Perception of Sexual Risk Behavior and Client Condom Use Among Female Commercial Sex Workers in Jakarta, Indonesia Rita Ismail 1, Sri Yona 2, Widyastuti 3, Endang Nurrochmi 4, Farida Ekasari 5, Tjutju Tjuraeni 4 1 University of Washington, 2 University of Illinois at Chicago, 3 East Jakarta Health District Office, 4 Ministry of Health Indonesia, 5 Indonesia National Family Planning Coordinating Board. Background An estimated 333,200 people are living with HIV in Indonesia 25% of them are women and between 6% to 10% are female commercial sex workers (FCSWs) Sexual transmission remains one of the main modes of HIV transmission Few studies have examined Indonesian FCSWs’ perceptions of sexual risk behavior and client condom use Understanding the factors that place FCSWs at risk is essential to maximize the effectiveness of HIV prevention in Indonesia Sample and Setting Data were collected from nine FCSWs Interviews were conducted at one of the Rehabilitation Houses in Jakarta, Indonesia Rehabilitation Houses are the national centers for rehabilitation of FCSWs who have been arrested and are required to stay in the center for 1 – 3 months The center provides social services, including health care and education for physical, mental, social, and behavioral changes. Purpose To explore the perceptions of sexual risk behaviors and client condom use among FCSWs in Jakarta, Indonesia Methods Design Qualitative description design Data Collection Semi-structured in-depth face to face interviews were conducted to explore the perception of client condom use and sexual risk behavior among FCSWs Each interviews were conducted over 30 to 45 minutes, audio recorder, and transcribed by the researchers Interviews were conducted in the Indonesian language Data Analysis Thematic analysis was completed by hand to identify recurring themes. Data were translated in to English for this poster Results The Context of FCSWs in Jakarta, Indonesia Half of the participants worked in a commercial sex establishment Years of commercial sex work: 1 month – 4 years Age : 22 to 33 years Duration of being FCSW: 1 month – 4 years Half are currently married and have 1-2 children Education level: -6 had elementary school or less -3 had completed junior high school Lack of Knowledge about STI and HIV/AIDS Prevention FCSWs lacked of knowledge about sign and symptoms of STI and HIV/AIDS “My friend used to have syphilis ….she said that it was painful when she had to pee, but I am not sure about it” “I do not know about AIDS, I do not know about “Raja Singa” (syphilis)….” “His genital will be very sore and itching” FCSWs lack of knowledge about STI and HIV/AIDS prevention “ To prevent STI, we have to be clean, everytime after ”doing that”we should wash our genital immediately using water and drink herbal medicine” Lack of Knowledge about STI and HIV/AIDS Treatment Believe that traditional herbal medicine is good “I believe that traditional herbal from my village is good” “I usually take “jamu gendong” (traditional herbal), supertetra (antibiotic) and ask the customer using condom” Believe that antibiotics can protect FCSWs from disease “It is important…that every time after serving the customer, I always take antibiotic, but just once” Lack of Self-Efficacy or Skill in Negotiating Condom Use FCSWs attempt to persuade clients to use condom “Usually I offered my customer for using condom, if he does not want you use it, it is ok” However, if the client refuse, they give up “If he does not want to, it is ok…we are only small people who need money” Conclusion These finding provide guidance for developing future HIV prevention with focus on negotiation skill and increase STI and HIV/AIDS knowledge Interventions must be targeted not only to FCSWs, but also to their clients Training regarding negotiation of condom use is needed to improve safe sex practices Sexual establishment in Indonesia should consider political adopt from other countries including FCSWs to all insist on condom use or establishing condom policy Acknowledgements John Fogarty International Centre AIDS AITRP at UIC (D43TW001419) provided support to Sri Yona during preparation of this poster Map of HIV Epidemic in Indonesia (2009) ) Educating FCSWs at the referral center The Rehabilitation House Jakarta

Method Data were collected from nine CSWs and three key informants at the Ciracas and Panti Rehabilitation, Jakarta, using in-depth interview. Thematic analysis was used to assess perception of risk behavior and condom use. Results: Three predominant themes emerged : 1)Lack of knowledge about HIV/STD prevention (2) Lack of Self-Efficacy or Skills in Negotiating Condom (3) Misperception in using antibiotic and herbal as prophylactic for HIV and STD transmission. Conclusion: Improve negotiation a skill of sex workers to increase consistent of condom use is needed by providing regular training about negotiation skill. This finding also provide guidance for developing future HIV prevention with focud on negotiation skill and incease HIV /STD knowledge.Such interventions must be targeted not only to CSWs, but also to their clients. Background Understanding the factors that put sex workers at risk is essential to maximize the effectiveness of HIV prevention in Indonesia. P urpose To iexplore the perception of sexual risk behaviors and condom use among female commercial sex workers (CSWs) in Jakarta, Indonesia. Aim.

Background There were an estimated 333,200 people living with HIV in Indonesia of which 25% were women (National AIDS Commission Republic of Indonesia, 2009). Sexual transmission are one of the main modes of HIV transmission (National AIDS Commision, 2009) Understanding the factors that put sex workers at risk is essential to maximize the effectiveness of HIV prevention in Indonesia Little data available on Perception of risk behavior and condom use among female sex workers in Jakarta, Indonesia Title Text Title Text Title Text Title Text Title Text Title Text Title Text sss Perception of Risk Behavior and Condom Use among Female Sex Workers in Jakarta, Indonesia Rita Ismail 1, Sri Yona 2, Widyastuti Widyastuti 3, Farida Ekasari 4, Endang Nurrochmi 5, Tjutju Turaeni