Analysis Factors Used Condom among Patient with HIV/AIDS
Transmission to Housewife Living at Ex-Prostitution Area
in Surabaya
Nessy Anggun Primasari, Niswa Salamung, Ahmad Ali Basri, Ester Radandima
Master Degree Student, Faculty of Nursing, Universitas Airlangga, Kampus C Mulyorejo, Surabaya, Indonesia
Keyword: Condom, HIV/AIDS, Transmission, Housewife.
Abstract: Since 2007-2011 as many as 2% of the 350 housewives under the management public health focus to
HIV/AIDS. The objective of the research was to analyse factors used condom among People Living with
HIV and AIDS (PLWHA) transmission to housewife living at ex-prostitution area. This research used cross-
sectional research. The population in this study were 103 housewives who were married, as a housewife and
at the age of 17-49 years. Samples were taken by purposive sampling according to inclusion and exclusion
criteria of 60 samples. Data were analysed by using correlation and logistic regression with significance
level alpha <0.05. The results showed that there was all factors namely knowledge, attitude, and behaviour
on using condom among PLWHA with significantly level respectively knowledge p = 0,001; r = 0,432),
attitude and behaviour, the value of significance (p = 0,001, r = 0,420). PWHLA who had a good in
knowledge, attitude, and behaviour, impact on condom used as prevention effort of HIV/AIDS. From this
study, it can be concluded that knowledge, attitudes and skill of housewife with HIV infection effect on the
used of condom for prevention of HIV/AIDS transmission.
1 BACKGROUND
Current developments the initially high-risk groups
of HIV are those with certain sexual behaviors,
homosexual groups; heterosexual groups multiple
partners; sex workers; and those who use
unsterilized needles, such as injecting drug users,
now HIV & AIDS also infect women, wives or
housewives loyal to their husbands or spouses. So
the exposure was no longer only in groups that had
been stigmatized, or considered "worthy of a bad
stamp", but also extended to the most vulnerable
groups, women and infants (Yulianti, 2013). The
number of women with AIDS in the world continues
to increase, especially in reproductive age (Sarwono,
2008). Facts that happened in preliminary study that
got data of Sememi Public Health Center from 2007
until 2011 years, there is 7 prevalence of housewife
who suffer from HIV/AIDS. One of the most
common attempts to reduce HIV/AIDS prevalence is
that 100% condom use programs, not multiple
partners during sex, are primary prevention efforts to
respond to high risk of sexual transmission (RI,
2007).Unprotected heterosexual transactional sex is
one of the major drivers of the HIV epidemic in
Indonesia. Indonesia’s efforts have focused on
increasing AIDS awareness and access to male
condoms among sub-populations at high risk of
sexually transmitted HIV infection, such as female
sex workers (FSWs) (Puradiredja and Coast, 2012) .
However condom use in Indonesia is considered less
significant when compared with the large population
and the spread of HIV/AIDS(UNAIDS, 2006).
Condom use being a part of HIV prevention in
the world including Indonesia, start in Uganda at the
end of 80’s decade with ABC slogans contains:
Abstain, Be faithful, Condom. And The right way to
use condoms is the most efficient protection against
HIV and Sexuality Infectious Infection (STI)
(Oktavian and Krismawati, 2015). So it can be
concluded that HIV/AIDS is one thing that can harm
women, especially (Harahap, 2012). Factors that
influence behavior include: personal experience,
culture, others that are considered important, mass
media, institutions or educational institutions and
religious institutions, emotional factors in the
466
Primasari, N., Salamung, N., Basri, A. and Radandima, E.
Analysis Factors Used Condom among Patient with HIV/AIDS Transmission to Housewife Living at Ex-Prostitution Area in Surabaya.
DOI: 10.5220/0008326904660471
In Proceedings of the 9th International Nursing Conference (INC 2018), pages 466-471
ISBN: 978-989-758-336-0
Copyright
c
 2018 by SCITEPRESS – Science and Technology Publications, Lda. All rights reserved

individual (Azwar, 2008). However, until now,
factor analysis affecting the behavior of condom use
in HIV/AIDS prevention efforts for housewives
living in area ex-prostitution still cannot be
explained. The objective of the research was to
analysed factors effect on used of condom among
housewife living at ex-prostitution area.
2 METHODS
This research used descriptive-analytic research
design with cross-sectional design that is research
which emphasizes time measurement/ data
observation of independent and dependent variable
only once at one time. In this type, independent and
dependent variables are assessed simultaneously at a
time, so there is no follow-up(Nursalam, 2016). The
population in this study were 103 housewives who
were married, as a housewife and age range start
from 17 until 49 years. Samples were taken by
purposive sampling according to inclusion and
exclusion criteria of 60 samples. Data were
analysed by using correlation and regression logistic
with significantly level alpha <0.05.
