Session

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Statistique, Développement et Droits de l‘Homme
Session C-Pa 7a
The Relation between Source of Information
and the Knowledge about HIV / AIDS for
Adolescent Street Children in Bandung,
Indonesia, 1999
Ahyani RAKSANAGARA
Montreux, 4. – 8. 9. 2000
Statistique, Développement et Droits de l‘Homme
The Relation between Source of Information and the
Knowledge about HIV / AIDS for Adolescent Street Children
in Bandung, Indonesia, 1999
Ahyani RAKSANAGARA
Health Office, Bandung Municipality
Jl. Supratman No. 73
40235 Bandung, West Java, Indonesia
T. + 6222 720 2210 F.+ 6222 522 3517
grafist@indosat.net.id
ABSTRACT
The Relation between Source of Information and the Knowledge about HIV / AIDS for
Adolescent Street Children in Bandung, Indonesia, 1999
Economic development is not always make prosperity which is evenly distributed, some
people become a border community. Specially in big cities, they usually live in border of city or live
between the famous and big buildings in the centre of the city. The children from these families
become street children. They must work for the family, because they don’t have any capability for
working another job so they work in the street. They sale newspapers, candy or beg while singing
plating musical instruments. The economic crisis in Indonesia make the number of poor families
increase so the number of street children become increasing. Bandung is the capital city of West
Java Province, one province in Indonesia with 40 million people. We can see the street children
almost at every “traffic light” in the street or in the quarter of streets in Bandung. The street
children don’t have a healthy life style, street culture often encourages and reinforces risky
behaviors. They report of being forced to have sexual intercourse. Adolescent street children are a
high risk group for HIV/AIDS because of their risky behavior. In Indonesia 82.8 % of HIV/AIDS
cases are from productive age (15-35 years) and 83.3% transmission come from sexual
transmission. Because of that, we want to know the knowledge about HIV/AIDS from adolescent
street children and from what kind of source they get the information about HIV/AIDS. The sample
of this research is 77 adolescent street children, taken from five “stop in home” for street children;
we collected the data with questionnaire. The result of this research is: 88.3% are male, only 10.8%
still go to school, 52% are between 10 to 15 years old, the level of education 78% are passed
elementary school or below, only 57.1% have good level of knowledge about HIV/AIDS, 74% know
about HIV/AIDS from mass media (tv, radio, newspaper). We get a significant relation between
source information from mass media and level of knowledge about HIV/AIDS. Increasingly the
knowledge about HIV/AIDS for adolescent street children is very important, we have to increase the
health education for them. After we give them information we have to continue with another activity
like counseling or support them with recruitment the buddies for them.
RESUME
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Statistique, Développement et Droits de l‘Homme
Lien entre les sources d'informations et les connaissances sur le HIV / SIDA des enfants
des rues de Bandung, Indonésie, 1999
Le développement économique n'engendre pas toujours des richesses, qui sont réparties de
façon inégale, certaines personnes sont marginalisées. Dans les grandes métropoles notamment,
ces dernières vivent souvent aux frontières de la ville ou entre les grands buildings chics du
centre ville. Les enfants de ces familles deviennent des enfants des rues. Ils doivent travailler
pour subvenir aux besoins de leur famille et n’ayant aucune aptitude pour faire un autre travail,
ils se retrouvent dans les rues. Ils vendent des journaux, des sucreries ou mendient en chantant
et en jouant d’un instrument. La crise économique en Indonésie accroît le nombre de familles
pauvres, ce qui entraîne une augmentation du nombre d'enfants dans les rues. Bandung est la
capitale de la province de Java ouest, une province d'Indonésie qui compte 40 millions
d'habitants. A Bandung, il y a des enfants des rues à chaque feu tricolore et à chaque
intersection de rues. Ils n'ont pas un mode de vie sain et la culture de la rue encourage et
renforce les comportements à risque. Ils ont affirmé être contraints à avoir des rapports sexuels.
