Exploring Determinants of Unprotected Sexual Behaviours Favouring HIV Transmission among Men who Have Sex with Men in Yogyakarta, Indonesia

Abstract

A qualitative inquiry using individual interviews explored determinants of unprotected sexual behaviours favouring HIV transmission among Men who Have sex with Men (MSM) in Yogyakarta, Indonesia. The study was conducted in July 2015 with 24 MSM participants recruited using convenience sampling technique. Data were analysed using a qualitative data analysis framework, with the Social Cognitive Theory (SCT) employed as the study conceptual framework. Findings were grouped into a reciprocal triadic relationship involving behavioural, personal (cognitive) and environmental determinants. Behavioural determinants comprised having multiple casual sex partners, engagement in group sex and transactional sex practices. Environmental factors associated with unprotected sexual behaviours included influence of unsafe sex from regular partners and lack of access to HIV-related services. Personal (cognitive) determinants favouring unprotected sexual behaviours identified were lack of knowledge of condom and HIV/AIDS, individuals’ expectation of pleasurable sexual intercourse, and low self-efficacy to discuss condom use and HIV status with casual sex partners. As effort to address HIV in MSM in Indonesia is still at its infancy, the findings of the current study are insightful and will inform the development of evidence-based programs in addressing HIV/AIDS problem in MSM populations in Yogyakarta and other similar settings.