2.1. Ethical Consideration
The study was approved by The Health Ethics
Committee, Airlangga University Surabaya, Agency
for National Unity and Politics of East Java
Provincial Government and public health office East
Java. Letter of permission of the Agency for
National Unity and Politics of East Java Provincial
Government on January 3, 2013 number 23 /
H3.1.12 / PPd / 2012 concerning the request for data
collection facilities research results in the form of
research conducted must be in accordance with the
letter of application and researchers must comply
with the provisions applicable during the study.
After the research is completed and in getting the
results to be reported to the agency concerned
Respondents were informed that the study was
voluntary and that they could withdraw at any time
without permission. All participants provided
informed consent. All participants were assured of
the confidentiality and anonymity of their data, data
stored in secured place.
Table 1: Characteristic demographic of the respondents.
Respondent’s characteristic
n
%
Age:
Total
20-24 years
25-29 years
30-34 years
35-39 years
40-44 years
45-49 years
2
9
8
19
8
14
60
3.33%
15%
13.33%
31.66%
13.33%
23,33%
100%
Education Level :
Total
Elementary School
Junior High School
Senior High School
Academic
18
20
22
0
60
30%
33.33%
36.67%
0%
100%
Type Working of Husband:
Total
Government Employees
Private Employees
Entrepreneurship
Not working
6
49
4
1
60
10%
81.67%
6.67%
1.66%
100%
Marital Age:
Total
1-10 years
11-20 years
>20 years
20
18
22
60
33.33%
30%
36.67%
100%
Analysis Factors Used Condom among Patient with HIV/AIDS Transmission to Housewife Living at Ex-Prostitution Area in Surabaya
467

3 RESULTS
All of the respondents were housewife living at ex-
prostitution area, Sememi district, Surabaya. Overall
60 females most respondents on age criteria in the
age range 35-39 years (31.66%) (see Table 1).
Table 1 showed the characteristic of PWHLA in
ex-prostitution are in Surabaya. Most of PWHLA on
age 35-39 years with educational level on non-
academic. Their husband mostly works in private
and length of the marital status after 20 years.
Table 2 indicates the distribution of factors
affecting on the use of condom among housewife
Table 2: Distribution factor used condom.
Factors
Category
Σ
%
Knowledge aspect
Knowledge about HIV/AIDS (for example: sign and symptoms of the disease)
Transmission of HIV/AIDS (for example: Switching sexual partners, blood
transfusions of people with HIV/AIDS, alternating non-sterile needles with
HIV/AIDS sufferers)
Prevention of HIV/AIDS (faithful to the couple, used of condom during sexual
intercourse)
Knowledge about condom (for example: contraception that can reduce the risk of
infection transmission
HIV / AIDS due to sexual intercourse
Benefits used of condom (for example: Prevent contagion and free relations)
Type of condom (male and female condom)
The right time to used a condom (for example: any time or when will sexual
intercourse with anyone)
Advantages of condom used (for example: cheap, easy to get, not require
surveillance and reduce the possibility transmission of venereal diseases)
Disadvantages of condom used (for example: Irritation, loss of sexual sensation,
easily damaged or leaking)
Good
Average
Bad
Total Σ
22
16
22
60
36.67%
26.66%
36.67%
100%
Attitude aspect
Always used condom during sexual intercourse
Not used condoms during sexual with a husband
Advise to husband used condom during intercourse
Make a condom do not reduce comfort during incourse
Used condom can reduce satisfaction during intercourse
Difficult to used condom during sexual intercourse
Difficult to get condoms in the area
Positif
Negatif
Total Σ
37
23
60
61.67%
38.33%
100%
Behavior aspect
Used condoms during sexual intercourse with husband
Discussion with sexual partner about used condom for prevention transmission
HIV/AIDS
Discussion with sexual partner for how to used condoms properly
Discussion with sexual partner for used condom during intercourse
Providing condoms when going to have sex with a partner
Good
Bad
Total Σ
17
43
60
28.33%
71.67%
100%
Table 3: The result of research on the attitude of house wives to the behaviour used condom used
Variable
Determination
Coefficient
Regession
Coefficient
(B)
B
Sig.
