Association of Syphilis and HIV among Indirect Female Sex Worker in Indonesia: Secondary Data Analysis of Integrated Behaviour Biological Survey in 2015

Abstract

Background: Every day there are more than 1 million new cases of curable sexually transmitted infections
(STIs) among people aged 15-49 years. Female sex workers (FSWs) are a key-affected population susceptible
to acquiring HIV and sexually transmitted infections (STIs). Syphilis and human immunodeficiency virus
(HIV) infections are diseases that can be transmitted through sexual contact, so it is not surprising that a
person suffers from both at once. Syphilis was still considered an important cause of relation to the spread
of infection HIV and it has been shown to increase HIV sexual transmission. The aim of this study is to
determine the association of syphilis and HIV among IFSW in Indonesia in year 2015.
Method: This study was a cross sectional study with multistage random sampling (MRS) as a sampling
method from Integrated Behaviour Biological Survey (IBBS) in 2015. The study was conducted 22 districts/
cities in 11 provinces of Indonesia. The respondents were 1,678 IFSWs aged 15-49 years old who were
interviewed and willing to blood rapid test to determine the HIV and Syphilis status and never been tested
for the HIV.
Results; Study showed prevalence of HIV was 1.9% and prevalence of syphilis was 2.2%. Respondents with
positive syphilis were significantly about 8 times more likely to get HIV infection (8.4; 95%CI: 3.2- 21.8;
p-value <0.001). Respondents with positive syphilis that inconsistency of condom use were significantly
about 13 times more likely to get HIV infection (PR=12.7; 95%CI:3.0-56.7). The combination of syphilis,
education, knowledge about HIV and age decreased the risk to 8.2 (3.2 – 21.6) with p-value <0.001.As
stratified by age and education, all respondents with positive syphilis that younger less than 30 years were
significantly about 15 times more likely to get HIV infection (PR=14.4; 95%CI 5.2 – 46.0).
Conclusions: There was association between syphilis positive and HIV positive. Respondents with positive
syphilis that inconsistency in condom use, low education and younger less than 30 years were significantly
increased the risk of HIV infection among IFSWs.