Les enfants des rues constituent un groupe à haut risque pour le HIV / SIDA en raison de leur
comportement à risque. En Indonésie, les individus étant en âge de procréer (15-35 ans)
représentent 82,8 % des cas de HIV / SIDA et 83,3 % des transmissions du virus se font par voie
sexuelle. C’est pourquoi, nous souhaitons nous rendre compte du degré de connaissances des
enfants de la rue sur le virus HIV / SIDA et connaître leurs sources d'informations. Dans le
cadre de cette recherche, 77 adolescents des rues, rencontrés dans 5 refuges, ont été questionnés
afin d'obtenir des données. Voici ce qui est ressorti de cette enquête : 88,3 % des enfants sont de
sexe masculin, seuls 10,8 % sont toujours scolarisés, 52 % sont âgés de 10 à 15 ans, quant à
leur niveau d'éducation, 78 %, ou moins, sont allés à l'école primaire, seulement 57,1 % ont un
niveau de connaissance suffisant concernant le HIV / SIDA, 74 % tirent leur connaissance des
médias (télévision, radio, journaux). Un lien significatif s'établit entre les sources d'information
provenant des médias et le degré de connaissance des virus HIV / SIDA. Il est très important de
développer les connaissances des enfants des rues sur le HIV / SIDA ainsi que leur hygiène. Une
fois les informations transmises, nous devrons poursuivre par une autre activité, telle que
l’assistance socio-psychologique ou le soutien dans leurs fréquentations.
1. Background Information
The aim of the national development in Indonesia is to increase the standard of living and
prosperity for the community. The effort to increase the prosperity of Indonesian community is
pointed to all social class, including children. Children are source of nation potency and they are the
future generation to catch the aim. Because of that they need the chance to growth and
development.
Children have the strategic position to continue the development, they are hoped to be a
qualified human resources. In the other position they have a special character, so to guarantee their
growth and development they need founding and protection.
The fact is very different, there are so many children live without having opportunity to get
the right, specially the children come from poor family. In this condition the children must help
their parents to give the income for the family. They must work, go out from the family and live at
the street to be the street children. The street children will growth and develop, without control and
protection from the parents or other older people. Living in the street is very sensitive to get the
accident, violence and to be a person with high-risk behaviour for HIV/AIDS transmission.
There are three types of street children: children of the street are the children that live in the
street, children on the street are the children that work and spent the time at the street, and
vulnerable to be street children, they are the children that come from the poor family with high-risk
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Montreux, 4. – 8. 9. 2000
Statistique, Développement et Droits de l‘Homme
to be street children. The economic crisis and social crisis give the effect to increase the poor
family, this condition increasing the number of street children. In 1999 there are 1804 street
children in Bandung. And 66.6% from them are the children with age more than 14 years old. If we
can not handle this problem, they will loose the opportunity to be the productive and qualified
generation. The convention on the rights of child mention the rights for the children such as: to get
the information, live in the circle of family, children caring, get the health services, get the
education. The street children are far away from the rights, they are living with more
implementation the duties than the rights.
In the circle of life, the adolescent period is the very sensitive period that the children must
pass away. The reproductive organ is already mature for reproductive function, but at the other side
the adolescents still find the identity. This period is very important, because adolescent period like a
bridge that cross from children period to adult period with responsibility. They need the parents or
the person who has a role like their parents, to care and protect them.
The adolescent street children is the high risk behavior group for HIV/AIDS transmission, we
can see the data from the research in 1998. This research is worked by Unicef, Statistical Center
Office of Indonesia and Medicine faculty of University in Bandung. The result is 2.3% from street
children that get the medical examination are diagnosed GO (gonorhoe) positive. This condition
indicate that the sexual transmitted disease is already occurred there.
The impact of HIV/AIDS is very broad, it will touch the social, economic and culture aspect.
For example the economic aspect, to give treatment and caring the people with HIV/AIDS will need
very high cost. Usually the people with HIV/AIDS come from productive group, this condition will
inflict a financial lost for the country. The country with economic crisis will get the double
jeopardy.
