Factors Associated with Women\u27s Decision to Become Commercial Sex Workers in Banjarsari, Surakarta, Central Java

Background: In Indonesia, the number of new HIV cases in 2016 was 41.250, and AIDS cases was 7,491. HIV infection predominantly (67.6%) occur heterosexually. In Central Java, the number of Di Indonesia, new HIV cases in 2016 was 4.032, and AIDS cases was 1.402. Surakarta City has the second highest cases of HIV in Central Java after Semarang District with 38 HIV cases and 46 AIDS cases in September 2017. This study aimed to analyze factors associated with women\u27s decision to become commercial sex workers in Banjarsari.Subjects and Method: This was an analytical observational study with case control design. The study was conducted in Banjarsari, Surakarta, Central Java. A total sample of 200 study subjects consisting of 100 female commercial sex workers and 100 non sex workers. The dependent variable was women\u27s decision to become commercial sex worker. The independent variables were knowledge of sexually-transmitted disease, family income, pro-commercial sex worker family support, snobbish life style, and access to whore house. The data were collected by questionnaire and analyzed by multiple logistic regression.Results: Women\u27s decision to become commercial sex worker was negatively associated with good knowledge of sexually-transmitted disease (OR= 0.03; 95% CI= 0.01 to 0.18; p<0.001), high family income (OR= 0.01; 95% CI<0.01 to 0.05; p<0.001). Women\u27s decision to become commercial sex worker was positively associated with strong pro-commercial sex worker family support (OR=8.15; 95% CI= 2.63 to 25.23; p<0.001), snobbish life style (OR= 6.20; 95% CI= 1.81 to 21.24; p= 0.004), and access to whore house (OR= 8.52; 95% CI=2.49 to 29.17; p= 0.001).Conclusion: Women\u27s decision to become commercial sex worker has negative association with good knowledge of sexually-transmitted disease, high family income. Women\u27s decision to become commercial sex worker has positive association with strong pro-commercial sex worker family support, life style, and access to whore house.Keyword: Women\u27s decision, commercial sex worker, knowledge, family income, family support, life style, access to whore houseCorrespondence: Syefira Ayudia Johar. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java. Email: [email protected]. Mobile: +6282136422448.Journal of Epidemiology and Publich Health (2018), 3(1): 72-82https://doi.org/10.26911/jepublichealth.2018.03.01.0

Safe Sex Behavior among Commercial Sex Workers in Banjarsari, Surakarta, Central Java, and its Associated Factors

Background: Worldwide it is estimated that more than one million people in contract sexually-transmitted disease (STDs) everyday. Annually approximately 357 million new infections occur by one of four STDs: chlamidia, gonorrhea, syphilis, and mouth ulcer. The incidence of HIV/AIDS has been increasing year by year. HIV/AIDS has spread in 407 of 507 districts and municipalities in Indonesia, or equivalently covering 80% districts and municipalities of the country. In Surakarta, the cumulative incidence of HIV/AIDS from 2005 to 2017 was 561 cases, with 38 HIV cases and 46 AIDS cases in 2017 alone. Safe sex is important to prevent pregnancy, STDs, and most importantly HIV and AIDS. This study aimed to examine factors associated with safe sex behavior among commercial sex workers in Banjarsari, Surakarta, Central Java. Subjects and Method: This was a cross-sectional study conducted in Banjarsari Sub-district, Surakarta, Central Java. A total sample of 100 commercial sex workers was selected by stratified random sampling. The dependent variable was safe sex behavior. The independent variables were knowledge of STDs and HIV/AIDS, self efficacy, condom availability, access to health care service, health personnel support, and peer support. The data were collected by questionnaire and analyzed by a multiple linear regression. Results: Safe sex behavior was associated with good knowledge of STDs and HIV/AIDS (b= 0.19; 95% CI= 0.01 to 0.30; p= 0.032), strong self efficacy (b= 0.18; 95% CI= 0.01 to 0.38; p= 0.047), condom availability (b= 0.30; 95% CI= 0.36 to 1.20; p<0.001), good access to health care service (b= 0.19; 95% CI= 0.02 to 0.52; p= 0.035), strong health personnel support (b= 0.18; 95% CI= 0.01 to 0.57; p= 0.041), strong peer support (b=0.17; 95% CI= 0.01 to 0.50; p= 0.046). Conclusion: Safe sex behavior is associated with good knowledge of STDs and HIV/AIDS, strong self efficacy, condom availability, access to health care service, strong health personnel support, and strong peer support. Keywords: safe sex behavior, knowledge, self efficacy, condom availability, access to health service, health personnel support, peer suppor

