Prevalence over time and risk factors for sexually transmissible infections among newly-arrived female sex workers in Timika, Indonesia

Abstract

Background: HIV rates are escalating in Indonesia. At Timika in Papua, the world’s largest gold mine employs many single and migrant men, who frequently have sex with female sex workers (FSWs). We investigated trends of sexually transmissible infections (STIs) in FSWs in Timika. Methods: From 1997 to 2002, FSWs at clinics were recruited for their first STI screening. Sociodemographic and sexual behaviour data were obtained and laboratory tests were performed to diagnose STIs. Results: From 1997 to 2002, 3086 FSWs were recruited. Prevalence of gonorrhoea varied from 11% to 19% (P = 0.71). Positive treponemal serology varied from 1.4% to 5.1% (P = 0.50). Trichomoniasis declined from 16% to 11% (P = 0.03). HIV infection increased significantly from 0.0% to 1.4% (P = 0.002). Chlamydia prevalence did not significantly change from 33% in 1997 compared with 41% in 1998 (P = 0.10). Consistent condom use was low, but increased from 8% to 16% (P = 0.001). Any STI was independently associated with younger age, high frequency of sexual activity, and not using contraceptives. Conclusions: The high rates of STIs, low condom use and increasing prevalence of HIV among these FSWs require enhanced interventions, and consideration of periodic presumptive treatment. A partnership with industry can aid and sustain an intervention program.