Prevalence of HIV

Immunological Failure among

Sex Workers in Yayasan Kerti
Praja Bali
Hilda Citrajaya
Ni Putu Ayu Astri Prana Iswara
I Nyoman Sutarsa
Medical Faculty Of Udayana University
Introduction

 Key Population
 Sex Worker
 Injecting Drug Users
 Male who have sex with male (MSM)
Introduction
Introduction

 Immunological Failure Prevalence among Sex Workers in Kerti Praja Bali?

Method

• Non-governmental organization
established in 1992.
• Kerti Praja foundation field of expertise:
addressing sexual and reproductive
health concerns within the general
public and in most at risk population..
Kerti Praja Foundation • Injecting drug users
• Female sex workers
• MSM
• Programs offered:
• Care, support and treatment
program
• STI Screening
• ARV Dispensing
• Voluntary Counselling and Testing
Method

Study design cross-sectional retrospective analysis

549 CST Clients’ medical records of YKP from 2002 to 2013

205 Clients’ medical records eligible for analysis

Univariate, bivariate analysis

 Method (Demographic variables)

Gender Age Weight Education Occupation

• Male • Young (18-32 • 32-55kg • Low (no • Employed

• Female y/o) • >55kg formal • Unemployed
• Adult education/
(>32y/o) primary
school
graduate)
• Moderate to
High (junior
high or senior
high or higher
education
graduate)
 Method (Clinical variables)

Opportunistic
Route of Presence of CD4 Count
Infection Prior Anemia Status
Transmission Lay Counsellor Baseline
to ART
• Injecting drug • Yes • Absent • ≤100 cells/mm3 • Yes
user (IDU) • No • Present • >100 cells/mm3 • (<13 mg/dl
for male, <12
• Sexual activity mg/dl for
(Heterosexual, female)
Homosexual, • No
Bisexual) • (≥13 mg/dl
for male, ≥12
mg/dl for
female)
Result

549
Clients

205
Clients

Male Female

Sex Not Sex Sex Not Sex

Worker Worker Worker Worker
Result

Client Characteristic Sex Worker

Yes (%) No (%)
Gender (n=205)
Man 3 (2.4%) 122 (97.6%)
Woman 28 (35.0%) 52 (65.0%)
Age (n=205)
Young (18-32 years) 20 (15.3%) 111 (84.7%)
Adult (>32 years) 11 (14.9%) 63 (85.1%)
Weight (n=204)
32-55 kg 16 (14.4%) 95 (85.6%)
>55 kg 15 (16.1%) 78 (83.9%)
Education (n=205)
Low level of education 23 (39.7%) 35 (60.3%)
(no formal education or high school graduate)
Moderate-high level of education 8 (5.4%) 139 (94.6%)
Result

SEX WORKER IMMUNOLOGICAL FAILURE TOTAL

YES NO
YES 5 (16.1%) 26 (83.9%) 31 (100.0%)
NO 23 (13.7%) 151 (86.3%) 172 (100.0%)
Result

OI PRIOR TO SEX WORKER IMUNNOLOGICAL FAILURE TOTAL

ART
YES NO
HAVE OI YES 1 (20.0%) 4 (80.0%) 5 (100%)
NO 13 (27.7%) 34 (72.3) 47 (100%)
DON’T HAVE YES 4 (15.4%) 22 (84.6%) 26 (100%)
OI
NO 10 (7.9%) 117 (92.1%) 127 (100%)
Result

SEX WORKER CD4 COUNT IMUNNOLOGICAL FAILURE TOTAL

BASELINE
YES NO

YES ≤ 100 2 (20.0%) 8 (80.0%) 10 (100.0%)

cells/mm3
>100 3 (14.3%) 18 (85.7%) 21 (100.0%)

NO ≤ 100 20 (23.5%) 65 (76.5%) 85 (100.0%)

>100 3 (3.4%) 86 (96.6%) 89 (100.0%)

Result

SEX LAY IMUNNOLOGICAL FAILURE TOTAL

WORKER COUNSELLOR
YES NO
YES Have Lay 3 (13.6%) 19 (86.4%) 22 (100.0%)
Counsellor
Don’t have 2 (22.2%) 7 (77.8%) 9 (100.0%)
Lay Counsellor
NO Have PMO 21 (16.4%) 107 (83.6%) 128 (100.0%)
Don’t have 2 (4.3%) 44 (95.7%) 46 (100.0%)
PMO
Conclusion

 Sex workers has higher IF Occurrence (16.1%) compared with non-

sex workers (13.7%)
 Sex workers who have OI have lower IF Occurrence (20.0%)
compared with non-sex workers (27.7%)
 Sex workers with CD4 count baseline ≤100 cells/mm3 have higher IF
Occurrence (20.0%) compared with sex workers with CD4 count
baseline >100 cells/mm3
 Sex workers who have lay counsellor have lower IF prevalence
(13.6%) compared with Sex workers who does not lay counsellor
(22.2%)