PrEP Use Awareness and Interest Cascade among MSM and Transgender Women Living in Bali, Indonesia
Abstract
:1. Introduction
2. Methods
2.1. Data and Samples
2.2. Procedures
2.3. Variables and Measures
- 1
- Classified as high risk for HIV infection: measured by questions on sexual behavior and STI diagnoses; those who reported any STI diagnoses in the last 6 months, >1 sexual partner in the last 6 months, and/or reported condom-less anal intercourse (CLAI) with MSM/waria partners in the last 6 months were classified as high risk.
- 2
- Self-perceived high risk for HIV infection: measured by the question, “Based on your sexual activities in the last 6 months, how likely do you perceive your risk of being infected with HIV?”; of 4 options provided for the participants (not at all at risk, less risky, risky, and highly risky) those answering “not at all” were classified as not perceiving themselves as high risk.
- 3
- Aware of PrEP: measured by the question, “Have you ever heard of or received information about PrEP?”; those answering “yes” were classified as being aware of PrEP.
- 4
- Interested in using PrEP: measured by the question, “Are you interested in using PrEP to protect yourself from HIV infection?”; those answering “yes” were classified as interested.
- 5
- Willing to do PrEP procedures: measured by the question, “How willing are you to take PrEP if it involves regular consultation visits including voluntary counselling and testing (VCT) and liver function check?”; those answering “yes” were considered to be willing to do PrEP procedures.
- 6
- Willing to pay 500,000 to 600,000 IDR for PrEP (the cost of locally available PrEP at the time): Measured by the question, “How willing are you to use PrEP if it costs 500,000–600,000 IDR per month?”; of the 5 options provided for the participants (highly unwilling, unwilling, slightly willing, willing, and highly willing) those answering “highly unwilling” and “unwilling” were classified as unwilling.
- 7
- Already in PrEP: measured by the question, “Have you ever used ARV as PrEP before any sexual activities?”; those answering “yes” were classified as already on PrEP.
2.4. Analysis
2.5. Ethical Consideration
3. Results
4. Discussion
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Variable | Number of Participants (n = 220) |
---|---|
Demography | |
Age (years) | |
<25 | 67 (30.5%) |
25–29 | 66 (30.0%) |
30–39 | 73 (33.2%) |
40 and above | 14 (6.4%) |
Not married to a woman | 200 (90.9%) |
Education | |
Primary education | 26 (11.8%) |
Senior high school | 128 (58.2%) |
University | 66 (30.0%) |
Full-time employee | 163 (74.1%) |
Income more than Bali minimum wage | 105 (47.7%) |
High social engagement as MSM/waria | 68 (30.9%) |
Adequate HIV risks/prevention knowledge | 93 (42.3%) |
Sexual and HIV Prevention-Related Behavior in the Last 6 Months | |
Sex with women | 73 (33.2%) |
Multiple sex partner | 111 (50.5%) |
Sex with the regular partner/s | 126 (57.3%) |
Inconsistent condom use | 136 (61.8%) |
Sex with casual partner/s | 128 (58.2%) |
Paid for sex | 34 (15.5%) |
Sexually transmitted infection (STI) diagnoses | 26 (11.8%) |
Assessed HIV high risk | 170 (77.3%) |
Self-assessed HIV high risk | 150 (68.2%) |
PrEP Awareness and Interest | |
Have heard of PrEP before | 36 (16.4%) |
Want to use PrEP | 164 (74.5%) |
Willing to do PrEP procedures | 134 (60.9%) |
Willing to pay 500K–600K IDR | 84 (38.2%) |
Have been in PrEP before | 2 (0.9%) |
Variables | Self-Perception of no HIV Risk | Self-Perception of High HIV Risk | Crude Odds Ratio (OR) | Adjusted OR (aOR) | ||||
---|---|---|---|---|---|---|---|---|
n = 41, n (%) | n = 129, n (%) | OR | 95% CI | p-Value | aOR | 95% CI | p-Value | |
Age | ||||||||
<25 years | 4 (9.8) | 49 (38.0) | Ref | Ref | Ref | |||
25–29 years | 10 (24.4) | 45 (34.9) | 0.37 | 0.11–1.25 | 0.110 * | 0.30 | 0.11–1.30 | 0.0073 |
30–39 years | 22 (53.7) | 30 (23.3) | 0.11 | 0.03–0.35 | 0.000 * | 0.07 | 0.03–0.29 | 0.000 ** |
