STD knowledge and behaviours among clients of female sex workers in Bali, Indonesia
Fajans, P.; Wirawan, D.N.; Ford, K.
Aids Care 6(4): 459-475
1994
ISSN/ISBN: 0954-0121 PMID: 7833364 DOI: 10.1080/09540129408258661Document Number: 286668
In Indonesia, interviews with 401 16-65 year old clients of low-price sex workers in Bali were conducted to examine knowledge, beliefs, and practices related to sexually transmitted diseases (STDs) and AIDS. They had had a high number of paid sexual partners (mean, 1.9) in the week before the survey. They rarely used condoms (8%). The level of a history of STDs among the clients was high (50%). For example, 34% reported urethral discharge, 20% a genital ulcer, and 25% had a history of syphilis. Almost 20% had had intercourse with a sex worker while experiencing symptoms during their most recent episode. The most common treatment was self-treatment with antibiotics (35-46%). Perceived STD and AIDS prevention strategies were partner selection based on cleanliness or lack of mouth or body odor and prophylactic medications. Most clients (95%) were familiar with STDs. High level of education and previous experience with an STD were positively correlated with STD knowledge (p 0.01 and 0.05, respectively). Most clients (almost 75%) had heard of AIDS, but few had accurate knowledge about HIV transmission. For example, 33% believed that medication would prevent HIV infection. AIDS knowledge level was positively associated with age (p 0.001), education (p 0.001), and never having been married (p 0.05). Five or more sex worker partners in the previous month and never use of a condom with a sex worker were positively associated with having recent STD symptoms (relative risk = 3.34 (for syphilis) and 2.41, respectively; p 0.01). These findings indicate a need for developing a comprehensive STD control program consisting of educational campaigns, condom promotion, and improving case management by health providers. Specific messages for campaigns should revolve around recognition of STD symptoms, possibility of asymptomatic infection, need for medical consultation at onset of STD symptoms, inefficacy of existing STD prevention strategies, and consistent use of condoms.