Women’s Decision to Become Commercial Sex Workers in Banjarsari, Surakarta, Central Java, and its Associated Factors

Background: Worldwide, an estimated 33 million people are living with Human Immuno Deficiency Virus (HIV). Sex workers are 10 times more at risk of HIV compared with the general population, due to an increased likelihood of being economically vulnerable, unable to negotiate consistent condom use, and experiencing violence, criminalisation and marginalisation. Little is known about factors associated with the decision to work as a female sex worker in Indonesia. This study aimed to examine factors associated with women’s decision to become commercial sex workers in Banjarsari, Surakarta, Central Java. Subjects and Method: This was a case control study conducted in Banjarsari, Surakarta, Central Java. A total sample of 200 study subjects consisting of 100 female commercial sex workers and 100 non sex workers. The dependent variable was women’s decision to become commercial sex worker. The independent variables were knowledge of sexually-transmitted disease (STDs), family income, pro-commercial sex worker family support, snobbish life style, and access to whore house. The data were collected by questionnaire and analyzed by a multiple logistic regression. Results: Women’s decision to become commercial sex worker was negatively associated with good knowledge of STDs (OR= 0.03; 95% CI= 0.01 to 0.18; p<0.001), high family income (OR= 0.01; 95% CI<0.01 to 0.05; p<0.001). Women’s decision to become commercial sex worker was positively associated with strong pro-commercial sex worker family support (OR= 8.15; 95% CI= 2.63 to 25.23; p<0.001), snobbish life style (OR= 6.20; 95% CI= 1.81 to 21.24; p= 0.004), and access to whore house (OR= 8.52; 95% CI= 2 .49 to 29.17; p= 0.001). Conclusion: Women’s decision to become commercial sex workers decreases with good knowledge of the STDs and higher family income. Women’s decision to become commercial sex workers increases with strong pro-commercial sex worker family support, life style, and access to whore house. Keywords: Women’s decision, commercial sex worker, knowledge, family income, family support, life style, access to whore hous

Protease-mediated release of chemotherapeutics from mesoporous silica nanoparticles to <em>ex vivo</em> human and mouse lung tumors.

Nanoparticles allow for controlled and targeted drug delivery to diseased tissues and therefore bypass systemic side effects. Spatiotemporal control of drug release can be achieved by nanocarriers that respond to elevated levels of disease-specific enzymes. For example, matrix metalloproteinase 9 (MMP9) is overexpressed in tumors, is known to enhance the metastatic potency of malignant cells, and has been associated with poor prognosis of lung cancer. Here, we report the synthesis of mesoporous silica nanoparticles (MSNs) tightly capped by avidin molecules via MMP9 sequence-specific linkers to allow for site-selective drug delivery in high-expressing MMP9 tumor areas. We provide proof-of-concept evidence for successful MMP9-triggered drug release from MSNs in human tumor cells and in mouse and human lung tumors using the novel technology of ex vivo 3D lung tissue cultures. This technique allows for translational testing of drug delivery strategies in diseased mouse and human tissue. Using this method we show MMP9-mediated release of cisplatin, which induced apoptotic cell death only in lung tumor regions of Kras mutant mice, without causing toxicity in tumor-free areas or in healthy mice. The MMP9-responsive nanoparticles also allowed for effective combinatorial drug delivery of cisplatin and proteasome inhibitor bortezomib, which had a synergistic effect on the (therapeutic) efficiency. Importantly, we demonstrate the feasibility of MMP9-controlled drug release in human lung tumors

Applicability of avidin protein coated mesoporous silica nanoparticles as drug carriers in the lung.

