Background: Human Immunodeficiency Virus (HIV) has become one of the fastest-increasing epidemics in Indonesia. The HIV prevalence among female sex workers in Indonesia was 10% in 2011. HIV/AIDS VCT services for female sex workers population can play a major role in reducing HIV infection spread through sexual contact.
Purpose: The study aimed to apply the Theory of Planned Behavior to investigate factors associated with the utilization of voluntary HIV counseling and testing services among female sex workers in Indonesia.
Methods: A cross-sectional design among 128 of female sex workers (FSW) in Dolly and Jarak prostitution of Surabaya, Indonesia was conducted between Augusts and September 2013. Data were collected by applying structured questionnaire on self-administered base to measure the main constructs of the theory of planned behavior (TPB). A multiple linear regression analysis was conducted to predict the key variables on the intention to utilize VCT services using SPSS version 17.0.
Results: All of 128 female sex workers had done VCT. Attitude (β = 0.45, p = <0.001), and perceived behavioral control (β = -0.21, p = 0.009) were the two key predictors in TPB justified the variance of FSWs’ intention to utilize VCT services by 32 %.
Conclusions: The final model showed that TPB was applicable to predict FSWs’ intention to utilize VCT services. The results will be useful to develop the health care programs targeted at both maintaining and developing a positive attitude and improving FSWs’ intention to utilize VCT services.

Abamecha, F., Godesso, A., & Girma, E. (2013a). Intention to voluntary HIV counseling and testing (VCT) among health professionals in Jimma zone, Ethiopia: the theory of planned behavior (TPB) perspective. BMC Public Health, 13, 140. doi: 10.1186/1471-2458-13-140
Abamecha, F., Godesso, A., & Girma, E. (2013b). Predicting intention to use voluntary HIV counseling and testing services among health professionals in Jimma, Ethiopia, using the theory of planned behavior. J Multidiscip Healthc, 6, 399-407. doi: 10.2147/jmdh.s49339
Bwambale, F. M., Ssali, S. N., Byaruhanga, S., Kalyango, J. N., & Karamagi, C. A. (2008). Voluntary HIV counselling and testing among men in rural western Uganda: implications for HIV prevention. BMC Public Health, 8, 263. doi: 10.1186/1471-2458-8-263
Chiao, C., Morisky, D. E., Ksobiech, K., & Malow, R. M. (2009). Promoting HIV testing and condom use among Filipina commercial sex workers: findings from a quasi-experimental intervention study. AIDS Behav, 13(5), 892-901. doi: 10.1007/s10461-008-9418-9
de Paoli, M. M., Manongi, R., & Klepp, K. I. (2004). Factors influencing acceptability of voluntary counselling and HIV-testing among pregnant women in Northern Tanzania. AIDS Care, 16(4), 411-425. doi: 10.1080/09540120410001683358
Directorate General of Communicable Diseases & Environmental Health, MoH, RI. (2012). Laporan Perkembangan HIV-AIDS di Indonesia: Triwulan IV 2011.
Feinstein, L, Dimomfu, BL, Mupenda, B, Duvall, S, Chalachala, JL, Edmonds, A, . . . Luna, JR. (2013). Global report: UNAIDS report on the global AIDS epidemic 2013. Tropical Medicine and International Health, 18(10), 1211-1221.
Gu, J., Lau, J. T. F., & Tsui, H. (2011). Psychological factors in association with uptake of voluntary counselling and testing for HIV among men who have sex with men in Hong Kong. Public Health, 125(5), 275-282. doi: http://dx.doi.org/10.1016/j.puhe.2011.01.010
Hinduan, Z. R., Kesumah, N., Iskandar, Z., van Crevel, R., Alisjahbana, B., & Hospers, H. J. (2009). Characteristics of subjects counseled and tested for HIV in an Indonesian hospital; factors associated with HIV-status and CD4 cell-count. Acta Med Indones, 41 Suppl 1, 12-17.
Iliyasu, Z., Abubakar, I. S., Kabir, M., & Aliyu, M. H. (2006). Knowledge of HIV/AIDS and attitude towards voluntary counseling and testing among adults. J Natl Med Assoc, 98(12), 1917-1922.
Indonesia, Kementerian Kesehatan Republik. (2009). Estimasi Rawan Populasi Dewasa Terinfeksi HIV 2009.