40 and above | 5 (12.2) | 5 (3.9) | 0.08 | 0.02–0.41 | 0.002 * | 0.06 | 0.01–0.34 | 0.002 ** |
Education | ||||||||
Less than senior high school | 8 (19.6) | 15 (11.6) | Ref | Ref | Ref | Ref | Ref | Ref |
Senior high school | 23 (56.1) | 72 (55.8) | 1.67 | 0.63–4.44 | 0.304 | 1.43 | 0.44–4.69 | 0.552 |
University | 10 (24.4) | 42 (32.6) | 2.24 | 0.74–6.74 | 0.151 * | 2.51 | 0.68–9.26 | 0.167 |
Income more than Bali minimum wage | 22 (53.7) | 59 (45.7) | 0.73 | 0.36–1.47 | 0.377 | |||
High social engagement as MSM/waria | 13 (31.7) | 42 (32.6) | 1.04 | 0.49–2.21 | 0.919 | |||
Adequate HIV risk/prevention knowledge | 15 (36.6) | 61 (47.3) | 1.55 | 0.75–3.21 | 0.232 * | 2.10 | 0.89–4.95 | 0.088 |
Sex with women in the last 6 months | 17 (41.5) | 43 (33.3) | 0.71 | 0.34–1.45 | 0.344 | |||
>1 MSM/waria sex partner in the last 6 months | 20 (48.8) | 91 (70.5) | 2.51 | 1.22–5.17 | 0.012 * | 3.08 | 1.23–7.72 | 0.016 ** |
Inconsistent condom use in the last 6 months | 36 (87.8) | 93 (72.1) | 0.36 | 0.13–2.30 | 0.047 * | 0.57 | 0.18–1.83 | 0.348 |
Paid sex in the last 6 months | 8 (19.5) | 24 (18.6) | 0.94 | 0.39–2.3 | 0.897 | |||
STI diagnoses in the last 6 months | 3 (7.3) | 23 (17.8) | 2.75 | 0.78–9.68 | 0.115 * | 2.44 | 0.61–9.74 | 0.206 |
Variables | Not Interested In Prep Use | Interested in PrEP Use | Crude OR (OR) | Adjusted OR (aOR) | ||||
---|---|---|---|---|---|---|---|---|
n = 24, n (%) | n = 105, n (%) | OR | 95% CI | p-Value | aOR | 95% CI | p-Value | |
Age | ||||||||
<25 years | 12 (50.0) | 37 (35.2) | Ref | Ref | Ref | Ref | Ref | Ref |
25–29 years | 4 (16.7) | 41 (39.1) | 3.32 | 0.99–11.21 | 0.053 * | 4.23 | 0.96–18.60 | 0.056 |
30–39 years | 6 (25.0) | 24 (22.9) | 1.30 | 0.43–3.92 | 0.645 | 1.59 | 0.40–6.30 | 0.509 |
40 and above | 2 (8.3) | 3 (2.9) | 0.49 | 0.07–3.27 | 0.458 | 1.57 | 0.15–16.95 | 0.707 |
Education | ||||||||
Less than senior high school | 1 (4.17) | 14 (13.3) | Ref | Ref | Ref | Ref | Ref | Ref |
Senior high school | 14 (58.3) | 58 (55.2) | 0.30 | 0.04–2.44 | 0.258 | 0.31 | 0.03–3.23 | 0.330 |
University | 9 (37.5) | 33 (31.4) | 0.26 | 0.03–2.27 | 0.224 * | 0.26 | 0.02–3.41 | 0.303 |
Income more than Bali minimum wage | 15 (62.5) | 44 (41.9) | 0.43 | 0.17–1.08 | 0.072 * | 0.38 | 0.10–1.43 | 0.151 |
High social engagement as MSM/waria | 15 (62.5) | 27 (25.7) | 0.21 | 0.08–0.53 | 0.001 * | 0.17 | 0.06–0.51 | 0.002 ** |
Adequate HIV risk/prevention knowledge | 13 (54.2) | 48 (45.7) | 0.71 | 0.29–1.74 | 0.455 | |||
Sex with women in the last 6 months | 5 (20.8) | 38 (36.2) | 2.16 | 0.74–6.24 | 0.157 * | 1.37 | 0.38–4.88 | 0.628 |
>1 MSM/waria sex partner in the last 6 months | 14 (58.3) | 77 (73.3) | 1.96 | 0.78–4.93 | 0.150 * | 4.26 | 1.26–14.45 | 0.020 ** |
Inconsistent condom use in the last 6 months | 14 (58.3) | 79 (75.2) | 2.17 | 0.86–5.47 | 0.100 * | 4.80 | 1.43–16.09 | 0.011 ** |
Paid sex in the last 6 months | 3 (12.5) | 21 (20.0) | 1.75 | 0.48–6.43 | 0.399 | |||
STI diagnoses in the last 6 months | 3 (12.5) | 20 (19.1) | 1.65 | 0.45–6.07 | 0.453 |
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Cempaka, R.; Wardhani, B.; Sawitri, A.A.S.; Januraga, P.P.; Bavinton, B. PrEP Use Awareness and Interest Cascade among MSM and Transgender Women Living in Bali, Indonesia. Trop. Med. Infect. Dis. 2020, 5, 158. https://doi.org/10.3390/tropicalmed5040158
Cempaka R, Wardhani B, Sawitri AAS, Januraga PP, Bavinton B. PrEP Use Awareness and Interest Cascade among MSM and Transgender Women Living in Bali, Indonesia. Tropical Medicine and Infectious Disease. 2020; 5(4):158. https://doi.org/10.3390/tropicalmed5040158
Chicago/Turabian StyleCempaka, Rissa, Brigitta Wardhani, Anak Agung Sagung Sawitri, Pande Putu Januraga, and Benjamin Bavinton. 2020. "PrEP Use Awareness and Interest Cascade among MSM and Transgender Women Living in Bali, Indonesia" Tropical Medicine and Infectious Disease 5, no. 4: 158. https://doi.org/10.3390/tropicalmed5040158