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This essay contains an introduction and a translation of an account provided in Indonesian by Rully Mallay, a transgender community leader and activist at the Kebaya Foundation, a shelter for people living with HIV in the province of Yogyakarta. It describes the impact of restrictions imposed to reduce the spread of COVID-19 and mobilization in response to it by those who identify as “waria” between February and September 2020. Waria played a pivotal role in mobilizing a community response in that city, providing support not only to their own community but also to other marginal groups impacted in similar ways. Harsh lockdown measures imposed to respond to COVID-19 disproportionately affected waria, cutting off access to economic and community support. This was particularly acute for the many waria without state-issued identity cards. Nevertheless, Rully expresses her hope that through the skills and adaptability they have demonstrated in their response to the public health emergency, they might achieve recognition and acceptance from Indonesian society.

Background Community-based outreach programs play an important role in the provision of HIV testing, treatment and health care for men who have sex with men (MSM) in Indonesia. However, qualitative studies of community-based HIV programs have mostly focused on clients rather than on outreach workers (OW). The experiences of MSM peer OW provide insights into how to extend and improve community involvement in HIV programs in Indonesia. Methods: This is a qualitative study based on focus group discussions, which brought together MSM OW (n = 14) and healthcare workers (n = 12). This approach facilitated documentation of the challenges associated with community-based outreach programs in Indonesia through a participatory focus group discussion between OW and healthcare workers. Results: Findings are reported in relation to challenges experienced in the context of community outreach, and solutions to the challenges faced by OW. It was found that awareness of a shared commitment to delivering HIV programs can facilitate good relationships between OW and healthcare workers. Conclusion: Future efforts should consider the role of OW within broader relationships, especially with healthcare workers, when developing community-based responses to HIV testing and treatment. Documenting the role of OW can help contribute to an understanding of ways to adapt HIV programs to reduce barriers to access both for those identified as MSM and others who are ambiguously placed in relation to the programmatic use of such categories.

The COVID-19 pandemic has had a significant impact on HIV services globally, including communitybased outreach programmes. This article draws on a qualitative study of HIV outreach workers for men who have sex with men (MSM) in Jakarta, Indonesia undertaken between July and September 2020. The research documented the impact of the COVID-19 pandemic on HIV outreach programmes for MSM based on interviews, focus group discussions and video diaries collected from outreach workers. As a result of the pandemic, and in response to the guidelines issued by international donors and the Indonesian government, outreach workers shifted activities to 'virtual outreach' where possible. However, outreach workers consistently performed in-person work to address what they referred to as 'urgent' cases (e.g. required them to attend the clinic). Regardless of delivery mode, the steps comprising outreach work during the pandemic aligned with the 'cascade of care', which forms the dominant policy narrative for the management of HIV. Outreach work during the pandemic therefore continued to be based primarily on the objective of maintaining testing and treatment rates. Although outreach workers responded innovatively to the pandemic, including to the risk of COVID-19 infection, they were limited by the prevailing emphasis on targets in HIV programmes