POST GRADUATE PROGRAM
THE PUBLIC HEALTH STUDY
Thesis, 15 July 2008
Propensity Score Matching (PSM) Analysis, The Relationship between The Level of Information Exposed about HIV/AIDS and Behavior in Condom Use among the Consumer of Female Sex Workers (FSW) in Papua (Behavioral Survaillance Survey Data (BSS) 2004/2005).
xvi + 153 pages + 27 tables + 5 pictures + 4 appendices.
It has been more than 25 years, since the first time the HIV/AIDS was found in 1981, there are many different programs have been developed by countries around the world in attempt to control the growth and spreading of HIV/AIDS. But unfortunately, the uncontrolable growth of this disease has attracted more serious attentions. The estimated number of sufferes from the disease has increased dramatically from about 7,8 million people in 1990 to approximately 33,2 million sufferes in late December 2007. There was 90% of the total sufferers from developing countries (WHO&UNAIDS, 2007). The growth of the HIV/AIDS epidemic in Indonesia has been recorded as the fastest among Asian countries. It has progressed from “low” to “concentrated”. Untill late September 2007, the total number of people infected by HIV cumulatively reached 5904 and the number of AIDS cases was 10384, that found within 33 provinces of Indonesia. The national cumulative rate of the AIDS cases in Indonesia was 4,57 per 100.000 people (Dit.Jen PPM&PL, 2007).
The highest proportion of the HIV/AIDS found in Indonesia is in Papua where the spread of the infectious disease has reached its most comunities with the prevallance of the cases is more than 1%. If this value is being compared with its population of the province in general, the case rate will be 60,93 per 100.000 peoples. This rate is 15,39 times higher than the national rate which is only 3,96. The most common cause of the spreading process of the disease in Papua is through heterosexual behaviours which is up to 90 percent (BPS & Depkes RI, 2007). The increased number of HIV/AIDS in Papua is also led by the usage of condom at high risk group still low, a lack of information and education about HIV/AIDS .
The information about relationship between information exposed about HIV/AIDS with behavior in condom use among the consumer of FSW is necessary to be considered by public health policy makers as a sugestion to prevent and control the growth of HIV/AIDS effectively and effecient in Papua.
This research is aimed to identify the relationship between the information exposed about HIV/AIDS with behavior in condom use among the consumer of FSW in Papua by focussing on ages, marital status, educational level, information level and the story of suffering from Sexual Transmited Infection symptoms which act as confounder, and using Propensity Score Matching Analysis. This research uses secondary data of Behavioral Surveillance Survey(BSS) of HIV/AIDS in 2004/2005 from P2MPL, Health Department of Indonesia and the design of this research is cross sectional. The samples used in this research are the consumers of FSW. They are tukang ojek (motorcycle taxi drivers) and tukang bongkar muat pelabuhan (workers loading goods in Papua’s harbour. Further they will be mentioned as the FSW consumers.
The results of this research show that the number of respondents who are consistent to use condoms in conducting their sexual intercourses with FSW is still remaining low (19,14%). By bivariate analysis, the result shows that the variable age (p=0,650), marital status (p=0,403) have not significantly with the consumer of FSW behavior’s in condom use. Meanwhile, the variable educational level (p=0,0001), knowledge level (p=0,000), and the history of suffering from IMS symptoms (p=0,000) have showed the significant relation with the behaviours of using condoms among FSW consumer’s.
The multivariate analysis with Propensity Score Matching, either nearest neighbor or caliper show that variabel age and marital status have to be excluded from the model because the reductive bias before matching process is lower than after the match. The final result of the analysis of PSM on a fit model is found the same value for both algoritma either OR value or T-stat value. The value of odds ratio (OR) is 2,3 (95%CI=1,2-4,5). This means that the FSW consumers with adequate exposed information of HIV/AIDS have 2,3 times of possibilities to use condoms consistently compared with the other ones, who do not have enough exposed information of HIV/AIDS, and T-stat value is 0,85(p>0,05) which means the relationship between the level of exposed information of HIV/AIS and the behavior of condom use among FSW consumers in Papua have not significant.
Based on the results of this research, it is suggested that the managers of the HIV/AIDS programs either in the centre or in district areas to improve the intensity and the depth of relevant information of HIV/AIDS for high risk community groups, to develop the roles of health workers, and to build a good relationships and supports with religionists, traditional/ cultural values, NGO’s, local businesses and formal educational institutions in order to be able to spread and share accurate, adequate and proper information about HIV/AIDS. It is also suggested to involve communication experts and encourage companies and electronic medias of communication to be more active in anticipation and controling the spreads of HIV/AIDS and the socialisation of using condoms, empowering the high risk groups (peer group) to take in part of HIV/AIDS information spreading, and the local policy makers are suggested to make 100% condom policy.
Key words : propensity score matching, information exposed, behavior, condom use, FSW consumer’s.
Reference: 78 (1999-2008)