HIV transmission risk implications of estimates of premarital conceptions: the case of Indonesia.

The governments of some Asian countries until recently denied that they had a problem with HIV. They are now moving from that denial to actively seek information to help them define the magnitude of their problem and target sub-populations of at-risk individuals. Some of these countries have modernized and Westernized extensively since the mid 1970s. By definition this process of Westernization has entailed a certain abandonment by populations in these selected Asian countries of traditional beliefs norms and practices in favor of that which is more prevalent in Western society. Adolescents and youths are delaying marriage and childbearing but still having sex. In so doing many sexually active single individuals are at risk of contracting and/or transmitting HIV. The authors examine data from the National Indonesian Contraceptive Prevalence Survey in a study of how patterns of premarital conceptions have changed. This survey is the Indonesian version of the 1987 Demographic and Health Survey covering 20 of the 27 provinces within the country. Data come from completed interviews with 11884 women aged 15-49 years. The researchers looked at the marital month of first birth to derive estimates of premarital conceptions for marriage cohorts. Estimates produced suggest that the level of premarital sexual intercourse has been increasing steadily since the late 1950s but particularly fast since the mid to late 1970s. Premarital intercourse is now prevalent and increasing rapidly in many segments of the country. The implications of these observations for the development and targeting of intervention programs is discussed.