<p>Human immunodeficiency virus (HIV) prevalence on pregnant women in Indonesia is estimated around 0.3%. The prevention of mother-to-child disease transmission (PMTCT) program has been implemented nationally since 2008, though, less than 50% of the total pregnant women each year get an HIV test and only 18% of those who are HIV positive get antiretroviral (ARV) treatment until now. COVID-19 pandemic, occurred since 2019, has brought significant changes to public health aspects including the utilization of HIV services. This study is aimed to determine factors influencing the PMTCT program services utilization during pandemic. This study used mix method approach with quantitative approach using a cross-sectional study design (174 HIV mothers from six provinces in Indonesia) and qualitative approach with in-depth interviews of 13 informants consisting of HIV mothers, health workers, program holders and peer facilitators. The results showed the HIV services utilization during pandemic was 52.3%. The most influenced factor was peer facilitators support (POR 2.96; 95% CI=1.45-6.03), HIV mothers who did not receive assistance from peer facilitators had 2.96 times chance of not utilizing the services compared to them who received. It requires to strengthen cooperation between health services and peer facilitators to support HIV mothers in accessing HIV services.</p>

Objectives: Low adherence to antiretroviral (ARV) therapy in pregnant women with human immunodeficiency virus (HIV) increases the risk of virus transmission from mother to newborn. Increasing mothers’ knowledge and motivation to access treatment has been identified as a critical factor in prevention. Therefore, this research aimed to explore barriers and enablers in accessing HIV care and treatment services.Methods: This research was the first phase of a mixed-method analysis conducted in Kupang, a remote city in East Nusa Tenggara Province, Indonesia. Samples were taken by purposive sampling of 17 people interviewed, consisting of 6 mothers with HIV, 5 peer facilitators, and 6 health workers. Data were collected through semi-structured interviews, focus group discussions, observations, and document review. Inductive thematic analysis was also performed. The existing data were grouped into several themes, then relationships and linkages were drawn from each group of informants.Results: Barriers to accessing care and treatment were lack of knowledge about the benefits of ARV; stigma from within and the surrounding environment; difficulty in accessing services due to distance, time, and cost; completeness of administration; drugs’ side effects; and the quality of health workers and HIV services.Conclusions: There was a need for a structured and integrated model of peer support to improve ARV uptake and treatment in pregnant women with HIV. This research identified needs including mini-counseling sessions designed to address psychosocial barriers as an integrated approach to support antenatal care that can effectively assist HIV-positive pregnant women in improving treatment adherence.