Coberturas Adicionales

In general, the percentage of FSW aged15-19 years who ever been reached by field worker, receiving STI clinic services and receive free condoms in the last 3 months is lower than the older age groups of FSW. This condition also occurs among Waria respondents except for the coverage of those who receive STI services, where percentage among Waria aged 15- 19 is equals to 25 years and older age group.

Figure 31.Percentage of Female Sex Worker and Waria Who Were Exposed to HIV Prevention Program in The Last 3 Months

Differences program coverage by age group as in Figure 31 also occurs in the coverage Percentage of FSW and Waria who are older and ever been tested for HIV, receive counseling services and receive HIV test results higher than the younger age groups. This indicates that the older the age groups of FSW and Waria the more who knows their HIV status.

The lower coverage of HIV Voluntary Counseling and Testing (VCT) among younger FSW led to the possibility of such continued access to care, support and treatment for them are also becoming smaller.

Figure 32. Percentage of Female Sex Worker and Waria Who Ever Received VCT Services

Further analysis on the correlation between several program coverage with age group using odds ratio reveals that statistically, the difference of several program coverage to each age group is fairly significant (p value < 0.05 and OR or CI does not exeed 1).

As seen in Table 11, FSW age group 25 years old and older has 1.7 times bigger opportunity to be reached by the field worker than those of 15-19 years old group. As well as FSW aged 25 years and older who have ever received condom and STI services have odds ratio of 1.4 times compared to 15-19 years age group. Meanwhile, the odds ratio of FSW aged 20-24 and 25 years and older compared to aged 15-19 who have had HIV test is 2.1 and 3.0 respectively with p value of 0.01 which indicates that the ratio is statistically significant. Odds ratio of several program coverage based on Waria age group which statistically have strong correlation is ever been reached by field worker and have had HIV test. Meanwhile, the odds ratio of the group who ever received free condom and STI clinic service is statistically insignificant which means that there is no difference in program coverage toward Waria aged 15-19, 20-24 or 25 years and older.

Table 11. Odds Ratio Program Coverage of Female Sex Worker and Waria Age Group 15-19 to 20-24 and 25 Years Old

FSW Waria

OR 95% CI value OR p 95% CI value p

Ever reached by outreach worker

20-24 years old 1.3 1.0 - 1.7 0.06 1.3 0.6 - 2.5 0.51

25 + years old 1.7 1.3 - 2.1 < 0.01 2.5 1.4 - 4.6 < 0.01

Ever received free condom

20-24 years old 0.9 0.7 - 1.2 0.53 0.6 0.3 - 1.2 0.18

25 + years old 1.4 1.1 - 1.8 < 0.01 1.4 0.8 - 2.4 0.18

Ever received STI services

20-24 years old 1.1 0.9 - 1.4 0.42 0.8 0.4 - 1.5 0.45

25 + years old 1.4 1.1 - 1.7 0.01 1.3 0.7 - 2.3 0.42

Ever had HIV test

20-24 years old 2.1 1.6 - 2.9 < 0.01 2.8 1.4 - 5.7 < 0.01

25 + years old 3.0 2.3 - 3.9 < 0.01 4.4 2.3 - 8.2 < 0.01

2.3.4.

Sex Behavior & Condom Use

As expected, the older the sex worker, the longer time they have been selling sex. The mean length of time for being Sex Worker among FSW age group 15-19 are 1.2 years, increased

Waria, the average length of time for being Sex Workers in sequence from the youngest age group is 2.2, 4 and 12.3 years. This may suggest that older Waria have also begun to become sex workers at the early age. Figure 32 shows that length of time for selling sex among Waria for each age group is much longer than FSW, even for 25 years and older Waria , length of time is four times longer than FSW with the same age group.

The mean number of clients in the last 1 week among FSW age group 15-19 years and 20- 24 years are relatively similar (7.5 and 7.6 persons / week) and more than FSW age group 25 years and older which is only 6.1 people per week. While the average number of clients in the last 1 week among Waria respondents relatively similar in all age groups and much less than the average number of FSW clients in the last 1 week.

Figure 33. Average Length of Selling Sex (Years) and Number of Client/Week of Female Sex Worker and Waria

The level of condom use among FSWs during the last commercial sex and its consistency in the last 1 week increases along with the higher age group. This can be seen from Figure 33 below where the percentage of FSWs aged 15-19 who always use condom in their last commercial sex is only 24 percent, lower than FSW aged 20-24 (30 percent) and 25 years and older (35 percent). Meanwhile, among Waria, the lowest percentage of those who always use condom in their last commercial sex is in age group of 25 years and older as well as the percentage of Waria who use condom in the last commercial sex.

Figure 34. Percentage of Female Sex Worker and Waria Who Use Condom at Commercial Sex

From Figure 33 and Figure 34, it can be concluded that younger FSW have more risky sexual behaviors than older FSW, due to the bigger number of clients while the level of condom use is lower. This is in line with findings from many qualitative studies which indicate that young are much more preferred by clients while its ability to negotiate condom use is lower than the older FSW

Meanwhile, the percentage of FSWs aged 15-19 (62%) who had sex with casual and non commercial partner is nearly twice higher than 25 years old group FSW (35%). While, the percentage of FSW aged 20-24 who had sex with casual and non commercial partner is in between (51 %). Therefore, it can be concluded that the younger FSW the more likely to have sex with casual and non-commercial partner. On the other hand, the level of condom use in the last sex with casual partner and non-commercial among FSW from 15-19 years age group is higher than the older age group.

The percentage of Waria who had sex with casual and non-commercial partner in the last 1 years is relatively the same between all age group and overall is much higher than FSW. This description also applies to the level of condom use in the last sex with casual and non- commercial partner, where the percentage is ranging from 73-75 percent, far higher than FSW which is only 35-62 percent.

Figure 35. Percentage of FSW and Waria Who Had Sex With Casual Partner and Their Condom Use at Last Sex