Konsumsi minuman beralkohol dan proses negosiasi pemakaian kondom pada pekerja seks perempuan dan pelanggannya di Denpasar

SAWITRI, Anak Agung Sagung, Dr. Sri Suryawati

2009 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar Belakang. Prevalensi HIV/AIDS pada pekerja seks perempuan (PSP) cenderung meningkat, yaitu dari 1% (1999) menjadi 17% (2008). Hasil survei menunjukkan ada perilaku konsumsi minuman beralkohol pada PSP dan pelanggannya sebelum melakukan hubungan seks, yang memungkinkan mempengaruhi proses negosiasi pemakaian kondom. Metode. Rancangan studi cross sectional, melibatkan 190 PSP dari 22 kluster di Denpasar yang dipilih secara acak. PSP diwawancarai di tempat kerja, menggunakan kuesioner terstruktur, tentang karakteristik demografis, pola konsumsi, pasangan/pelanggan, serta proses negosiasi pemakaian kondom. Konsumsi alkohol dikategorikan menjadi 3 situasi yaitu PSP dan pelanggan minum, pelanggan minum, serta PSP minum. Proses negosiasi dikategorikan menjadi baik dan buruk. Hubungan antar variabel dianalisis dengan uji Chisquare dan dilanjutkan dengan Logistic Regression. Hasil. Rerata usia PSP 27,75 tahun, 78,4% berpendidikan rendah, 85,8% suku Jawa, 84,2% pernah menikah, 48,4% merokok dan 8,9% menggunakan ekstasi/shabu-shabu. Sebanyak 105 (55,3%) PSP mengkonsumsi alkohol, 62,3% dimulai <25 tahun, 64,8% minum >1 tahun, dan jenis minuman bir (95,2%), anggur (34.3%), dan arak (26,7%). Separuh (54,8%) PSP tidak pernah minum >6 gelas, dan 41,3% tidak pernah mabuk saat menemani pelanggan. Pada pelanggan baru, konsumsi alkohol terbukti mempengaruhi proses negosiasi pada skenario 1 (RP 3,324, 95%CI 1,384-7,980), skenario 2 (RP 1,822, 95%CI 1,220- 2,721), serta skenario 3 (RP 2,079, 95%CI 1,452-2,977). Hasil analisis multivariabel konsisten menunjukkan konsumsi alkohol bersama akses kondom mempengaruhi proses negosiasi pada skenario 1 dan 2. Sedangkan pada pelanggan lama, peran konsumsi alkohol tidak signifikan pada skenario 1 dan 2. Kesimpulan. Konsumsi alkohol pada PSP dan pelanggannya merupakan masalah yang berkembang. Faktor ini mempengaruhi proses negosiasi pemakaian kondom pada PSP dan pelanggannya sehingga meningkatkan risiko penularan HIV.

Background. HIV/AIDS prevalence among female sex workers (FSWs) tend to increase, at 1% in 1999 to 17% in 2008. Meanwhile, previous surveys showed the existence of alcohol consumption behavior among FSWs and their clients, which possibly influence the condom negotiation process among them. Method. Design study was cross sectional, involving 190 FSWs from 22 randomly selected clusters in Denpasar. FSWs were interviewed in their workplace using structured questionnaire, on some variables: demographic characteristics, alcohol consumption pattern, partner/clients characters, and condom negotiation process. Alcohol consumption was categorized into 3 scenes: both FSWs and clients consumed, clients consumed, and FSWs consumed. Condom negotiation process were divided into effective and poor process. Those variables were analyzed using Chi-square test, followed by Logistic Regression. Result. Mean age of FSWs was 27.75 years, 78.4% low educated, 85.8% Javanese, 84.2% ever married, 48.4% smoking, and 8.9% use ecstacy and/or shabu-shabu. Around 105 (55.3%) FSWs were consuming alcohol, 62.3% started <25 years, 64.8% has been consumming for >1 year, with three majority drinks were bir (95.2%), wine (34.3%), and arack (26.7%). More than half (54.8%) FSWs never drank >6 drinks, and 41.3% has never been drunken with their clients. To new clients, alcohol consumption was proven to influence negotiation process in scene 1 (PR 3.324, 95%CI 1.384-7.980), scene 2 (PR 1.822, 95%CI 1.220-2.721), and scene 3 (PR 2.079, 95%CI 1.452-2.977). Multivariate analysis demonstrated consistent result in scenes 1 and 2, along with condom access. Meanwhile, on regular clients, the role of alcohol consumption was not significant in scene 1 and 2. Conclusion. Alcohol consumption among FSWs and their clients was potential problem to develop. This factor has proven to affect condom negotiation process among FSWs and new clients, which may consequence to increase risk of HIV transmission among them.

Kata Kunci : Pekerja seks,Konsumsi alkohol,Negosiasi,Kondom,Sex Workers,Alcohol consumption,Condom negotiation