Jereni, B. H., & Muula, A. S. (2008). Availability of supplies and motivations for accessing voluntary HIV counseling and testing services in Blantyre, Malawi. BMC Health Serv Res, 8, 17. doi: 10.1186/1472-6963-8-17
Kakoko, D. C., Astrom, A. N., Lugoe, W. L., & Lie, G. T. (2006). Predicting intended use of voluntary HIV counselling and testing services among Tanzanian teachers using the theory of planned behaviour. Soc Sci Med, 63(4), 991-999. doi: 10.1016/j.socscimed.2006.02.016
Kam, L. Y., Knott, V. E., Wilson, C., & Chambers, S. K. (2012). Using the theory of planned behavior to understand health professionals' attitudes and intentions to refer cancer patients for psychosocial support. Psychooncology, 21(3), 316-323. doi: 10.1002/pon.1897
Ko, N. Y., Feng, M. C., Chiu, D. Y., Wu, M. H., Feng, J. Y., & Pan, S. M. (2004). Applying theory of planned behavior to predict nurses' intention and volunteering to care for SARS patients in southern Taiwan. Kaohsiung J Med Sci, 20(8), 389-398. doi: 10.1016/s1607-551x(09)70175-5
Mirkuzie, Alemnesh, Sisay, Mitike, Moland, Karen, & Åstrøm, Anne. (2011). Applying the theory of planned behaviour to explain HIV testing in antenatal settings in Addis Ababa-a cohort study. BMC health services research, 11(1), 196.
O'Boyle, Carol A., Henly, Susan J., & Larson, Elaine. (2001). Understanding adherence to hand hygiene recommendations: The theory of planned behavior. American Journal of Infection Control, 29(6), 352-360. doi: http://dx.doi.org/10.1067/mic.2001.18405
Obermeyer, C. M., & Osborn, M. (2007). The utilization of testing and counseling for HIV: a review of the social and behavioral evidence. Am J Public Health, 97(10), 1762-1774. doi: 10.2105/AJPH.2006.096263
Omer, S. (2010). Applicability of the theory of planned behavior in predicting intended use of Voluntary HIV Counseling and Testing services among teachers of Harari Region, Ethiopia. The Ethiopian journal of health development, 24(2). doi: 10.4314/ejhd.v24i2.62957
Sasaki, Y., Arifin, A., Ali, M., & Kakimoto, K. (2011). Willingness to undergo HIV testing among factory workers in Surabaya, Indonesia. AIDS Care, 23(10), 1305-1313. doi: 10.1080/09540121.2011.555745
UNAIDS. (2000). Voluntary Counselling and Testing (VCT). UNAIDS Technical update.
UNAIDS. (2012a). Global Report: UNAIDS Report on the Global AIDS Epidemic 2012.
UNAIDS. (2012b). Together We Will End AIDS.
USAID. (2010). Indonesia: HIV/AIDS Health Profile.
Wang, Y., Li, B., Pan, J., Sengupta, S., Emrick, C. B., Cohen, M. S., & Henderson, G. E. (2011). Factors associated with utilization of a free HIV VCT clinic by female sex workers in Jinan City, Northern China. AIDS Behav, 15(4), 702-710. doi: 10.1007/s10461-010-9703-2
Wang, Y., Li, B., Zheng, J., Sengupta, S., Emrick, C. B., Cohen, M. S., & Henderson, G. E. (2009). Factors related to female sex workers' willingness to utilize VCT service: a qualitative study in Jinan city, northern China. AIDS Behav, 13(5), 866-872. doi: 10.1007/s10461-008-9446-5
Wang, Ying, Pan, Jing-Bin, Wang, Xiao-Feng, Li, Bing, Henderson, Gail, Emrick, Catherine Boland, . . . Cohen, Myron. (2010). Reported Willingness and Associated Factors Related to Utilization of Voluntary Counseling and Testing Services by Female Sex Workers in Shandong Province, China. Biomedical and Environmental Sciences, 23(6), 466-472. doi: 10.1016/s0895-3988(11)60009-3
WHO. (2011). Global Health Sector Strategy On HIV/AIDS 2011-2015.
WHO. (2012a). Prevention and Treatment of HIV and Other Sexually Transmitted Infections for Sex Workers in Low and Middle Income Countries. 46.
WHO. (2012b). Prevention and Treatment of HIV and Other Sexually Transmitted Infections for Sex Workers in Low and Middle Income Countries: recommendations for A Public Health Approach.