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Conclusion: HIV has reached substantial levels among transgender sex workers, and is not negligible in other MSM groups.Risk behaviour is high in all subpopulations, and bisexual behaviour is common, meaning the threat of a wider epidemic is substantial.For syphilis testing, sera were screened using a rapid reagin test (Macro View RPR, Becton Dickenson, Meylan, France).Samples found to be RPR (rapid plasma reagin) positive had serial twofold titres performed using the same test.Prevention programmes targeting male-male sex are needed to reduce this threat.Indonesia, the world’s fourth most populous nation, recorded very low levels of HIV infection throughout the 1990s, even in populations at high risk for HIV such as female sex workers and injecting drug users. HIV began to rise significantly in several sentinel populations in Indonesia at the beginning of this century.Many waria identify themselves as females; none of the other groups necessarily identified themselves as homosexual or bisexual.Community organisations mapped the locations where these populations gathered to meet new partners and where commercial sex transactions took place.

At the data collection point, the supervisor explained the study procedures more fully, answered questions, and sought informed consent before enrolling participants.

The Indonesian Ministry of Health therefore collaborated in cross sectional surveys of HIV and syphilis seroprevalence and sexual behaviour among these groups in the capital city, Jakarta.

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