Barriers to HIV testing among male clients of female sex workers in Indonesia

Abstract

BackgroundFrequent engagement of men in sexual encounters with female sex workers (FSWs) without using condoms places them at a high risk for HIV infection. HIV testing has been noted to be among important strategies to prevent HIV transmission and acquisition. However, it is known that not all men willingly undertake an HIV test as a way to prevent HIV transmission and/or acquisition. This study aimed to identify barriers to accessing HIV testing services among men who are clients of FSWs (clients) in Belu and Malaka districts, Indonesia.MethodsA qualitative inquiry employing face to face open ended interviews was conducted from January to April 2017. The participants (n = 42) were clients of FSWs recruited using purposive and snowball sampling techniques. Data were analysed using a qualitative data analysis framework.ResultsFindings indicated three main barriers of accessing HIV testing services by clients. These included: (1) personal barriers (lack of knowledge of HIV/AIDS and HIV testing availability, and unwillingness to undergo HIV testing due to low self-perceived risk of HIV and fear of the test result); (2) health care service provision barriers (lack of trust in health professionals and limited availability of medication including antiretroviral (ARV)); and (3) social barriers (stigma and discrimination, and the lack of social supports).ConclusionsThese findings indicated multilevelled barriers to accessing HIV testing services among participants, who are known to be among key population groups in HIV care. Actions to improve HIV/AIDS-related health services accessibility are required. The dissemination of the knowledge and information on HIV/AIDS and improved available of HIV/AIDS-related services are necessary actions to improve the personal levelled barriers. System wide barriers will need improved practices and health policies to provide patients friendly and accessible services. The societal levelled barriers will need a more broad societal approach including raising awareness in the community and enhanced discussions about HIV/AIDS issues in order to normalise HIV in the society.

Men’s perspectives on HIV self-testing in sub-Saharan Africa: a systematic review and meta-synthesis

“…The findings of this study, consistent with the findings of other studies conducted in resource-limited settings, revealed that, given the many barriers associated with HIV testing in a clinic setting, more men preferred to engage themselves with HIV testing services that were conducted outside this setting [16,[46][47][48][49][50][51]. In addition to that, the HIVST model further empowers young people and sexually active individuals to be independent and have the option to choose the location and timing of the test and to control the disclosure of their results [36].…”

Hubungan Antara Umur, Jenis Kelamin, Pendidikan Dan Pekerjaan Dengan Stigmatisasi Terhadap Orang Dengan Hiv/Aids Di Rsud Mgr. Gabrielmanek,svd Atambua

“…Kasus HIV / AIDS didunia mencapai 39,4 juta orang yang dikelompokkan menjadi kelompok dewasa sebanyak 37,2 juta orang, dan anakanak dibawah usia 15 tahun sebanyak 2,3 juta orang (KemenkesRI, 2007 (Fauk et al, 2018). Selanjutnya penelitian lainnya menemukan bahwa tidak ada hubungan antara umur dengan tingkat pengetahuan remaja tentang HIV/AIDS (p = 0,591 pada alfa 0,05) namun terdapat hubungan yang bermakna antara jenis kelamin dengan tingkat pengetahuan remaja tentang HIV/AIDS dengan p = 0,010 pada alfa 0,05.…”

The burden of HIV infection among men who purchase sex in low- and middle-income countries – a systematic review and meta-analysis

“…A global report has noted that there are around 8.1 million people living with HIV/AIDS (PLWH) who are not aware of their HIV status [ 93 ], many of them are men [ 94 ]; lower testing coverage among men, compared to women, has also been emphasized by the WHO [ 95 ]. Several studies reveal that the low HIV testing rates among this group [ 89 , 96 ] is due to many reasons, including resistance to being seen at the VCT clinic [ 97 ], logistical issues [ 96 ], low levels of knowledge about HIV and HIV testing [ 98 ], self-perception of being at low HIV risk [ 99 ], and concerns about confidentiality in the event of a positive test result [ 99 ].…”

“…Several studies reveal that the low HIV testing rates among this group [89,96] is due to many reasons, including resistance to being seen at the VCT clinic [97], logistical issues [96], low levels of knowledge about HIV and HIV testing [98], self-perception of being at low HIV risk [99], and concerns about confidentiality in the event of a positive test result [99].…”