In Indonesia, the first case is reported on 1987, after that the number of case increase every
year. 85.6% for the HIV/AIDS cases come from young people for 15 to 49 years old. 82% from the
model of transmission is sexual transmission. In December 1999 Indonesia Health Department is
reported 1014 cases HIV/AIDS, 9 cases come from Bandung.
Prevention action is one of the strategic to fight HIV/AIDS, this strategic is more effective
and efficient. People will keep away from the risk behavior for HIV/AIDS transmission, if they
know about HIV/AIDS.
Generally the growth and development problem in adolescent street children is the same as
other the adolescent. But there is a different between them, the difference is social contact. Street
children have a limit social contact. Usually they contact just with their friends at the street, for
some of them contact with parents and school circle just only a little time. In fact some of them
never touch with their family and never go to school anymore. This situation make them have a
limit source of information, including about HIV/AIDS.
From that condition bring out some questions:
• How far the adolescent street children know about HIV/ AIDS
• What kind of source of information existence in the circle of street children, that give the
information about HIV/AIDS
• How is the characteristic of adolescent street children
• How is the relation between source of information and the knowledge about HIV/AIDS at
adolescent street children
2. Objective
The general objective from this research is to find the image of adolescent street children
about the level of knowledge about HIV/AIDS, kind of source of information in the circle of street
children, and the relation between source of information and the knowledge about HIV/AIDS at
adolescent street children.
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Statistique, Développement et Droits de l‘Homme
The specific objectives are:
• To study the level of knowledge about HIV/AIDS in adolescent street children
• To study kinds of source of information that existence in the circle of street children
• To study the characteristic of adolescent street children
• To study the relation between characteristic of adolescent street children and the source of
information and the knowledge about HIV/AIDS
• To study the relation between source of information and the knowledge about HIV/AIDS
at adolescent street children
3. The Concept of Study
SOURCE OF INFORMATION :





Mass media
Leaflet/poster
Formal educator
(teacher, health worker)
Close circles (parent,
friends, volunteer that
assistance street
children)
Religion Leader
LEVEL OF KOWLEDGE
ABOUT HIV/AIDS
CHARACTERISTIC OF
ADOLESCENT STREET
CHILDREN :





Sex
Age
Religion
Status of schooling
Level of education
The level of knowledge about HIV/AIDS is the dependent variable, from the answer of
questioner is grouped to be good and less. Source of information is the independent variable, and
the characteristic of adolescent street children is the confounding variable.
4. Design and Methodology
The design of this research is quantitative and qualitative approach. The quantitative approach
by giving the questionnaire, and the qualitative approach by doing focus group discussion.
The population of this research is the street children in Bandung, there are 1804 street
children (data from NGO, 1999). The inclusion criteria for sample are age 10 to 19 years old,
registered at open house from street children (NGO).The exclusion criteria is married.
This quantitative research is cross sectional surveys method using questioner as the
instrument of survey. The qualitative data did by making focus group discussion with two groups
adolescent street children, each group consist of 7 (seven) adolescent street children.
Data analysis by using univariate, bivariate and multivariate analysis. To get the sample size
we use the Proportional Stratified Random Sampling formula from Adequacy of Sample Size in
Health Studies (Lemeshow):
Z 2 1-
/2
L
{N2 h Ph (1 - Ph ) } / W h
h=1
--------------------------------------------------------------------2 2
N d
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Statistique, Développement et Droits de l‘Homme
Level of confidence 95% and precision 10%, we get the sample size: 77,03. There are 5 open
houses in Bandung, the sample distribution for each open house is:
Table 1. The Sample Distribution For Each Open House
NO
1
2
3
4
5
Name of Open
House (NGO)
Ar Rufi
Bahtera
Mesra
Masyarakat Sehat
Saman
TOTAL
Number of
Street Children
436
563
389
286
130
1804
Number of
Sample
19
24
17
12
5
77
The location of this research is in Bandung City, the capital of West Java Province Indonesia.
