Surveillance-Based Program Planning

OBJECTIVE: to analyze the Integrated Behavioral & Biological Surveillance (IBBS) 2011 data for designing a condom utilization program. INTRODUCTION: The IBBS is part of the Indonesian MoH HIV Surveillance System, which include Serological Surveillance, Behavioral Surveillance, Reproductive Tract Infection Survey, and monthly HIV/AIDS facility-based (hospitals, HCs, VCT Sites) monthly reports. The IBBS 2011 was conducted in 11 provinces (22 districts/municipalities) encompassing eight Most At Risk Populations (MARPs) – injection drug users, transsexuals, men who have sex with men, youths, inmates, mobile men, direct female sex workers (FSWs), and indirect FSWs. Data of 442 direct FSWs of the Jayapura Municipality and Jayawijaya District (Papua Province) showed that 406 (91.85%) have sex with partners who did not use condoms. Of these 406 FSWs 60 (14.78%) were HIV positive and 231 (56.89%) were STD positive. METHODS: Items of the Direct FSW Questionnaire, IBBS 2011, were examined and items that would yield information regarding content and method of HIV prevention interventions by means of condoms were identified. The Stata12 software was used to inspect/codebook the variables related to the selected items, to recode numeric data into categorical data, to generate one-way and two-way tables, and to produce pairwise correlations (and their significance levels). RESULTS: The Direct FSWs IBBS 2011 data of the Jayapura Municipality and Jayawijaya District showed that there are significant positive correlations between condom use behavior variables of FSWs (i.e., to know, to possess, to buy, and to offer male condoms) and variables of last-sex encounter condom use by customers, and between the latter and HIV and STD lab results. The correlations were low, however, of the condom use behavior variables and variables that are related to comprehensive knowledge of HIV prevention, condom use by more steady sex partners (e.g., husbands, boyfriends, other males) and female condom utilization, and during last-week and last-month sex transactions. The data analyses also indicated details of the distribution of the FSWs, with their condom use behaviors, according to individual characteristics, CIE (communication, information & education) intervention utilization, condom acquirement, and sexual behavior. CONCLUSIONS: The condom utilization campaigns ought to focus on continuous reminders (instead of education programs) about how to persuade customers and other sex partners to use condoms, or to allow FSWs to use female condoms, and about where to go for HIV/STD testing and treatment. The condom promotion drives should use posters, TV ads, and field/health workers, The program should also make certain that good quality condoms be made avaible by local managers (of brothels, hotels, bars, etc.) and local vendors (drugists, stands, mobile carts).