Pemberdayaan waria dalam promosi pencegahan HIV/AIDS melalui sistem Multilevel Social Marketing di Kota Medan
MASTURA, Nur Siti, Dra. Ira Paramastri, M.Si
2008 | Tesis | S2 Ilmu Kesehatan Masyarakat (Perilaku dan PromosiLatar Belakang : Sumatera Utara termasuk pada urutan ke-7 setelah Jakarta, Papua, Jawa Timur, Bali, Jawa Barat, Riau dalam masalah penularan HIV/AIDS. Sumatera Utara, kasus HIV/AIDS berjumlah 1.133 orang dan jumlah yang meninggal sampai bulan Oktober 2007 adalah 80 orang. Penyebab penularannya, hubungan seks baik secara heteroseksual atau homoseksual menempati posisi teratas dengan persentase penderita HIV sebesar 46%. Hasil survey KPAD SU (2006) menyatakan bahwa tingkat penularan HIV/AIDS pada kelompok waria PSK telah mencapai 22 %. Pemerintah mencari alternatif metode promosi kesehatan yang efektif untuk memutus mata rantai penularan HIV/AIDS, karena jumlah penderita HIV/AIDS semakin meningkat setiap tahunnya termasuk waria. Masalah kesehatan komunitas waria seringkali dikarenakan oleh ketidakberdayaan dalam memperoleh promosi kesehatan, stigma dan dipicu bargaining position yang lemah untuk menghadapi permintaan pelanggan dalam melakukan hubungan seks tanpa kondom. Sistem jaringan multilevel social marketing adalah salah satu metode promosi kesehatan yang ingin dikembangkan yakni memberdayakan waria untuk penyampaian informasi kesehatan melalui mulut lewat mulut (word of mouth) secara berjenjang. Sistem ini diadopsi dari sistem multilevel marketing dan social marketing. Tujuan : Memperoleh gambaran penilaian dan harapan waria serta provider untuk perbaikan strategi multilevel social marketing dalam program promosi pencegahan HIV/AIDS pada waria di Kota Medan. Metode Penelitian : Penelitian ini merupakan penelitian operational research dengan kajian kualitatif dengan melakukan evaluasi formatif pada proses multilevel sosial marketing. Pengumpulan data melalui indepth intervieuw, focus groups Discussion dan observasi tidak terstruktur. Subjek penelitian adalah waria penjaja seks dan waria bukan penjaja seks serta petugas HIV/AIDS Dinas Kesehatan Kota Medan. Pemilihan sampel secara purposive sampling dengan criterion sampling. Analisis data kualitatif dilakukan setelah selesai proses pengumpulan data dan untuk validitas melakukan triangulasi sumber dan metode. Hasil penelitian: dalam waktu 1 bulan, waria pada level 1 berhasil memberdayakan 83 orang waria sebagai waria level 2, kemudian waria level 2 mengembangkan jaringan sampai level 3 dengan memberdayakan 11 orang waria. Jumlah downline yang diberdayakan terdapat peningkatan dari jumlah yang diperkirakan yaitu hanya 40 orang waria pada level 2. Kesimpulan : waria potensial untuk memberikan promosi kesehatan dalam pencegahan penularan HIV/AIDS melalui sistem multilevel social marketing, artinya waria mampu untuk menjadi agent of change.
Background: North Sumatera positioned in the 7th rank after Jakarta, Papua, East Java, Bali, West Java and Riau in HIV/AIDS transmission. In North Sumatera, HIV/AIDS case was 1.133 people and the number of those who died until October 2007 was 80 people. The transmission cause was sexual relationship heterosexually or homosexually that the highest position with HIV patient percentage was 46%. The result of the committee of HIV/AIDS and drugs misuse control of North Sumatera (2006) stated that the transmission level of HIV/AIDS in transgender was reached up to 22%. The government was looking for effective health promotion method alternative in order to cut the HIV/AIDS transmission chain, as the number of HIV/AIDS patients kept improved annually including the transgender. Public health problem of transgender often caused of disability in obtaining health promotion, stigma and stimulated by weak bargaining position in facing customer’s demand in having sexual relationship without condom. The system of multilevel social marketing is one of the health promotion methods that are aimed to delevop by empowering the transgender to convey the health information through word of mounth. This system is adopted from multilevel marketing system and social marketing. Objective: The research was aimed to obtain description of evaluation and expectation of transgender as well as provider for the improvement of multilevel marketing system in the program of HIV/AIDS promotion in transgender in Medan Municipality. Method: This was an operational research that used qualitative method by using formative evaluation in the process of multilevel social marketing. The data was gathered through indepth interview, focus group discussion and unstructured observation. The research subject was sexual worker transgender, non sexual worker transgender and provider HIV/AIDS in district health office of Medan. The sample was chosen by purposive sampling with snowball and criterion sampling. The analysis of qualitative data was conducted after the process of data collection and source and method triangulation was used for validity. Result: in one month period, level 1 transgender was succsessful in recruiting and empowering 83 transgender that was considered as level 2 transgender, and then level 2 transgender was developing network until level 3 by recruiting and empowering 11 transgender. There was an increasing number of downline who was empowered with 40 transgender in level 2. Conclusion: Transgender was very potential to give health promotion in HIV/AIDS transmission through multilevel social marketing system which means that the transgender is able to become an agent of change.
Kata Kunci : HIV/AIDS,Promosi Pencegahan,Pemberdayaan Waria, empowerment, multilevel social marketing, transgender
