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I. Praptoraharjo1.

Abstract: ICAAP2502-02131

Background: Male to female transgender (Waria) in Indonesia are estimated about 30% to be HIV-positive. Unprotected anal sex was the major route of HIV transmission among waria in Indonesia. As indicated by previous studies, multilevel factors were found to be significantly associated with condom use or unprotected anal sex including individual, interpersonal, and social factors. However, so far most of the studies focused on individual level factors. Less attention was given to interpersonal and social relationships. This study examines social factors associated with condom use during anal sex.

Methods: By using a modified chain referral method, 165 waria in Yogyakarta were recruited as participants for the study. Not all waria reported having had anal sex in the last 30 days. Therefore only 150 participants were included in the analyses of factors associated with condom use. A logistic generalized estimating equation was used to examine the association between independent variables and dependent variables, considering the data of the sexual partners were clustered in the respondent.

Results: Social relationships between waria with sex partners or friends were dominant factors compared to individual characteristics or psychosocial statuses in predicting protective anal sex. The study also showed that condom use during anal sex among waria varied by the types of partner and factors associated with condom use for each type also showed different patterns. The findings suggest that time dimension may have contribution to the variation of condom use in different types of sexual partnership.

Conclusions: The study has shown that protective anal sex involve more than mere episodes of sexual intercourse between two individuals, but also entail social interactions and communication that lead, frame, and give meaning to sexual encounters between partners. Current intervention must address this dynamic in developing strategies if they are to successfully promote safer anal sex among waria and their partners.

1AIDS Research Center, DKI JAKARTA, INDONESIA.

Resource: ICAAP 11