Prevalence over time and risk factors for sexually transmissible infections among newly-arrived female sex workers in Timika, Indonesia
Nurlan Silitonga A B , Stephen C. Davies C F , John Kaldor D , Stephen Wignall A and Maurist Okoseray EA PT Freeport Public Health and Malaria Control Program, Jl. Mandala No. 1, Kuala Kencana, Timika, Papua 99920, Indonesia.
B Current address: HIV Cooperation Program for Indonesia, Jl. MH Thamrin No. 53, Jakarta 10350, Indonesia.
C Northern Sydney Sexual Health Service, Royal North Shore Hospital, St. Leonards, NSW 2065, Australia.
D National Centre in HIV Epidemiology and Clinical Research, Cliffbrook Campus, University of NSW, Coogee, NSW 2031, Australia.
E RSU Dok 11 Jayapura, Jl. Kesehatan No. 1, Jayapura 99013, Papua, Indonesia.
F Corresponding author. Email: sdavies@nsccahs.health.nsw.gov.au
Sexual Health 8(1) 61-64 https://doi.org/10.1071/SH10038
Submitted: 30 March 2010 Accepted: 15 June 2010 Published: 24 January 2011
Abstract
Background: HIV rates are escalating in Indonesia. At Timika in Papua, the world’s largest gold mine employs many single and migrant men, who frequently have sex with female sex workers (FSWs). We investigated trends of sexually transmissible infections (STIs) in FSWs in Timika. Methods: From 1997 to 2002, FSWs at clinics were recruited for their first STI screening. Sociodemographic and sexual behaviour data were obtained and laboratory tests were performed to diagnose STIs. Results: From 1997 to 2002, 3086 FSWs were recruited. Prevalence of gonorrhoea varied from 11% to 19% (P = 0.71). Positive treponemal serology varied from 1.4% to 5.1% (P = 0.50). Trichomoniasis declined from 16% to 11% (P = 0.03). HIV infection increased significantly from 0.0% to 1.4% (P = 0.002). Chlamydia prevalence did not significantly change from 33% in 1997 compared with 41% in 1998 (P = 0.10). Consistent condom use was low, but increased from 8% to 16% (P = 0.001). Any STI was independently associated with younger age, high frequency of sexual activity, and not using contraceptives. Conclusions: The high rates of STIs, low condom use and increasing prevalence of HIV among these FSWs require enhanced interventions, and consideration of periodic presumptive treatment. A partnership with industry can aid and sustain an intervention program.
Additional keywords: chlamydia, gonorrhoea, HIV, Papua.
Acknowledgements
The present study was funded by PT Freeport Indonesia. The views presented in this paper do not necessarily reflect the views or policies of PT Freeport Indonesia. The authors thank health authorities in Indonesia for granting permission to undertake this study, particularly the Health District Office Mimika, Papua. We are grateful to the staff of Reproductive Health Clinic, Puskesmas Timika. We thank the following for their particular help: Brad Otto for developing the clinic database, Abby Ruddick for social research, Budi Harsana of Ford Foundation for scholarship support, Janaki Amin at NCHECR, UNSW for help with statistical analysis, Kevin Porter of NAMRU-2 for HIV Western blots, Elizabeth Donegan at University of California, San Francisco for LCR for C. trachomatis and for training of local laboratory staff. We are grateful to the women who participated as patients.
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