The research started from November 1999 to December 1999 for quantitative. And at May 2000 for
qualitative research.
Collecting the quantitative data was done by using questionnaire, that have been filled in by
the repondents. SPPS is used to analysis the data.
5. Results and Discussion
5.1 Univariate Analysis
a)
Level of Knowledge
From 22 questions, we give 0 for wrong answer and 1 for correct answer. The distribution of
score is shown in graphic 1.
Graphic 1. Adolescent Street Children Distribution by Score of HIV/AIDS Knowledge Bandung –
1999
Scoring of Knowledge about HIV/AIDS
20
Frequency
10
Std. Dev = 3,65
Mean = 15,1
N = 7 7,00
0
4,0
6,0
8,0
10,0
12,0 14,0
16,0 18,0 20,0
22,0
Sco ring of Knowled ge abo ut HIV/AIDS
We make categorization for the level of knowledge, with cut off point 15. The score 15 or
more is grouped good knowledge, and the score above 15 is grouped less knowledge. The
distribution of street children by level of knowledge about HIV/AIDS is shown by table 2:
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Statistique, Développement et Droits de l‘Homme
Table 2. Adolescent Street Children Distribution by Level of HIV/AIDS Knowledge, Bandung
1999
Level of Knowledge
Less
Good
Total
Number
33
44
77
%
42,9
57,1
100
From table 2 we can see only 57.1% adolescent street children are grouped in good
classification. On the other side, we know that street children have risk bevahiour for HIV/AIDS
transmission. Because of that its better if more adolescent street children know about HIV/AIDS.
b)
Source of Information
The source of information that exist for street children circles is showed in table 3:
Table 3. Distribution of Source Information at Adolescent Street Children, Bandung 1999
Source of Information
Yes
n
57
25
25
59
13
1. Mass Media
2. Leaflet/Poster
3. Formal Educator
4. Close Circles
5. Religion Leader
No
%
74
32,5
32,5
76,6
16,9
N
20
52
52
18
64
Total
%
26
67,5
67,5
23,4
83,1
n
77
77
77
77
77
%
100
100
100
100
100
The highest percentage about source of information is close circle (76.6%). Street children
spent hole time at the street with people who live at the street, like their friends, volunteer that
assistance street children. The relation between them are very close like a best friend. With this
source information we can give the information for the street children. Mass media has a high
percentage (74%). Newspaper, radio and television have a strength can give the information to
many people in the short time, entertain and attractive.
c)
Respondent Characteristics
The respondent characteristic that can give the influence to source of information and to level
of knowledge about HIV/AIDS are showed in table 4.
Table 4. Distribution of Adolescent Street Children According to Characteristics, Bandung 1999
Characteristics
Number
%
68
9
77
88,3
11,7
100
40
37
77
51,9
48,1
100
77
100
Sex :
 Male
 Female
Age :
 10 – 15 years old
 16 – 19 years old
Religion :
 Islam
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Statistique, Développement et Droits de l‘Homme
Status of Schooling:
 Still go to school
 Don’t go to school
Level of education :
 Never/drop out from elementary
 Graduated from elementary
 Graduated from high school
8
69
10,4
89,6
77
100
33
27
17
77
42,8
35,1
22,1
100
The important thing is 89.6% from respondents can not go to school anymore, besides they
are the children in school age. They live at the street for working, is hard to involve the street
children to the school, because in their mind just only to get the money today. They do not have a
motivation to go to school.