Information
Knowledge about HIV/AIDS, used
condom during intercourse with sexsual
partner, advantages and disadvantages
used condom
1.00
0.280
0.238
0.00
Significant
Attitude and respon sexsual partner for
used condom during intercourse
0.280
1.000
0.533
0.003
Significant
Behavior partner sexual for discussion
and using condom during intercourse
0.432
0.420
0.233
0.001
Significant
INC 2018 - The 9th International Nursing Conference: Nurses at The Forefront Transforming Care, Science and Research
468

with HIV AIDS. The used of condom among
housewife always discuss with their husband. Most
of them have bad on knowledge on prevention of
transmission of HIV.
Table 3 showed the result of regression logistic
test that all of the factors effects on the used of
condom among housewife with HIV AIDS are
significantly correlated. Knowledge of housewife is
better compare two other factor
4 DISCUSSION
Based on the results of the study showed that
respondents who have good knowledge and
knowledge have the same value, while a small
percentage for respondents who have enough
knowledge.
According to (Notoatmodjo, 2007) the factors
that influence knowledge are education. Education
affects the learning process, the higher a person's
education the easier the person is to receive
information. The more information that comes in the
more the knowledge gained about health.
Knowledge is closely related to education where it is
expected that someone with higher education, then
the person will be more knowledgeable. It should be
emphasized, however, that a person with a low level
of education does not mean an absolute low
knowledge. The economic status of a person will
also establish the availability of a facility necessary
for a particular activity, so that this socioeconomic
status will affect one's knowledge. Based on the
theory of adaptation if the level of knowledge can at
least encourage to have a good attitude and behavior
as well (Natalia et al., 2014). Given the knowledge
about HIV/AIDS, there is an attitude of awareness
and intention to use condoms.
Of the respondents with less knowledge, can be
influenced by education because the average
respondent with high school education level.
According to (Notoatmodjo, 2007). Someone with
low education can also have good knowledge due to
experience, age and number of members in the
family. Age affects the ability to catch and the
mindset of a person (Notoatmodjo, 2010). So the
more age will increase also the ability to catch and
the mindset, so the knowledge gained better. At
middle age, more active individuals will be more
active using much time to read. Someone also knows
new things by reading. Of the majority of
knowledgeable respondents less impact on attitudes.
It is viewed from the education taken by the
respondents, got mostly educated with high school
graduates. In residential area RW 02 Klakah Rejo
this knowledge of the respondents about the use of
condoms as an effort to prevent HIV/AIDS is still
lacking, this can be seen when researchers do
research some respondents asked about the use of
condoms is good and true because there is still no
extension from doctors and nurses Puskesmas
Sememi and health cadres in ex-prostitution area
used condom for housewives as an effort to prevent
HIV/AIDS.
Based on the results of research most
respondents have a positive attitude and a small
percentage of respondents have a positive attitude.
Among the factors that influence the formation of
attitudes are personal experiences, cultures, other
people, considered important, mass media,
institutions or educational institutions and religious
institutions as well as emotional factors in
individuals (Azwar, 2008).
That in the absence of any experience with a
psychological object tends to form a negative
attitude toward the object (Azwar, 2012). Alport
(1954) in (Notoatmodjo, 2010) states that attitude is
a readiness or willingness to act, and not an exercise
of a particular motive. In other words the function of
attitude is not yet an action (open reaction) or
activity, but is predisposing to behavior (action), or a
closed reaction
From a small percentage of respondents with
negative attitudes this can be affected by one's
experience, education and age. A housewife who is
never experienced in using a condom also affects her
attitude in using condoms during sexual intercourse
with her husband. In this case the attitude of
housewives is still relatively less responsive to the
use of condoms and also still taboo in discussing the
use of condoms with her husband. This is because
there is no counseling from doctors and nurses at
public health center in condom use as an effort to
prevent HIV/AIDS.
Based on the results of the study showed that
most respondents have poor behaviour in the use of
condoms when housewives intercourse with her
husband, while a small part of good behaviour of
housewives in the use of condoms during sexual
intercourse with her husband.
One of the most potent factors for influencing the
behaviour of a person is the socio-economic and
structural factors. Socio-economic and structural
factors that are the level of welfare, level of
education, access to health services (Puradiredja and
Coast, 2012).
Less knowledge turned out to also affect the
behaviour of poor housewives. There are still many
Analysis Factors Used Condom among Patient with HIV/AIDS Transmission to Housewife Living at Ex-Prostitution Area in Surabaya
469

housewives who have not realized that they belong
as a high-risk group. This makes housewife unaware
that they are very vulnerable to HIV/AIDS so there
are still many who have less behaviour, where there
are still many housewives who do not use condoms
during sexual intercourse with her husband. Due to
the lack of intensification of monitoring and
evaluation program of HIV/AIDS program by
Surabaya Health Office, especially in P2 which
cooperate across sectors with health cadres,
community-based organizations, self-help
organizations, community leaders and related mass
media.
