Consistency of Condom Use Associated with HIV among Transgender in Indonesia: Secondary Data Analysis of IBBS 2015

Abstract

Backgrounds: Transgender has been identified as engaging in receptive anal sex with men. Unprotected
anal sex is undoubtedly an important risk factor, therefore consistency of condom use is a fundamental
measure to prevent HIV transmission. This study was aimed to investigate association between condom use
consistency and HIV among transgender in several provinces in Indonesia.
Method: This study was done as secondary data analysis from a national cross-sectional study, namely the
Integrated Biological and Behavioral Surveillance (IBBS) 2015, done by the Ministry of Health of Republic
of Indonesia. In this IBBS survey, multistage cluster sampling was used. Condom use and sexual behaviors
was assessed through guided interview, while HIV infection was determined by series of rapid serologic test.
Association, between consistency of condom use and HIV, using PR (prevalent ratio), was analyzed using
chi-square test and cox regression model.
Result: Transgender who did not consistently use condom when having commercial sex transaction were 1.7
times (PR=1.7; 95% CI:0.4-6.3) after adjustable several confounders. Transgender who did not consistently
use condom use when having casual sex were 1.2 times (95% CI 0.1 -13.3) more likely to be infected with
HIV than transgender who consistently use condom after adjusted by several confounders. Transgender who
did not consistently use condom in both commercial and casual sex intercourses was 2.1 times (95% CI:
0.6 - 7.1) more likely to have HIV infection than transgender who consistently used condom after adjusted
by several confounders.
Conclusions: There were increased risks of not consistently using condom in each type of sexual intercourse,
commercial or casual, among transgenders. Condom inconsistency showed its higher effect when related to
both commercial and casual sexual intercourses.