Mesoporous silica nanoparticles (MSNs) exhibit unique drug delivery properties and are thus considered as promising candidates for next generation nano-medicines. In particular, inhalation into the lungs represents a direct, non-invasive delivery route for treating lung disease. To assess MSN biocompatibility in the lung, we investigated the bioresponse of avidin-coated MSNs (MSN-AVI), as well as aminated (uncoated) MSNs, after direct application into the lungs of mice. We quantified MSN distribution, clearance rate, cell-specific uptake, and inflammatory responses to MSNs within one week after instillation. We show that amine-functionalized (MSN-NH2) particles are not taken up by lung epithelial cells, but induced a prolonged inflammatory response in the lung and macrophage cell death. In contrast, MSN-AVI co-localized with alveolar epithelial type 1 and type 2 cells in the lung in the absence of sustained inflammatory responses or cell death, and showed preferential epithelial cell uptake in in vitro co-cultures. Further, MSN-AVI particles demonstrated uniform particle distribution in mouse lungs and slow clearance rates. Thus, we provide evidence that avidin functionalized MSNs (MSN-AVI) have the potential to serve as versatile biocompatible drug carriers for lung-specific drug delivery

Organ‐restricted vascular delivery of nanoparticles for lung cancer therapy.

Nanoparticle‐based targeted drug delivery holds promise for treatment of cancers. However, most approaches fail to be translated into clinical success due to ineffective tumor targeting in vivo. Here, the delivery potential of mesoporous silica nanoparticles (MSN) functionalized with targeting ligands for epidermal growth factor receptor and C─C chemokine receptor type 2 is explored in lung tumors. The addition of active targeting ligands on MSNs enhances their uptake in vitro but fails to promote specific delivery to tumors in vivo, when administered systemically via the blood or locally to the lung into immunocompetent murine lung cancer models. Ineffective tumor targeting is due to efficient clearance of the MSNs by the phagocytic cells of the liver, spleen, and lung. These limitations, however, are successfully overcome using a novel organ‐restricted vascular delivery (ORVD) approach. ORVD in isolated and perfused mouse lungs of Kras‐mutant mice enables effective nanoparticle extravasation from the tumor vasculature into the core of solid lung tumors. In this study, ORVD promotes tumor cell‐specific uptake of nanoparticles at cellular resolution independent of their functionalization with targeting ligands. Organ‐restricted vascular delivery thus opens new avenues for optimized nanoparticles for lung cancer therapy and may have broad applications for other vascularized tumor types

Cathepsin-B Induced Controlled Release from Peptide-Capped Mesoporous Silica Nanoparticles

New capped silica mesoporous nanoparticles for intracellular controlled cargo release within cathepsin B expressing cells are described. Nanometric mesoporous MCM-41 supports loaded with safranin O (S1-P) or doxorubicin (S2-P) containing a molecular gate based on a cathepsin B target peptidic sequence were synthesized. Solids were designed to show "zero delivery" and to display cargo release in the presence of cathepsin B enzyme, which selectively hydrolyzed in vitro the capping peptide sequence. Controlled delivery in HeLa, MEFs WT, and MEFs lacking cathepsin B cell lines were also tested. Release of safranin O and doxorubicin in these cells took place when cathepsin B was active or present. Cells treated with S2-P showed a fall in cell viability due to nanoparticles internalization, cathepsin B hydrolysis of the capping peptide, and cytotoxic agent delivery, proving the possible use of these nanodevices as new therapeutic tools for cancer treatment.We thank the Spanish Government (Project MAT2012-38429-C04 and SAF2010-15512) and the Generalitat Valenciana (Project PROMETEO/2009/016 and PROMETEOII/2014/061) for support. C. T. is grateful to the Spanish Ministry of Science and Innovation for her PhD fellowship. L. M. thanks the Generalitat Valenciana and Nice city council for their postdoctoral contracts VALI+D and "Aides Individuelles aux Jeunes Chercheurs 2011". C. C. thanks the Generalitat Valenciana for their postdoctoral contract VALI+D. M.O. thanks the CIPF for her postdoctoral fellowship. 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