Based on tabulation of analysis with Spearman's
Rho (r) test according to table 5.4 shows that there is
a correlation between knowledge and behavior of
condom use as an effort of preventing HIV/AIDS in
housewife with value (p) = 0,001 and got correlation
coefficient (r) = 0,432 means having a relationship
with a moderate correlation power. According to
(Notoatmodjo, 2010). Good knowledge obtained
results with a good indicator as well. Factors
affecting knowledge is education, education affects
the learning process, the higher a person's education
the easier the person is to receive information. So
the more information that comes in the more the
knowledge gained about health. Housewives are
found that some understand about the use of
condoms, because there are health cadres that are
there. And the peanut butter age also affects, it is
known that the age of respondents more at age with
ranged between 35-39 years. From this age affects
the experience of knowledge about condoms. In the
respondents with good knowledge has a bad
behavior as well. Supported by explanation
according to (Notoatmodjo, 2010). That knowledge
is a cognitive domain that is very important
formation of a person's actions. If the adoption of a
new behavior or adoption of behavior is based on
knowledge, then what is learned, among others, the
behavior will be lasting, otherwise if the behavior is
not based on knowledge it will not last long. This is
because the housewife is less familiar with the use of
condoms itself. This is influenced by the lack of
socialization of health workers. For enough
knowledge only a small part has good behavior.
Based on the theory of adaptation if the level of
knowledge can at least encourage to have a good
attitude and behavior as well (Natalia et al., 2014).
This is found when researchers do research that
housewives are still asking about the use of condoms
as an effort to prevent HIV/AIDS. For enough
knowledge can also be said most of the mothers with
bad behavior. It is viewed from the mother more
never use condoms during sexual intercourse with
her husband because the function of condom use as
prevention of HIV/AIDS in housewife less
understanding. On the knowledge less a few mothers
with good behavior. This is due to the possibility of
low knowledge of the respondents and the action of
condom use because there are still many who have
not been exposed to information about HIV/AIDS
and the level of knowledge is still at the stage of
understanding not yet through the application stage,
analysis, synthesis and evaluation as described
(Notoatmodjo, 2010). At the research site found that
no mother with no schooling education. at least the
mother's education is in elementary school. So that
only a small part of the mother is lacking in
education. Most of the knowledge is less
experienced behavior is less good as well. Can be
said if the better the knowledge of respondents about
HIV/AIDS, it affects the action to always use
condoms during sex. This is because housewives are
still taboo in discussing with husband about the
benefits of using condoms as an effort to prevent
HIV/AIDS.
Based on tabulation of analysis with Spearman's
Rho (r) test according to table 5.4 shows that there is
a correlation between attitude and behavior of
condom use as prevention effort of HIV/AIDS in
housewife with value (p) = 0,001 and got correlation
coefficient (r) = 0,420 means having a relationship
with a moderate correlation power. Azwar (2012)
argues that most positive attitudes experience good
behavior. In this study more emphasis on the
formation of attitudes in the form of personal
experience, while we know that to be the basis for
the formation of attitudes, personal experience must
leave a strong impression. Therefore, attitudes will
be more easily formed when personal experience
occurs in situations involving emotional factors. In
situations involving emotions, appreciation of the
experience will be more profound and longer lasting.
An attitude has not been automatically manifested in
action (overt behaviour). For the realization of the
attitude to be a real difference required supporting
factors or a condition that allows, among others,
facilities. Besides facilities also needed support
factor (support) from another party (Notoatmodjo,
2007).
When the implementation of the study found that
respondents are more well behaved and supported
with a good attitude as well. Respondent addressing
the use of condoms as an effort to prevent HIV /
AIDS. As for the positive attitude of behavior tend
to be less good. Among the factors that influence the
formation of attitudes are personal experience,
INC 2018 - The 9th International Nursing Conference: Nurses at The Forefront Transforming Care, Science and Research
470

culture, other important people, mass media,
institutions or educational institutions and religious
institutions and emotional factors in individuals
(Azwar, 2008). The formation of respondent attitude
is more triggered by the means of information
obtained from health, education, and media officers.