5.2 Bivariate Analysis
The result of bivariate analysis using Chi-Square Statistic analysis is shown in table 5:
Table 5. Result of Bivariate Analysis
NO
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
VARIABLE
Mass media and level of knowledge
Leaflet/poster and level of knowledge
Formal educator and level of knowledge
Close circles and level of knowledge
Religion leader and level of knowledge
Age and level of knowledge
Status of schooling and level of knowledge
Level of education and level of knowledge
Age and mass media
Status of schooling and mass media
Level of education and mass media
Age and leaflet/poster
Status of schooling and leaflet/poster
Level of education and leaflet/poster
Age and formal educator
Status of schooling and formal educator
Level of education and formal educator
Age and close circles
Status of schooling and close circles
Level of education and close circles
Age and religion leader
Status of schooling and religion leader
Level of education and religion leader
P Value
0.202
0.068
0.725
0.484
0.792
0.025
0.746
0.189
0.402
0.077
0.059
0.995
0.748
0.348
0.622
0.748
0.605
0.071
0,909
0.066
0.286
0.727
0.298
RESULT
Odds Ratio
0.54
0.389
0.841
0.686
1.175
2.889
0.780
1.014 & 3.059
0.644
1.408
0.350 & 0.205
1.003
1.282
1.225 & 2.450
1.273
1.282
2.337 & 0.990
2.720
0.906
2.537 & 5.075
0.518
0.679
0.967 & 0.381
There are not relation between source of information and level of knowledge, characteristic of
adolescent street children and the level of knowledge, characteristic and source of information. But
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Montreux, 4. – 8. 9. 2000
Statistique, Développement et Droits de l‘Homme
the variables with p value < 0.25 are included to be a candidate variables that will continue analysis
with multivariate.
5.3 Multivariate Analysis
The multivariate analysis for independent variable and dependent variable, controlled by
confounding variable is shown below:
POSTER
MASS MEDIA
AGE
LEVEL OF EDU
EDU(1)
EDU(2)
Constant
B
-,965
-,521
1,067
S.E.
,565
,578
,514
-,169
,799
,932
,583
,719
1,431
Wald
2,916
,813
4,313
1,856
,084
1,235
,424
df
1
1
1
2
1
1
1
Sig.
,088
,367
,038
,395
,772
,267
,515
Exp(B)
,381
,594
2,906
,845
2,223
2,539
The result from multivariate analysis is no relation between source of information and the
level of knowledge about HIV/AIDS at adolescent street children after was controlled by the
characteristic of the adolescent street children.
5.4 Qualitative Analysis
To know the answer why there is no relation between source of information and the level of
knowledge about HIV/AIDS at adolescent street children, but in the other side 57.1% are good level
of knowledge we did focus group discussion (FGD). From FGD they said that they know
HIV/AIDS from: books in the open house, poster (at the street, store, health facility), newspapers,
writing at the street, the volunteer, television, leaflet and magazine.
They said information with poster is interesting, but the picture must be attractive. Not all the
children can understand the message in the poster, the picture must easy to understand. From radio
is very rare, because the radio at the open house is rare available. From television is very
interesting, specially if giving information by using a story. By news paper is very rare, they said is
more interesting if giving information by using picture and is placed in first page.
The source information that very interesting for street children is using comic. They said if
something are not understand, they will ask to the volunteer that assistance them at the street.
6. Conclusion
•
•
•
•
•
The level of knowledge about HIV/AIDS at adolescent street children is still low
Source of information that already existence in the circle of street children still have not a
role to increase the knowledge about HIV/AIDS
There is no relation between source of information and level of knowledge about
HIV/AIDS
There is no relation between adolescent street children characteristic and level of
knowledge about HIV/AIDS, except age
There is no relation between source of information and the level of knowledge about
HIV/AIDS at adolescent street children after was controlled by the characteristic of the
adolescent street children.
7. Suggestions
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Statistique, Développement et Droits de l‘Homme
•
•
•
•
•
•
•
The intervention for increasing the knowledge about HIV/AIDS for adolescent street
children is still needed
Increasing the knowledge about HIV/AIDS for adolescent street children must use all the
source information that existence in the circle of street children
The information must be attractive, simple and easy to understand
The knowledge about HIV/AIDS of the volunteer must be increased by training
The monitoring program for prevention transmission of HIV/AIDS at street children is
needed, we can observe the STD case, make a behavior survey or to do HIV/AIDS
screening if its possible
Giving the information must do simultaneously by socialization using condom
The level of education of the street children must be increased by giving them fellowship,
training and open the “opening school” for them
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