senggigi were sampled: (1) discotheques and bars (freelance), (2) brothels, and (3) recreational enterprises such as karaoke establishments and massage parlors. The sample consisted of 115 women "nested" within 16 sex work venues. The FSWs reported on 326 clients interactions. RESULTS: Results show that FSWs consumed alcohol before commercial sex with 157 (48%) of the 326 clients interactions. Alcohol use varied by differences in HIV policies and services offered at the sex work venue, the FSW's educational level and age, and client characteristics. CONCLUSION: Alcohol use is common prior to sexual intercourse among FSWs and their clients in Senggigi, and the venue where FSWs meet their clients influences the women's alcohol use. Freelancers were likelier to use alcohol than those who work at brothels and recreational enterprises. Given the recognized links between alcohol use prior to sex and high risk behaviour, HIV prevention programmes that discourage alcohol use should be introduced to both women who engage in commercial sex and also sex-work venue managers, owners, and clients.