Only a minority of respondents' attitudes are
negative with good behaviour. While most of the
negative attitude has bad behaviour. This is because
the influence of others who are considered important
can be interpreted that others around us is one of the
social components that influence our attitude. In
general, individuals tend to have a conformist
attitude or direction with the attitude of people who
are considered important. Behave in certain
situations and against a certain stimulus will be
much found by how his beliefs and feelings toward
the stimulus. The tendency to behave consistently, in
harmony with these beliefs and feelings, shapes
individual attitudes (Azwar, 2012)
In addition, the influence of others who are
considered important can be interpreted that other
people around us is one of the social components
that influence our attitude. In general, individuals
tend to have a conformist attitude or direction with
the attitudes of people who are considered
important. Behave in certain situations and against a
certain stimulus will be much found by how his
beliefs and feelings toward the stimulus. The
tendency to behave consistently, in harmony with
these beliefs and feelings, shapes individual attitudes
(Azwar, 2012)
In this research attitude of housewife can
influence behavior in condom usage because mother
attitude still awkward in talking and using condom
during sexual intercourse with husband, this is seen
by researcher during research, there are housewife
that exist at time of group discussion took place the
mother asked how it feels to wear condoms during
sexual intercourse because the housewife and her
husband never use condoms during sexual
intercourse and rarely discuss about condoms, then
there is one housewife who is one of the group
discussion organizers said about his experience
using condoms when having sex with her husband it
feels different when not using condoms, but to break
the spread of HIV/AIDS from husband to wife
would be nice if using condoms. Based on current
research talks, researchers can conclude that there is
still a lack of knowledge of housewives about
condoms. This affects the lack of condom use
behavior. This is because the program of monitoring
and evaluation of HIV/AIDS program by the
Surabaya Health Office has not been intensively
monitored, especially in section P2 in cross-sectoral
cooperation with health cadres, community-based
organizations, self-help organizations, community
leaders and related mass media.
5 CONCLUSIONS
Knowledge, attitudes and behaviours in the
prevention of HIV / AIDS transmission are
important factors in providing insight and
understanding to housewives living in ex-
prostitution sites. so it can at least suppress the rate
of HIV / AIDS transmission through sexual
intercourse. It is recommended that the role of health
worker in preventing transmission of HIV to the
housewife is to educate and to involve the housewife
by increasing knowledge, fostering a positive
attitude and change a better behaviour through
regular meeting and public discussion.
REFERENCES
Azwar (2008) Sikap Manusia Manusia Teori dan
Pengukurannya. Edisi 2. Yogyakarta: Pustaka Pelajar.
Azwar (2012) Reliabilitas dan Validitas. edisi 4.
Yogyakarta: Pustaka Pelajar.
Harahap (2012) ‘, 2012, ,hhtml, Diakses tanggal 12
desember 2012, jam 16.00 WIB’, Kriminalisasi
Pengidap HIV/AIDS di Karawang Jawa Barat.
Natalia, Y. D. et al. (2014) ‘Penyuluhan Tentang HIV dan
AIDS Terhadap Sikap Remaja pada Orang dengan
HIV dan AIDS’, SMAN 8 Yogyakarta, 3(1), pp. 0–5.
Notoatmodjo (2005) Promosi Kesehatan Teori dan
Aplikasi. Jakarta: Rineka Cipta.
Notoatmodjo (2007) Promosi Kesehatan dan Ilmu
Perilaku. Jakarta: Rineka Cipta.
Notoatmodjo (2010) Ilmu Perilaku Kesehatan. Jakarta:
Rineka Cipta.
Nursalam (2016) Asuhan Keperawatan Pada Pasien
Terinfeksi HIV/AIDS. Jakarta: Salemba Medika.
Oktavian, A. and Krismawati, H. (2015) ‘JMSCR Vol || 3
|| Issue || 10 || Page 7912-7919 || October’, (October).
doi: 10.18535/jmscr/v3i10.34.
Puradiredja, D. I. and Coast, E. (2012) ‘Why Do Female
Sex Workers in Indonesia Not Use Condoms ’:
RI, B. dan D. (2007) Situasi Perilaku Berisiko dan
Prevalensi HIV di Tanah Papua 2006. Jakarta.
Sarwono, P. (2008) Ilmu Kebidanan. Jakarta: PT. Bina
Pustaka Sarwono Prawirohardjo.
UNAIDS (2006) ‘UNAIDS Action plan on intensifying
HIV prevention’, available at
http://data.unaids.org/pub/Report/2007/jc1218_preve
ntionactionplan_en.pdf.
Yulianti, A. P. (2013) ‘Kerentanan perempuan terhadap
penularan hiv&ids’, Palastren, 6(1), pp. 185–200.
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