Challenges and social support provisions in the treatment of HIV infected children in Indonesia

Yuniar, Yuyun; Handayani, Rini Sasanti

doi:10.22435/hsji.v10i2.684

Cited by 3 publications

(3 citation statements)

References 19 publications

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“…The case of missed HIV diagnosis during hospitalization highlights the importance of careful history taking, physical examination, and laboratory evaluation. 11,21 Because mother-to-child transmission is the most common etiology of pediatric HIV in Indonesia, a program providing HIV prevention, diagnosis, and treatment to young girls, women living with HIV, and pregnant women unaware of their status was started in 2012.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of HIV Infection and Resistance Mutations in Patients Hospitalized for Febrile Illness in Indonesia

Merati

Karyana

Tjitra

et al. 2021

The American Journal of Tropical Medicine and Hygiene

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HIV prevalence in Indonesia is increasing, and only 64% of infected individuals know their status. In a prospective cohort of 1,453 hospitalized patients with unexplained fever, 46 (3.2%) had HIV, including 15 (1.1%) patients without a prior HIV diagnosis. Among 31 subjects previously known to have HIV, 21 (68%) had been receiving combination antiretroviral therapy (cART) at the time of enrollment. Of 39 HIV cases with HIV RNA levels ≥ 100 copies/mL, sequencing for genotype analysis and resistance testing was successful in 30 (77%) subjects. The most common HIV subtypes were AE (90%) and B (10%). Five (16.7%) subjects had resistance mutations to nucleoside and non-nucleoside reverse transcriptase inhibitors, and all of them were on cART. No evidence of transmitted drug resistance was found in newly diagnosed individuals. Hospital-based screening may be an efficient method to expand HIV testing and identify a significant number of new cases. Access to care, close monitoring, expansion of anti-retroviral options, and ensuring availability of CD4 determinations, viral load testing, and genotyping are crucial to control of the epidemic in Indonesia.

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Section: Discussionmentioning

confidence: 99%

Prevalence of HIV Infection and Resistance Mutations in Patients Hospitalized for Febrile Illness in Indonesia

Merati

Karyana

Tjitra

et al. 2021

The American Journal of Tropical Medicine and Hygiene

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“…13 Memiliki kelompok dukungan sebaya juga merupakan salah satu faktor pendukung keberhasilan pengobatan. 14…”

Section: Pendukung Pemberian Tatalaksana Hiv DI Puskesmas Kabupaten S...unclassified

Implementasi Kebijakan Tatalaksana HIV di Puskesmas Kabupaten Sleman

Susila¹,

Subronto

Marthias

2022

JMPK

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Background: HIV AIDS is still a global and national challenge. The government is trying to control it by expanding access to HIV treatment at the Puskesmas, including 4 Puskesmas in Sleman Regency. However, efforts to expand access to treatment have not yet reached the target of 95% of people living with HIV who are receiving ART and 95% of people living with HIV who are viral loadsuppressed. WHO in 2017 recommended the immediate initiation of diagnosed HIV-positive people regardless of CD4 cell count and followed by changes in the national HIV management policy through a fast-track strategy in 2018 to provideimmediate initiation of ARVs, provision of Tuberculosis Preventive Therapy, and viral load monitoring. The rapid change in HIV management strategies raises the question of whether the Puskesmas in Sleman Regency can carry out HIVmanagement according to the latest policy recommendations in achieving the target of 90% of people living with HIV who are suppressed by viral load. Objectives: Measuring the suitability of the implementation of HIV management at the Puskesmas based on regulations and finding the supporting factors and obstacles in the implementation of HIV management at the Puskesmas.Methods: This is mixed-method research with a sequential explanatory approach. The location of research was carried out in four health centres in Sleman Regency, which had organized the HIV Treatment Support Care Service Program. Data was collected in May-June 2022. Quantitative data was secondary data on cases of people with HIV who accessed PDP services registered at the Puskesmas from 2019 until July 2021. Qualitative data were taken from 9 informants, selected by the purposive sampling method, through in-depth interviews. The quantitative sampling method uses a non-probability sampling method. Results: There is a discrepancy in the suitability of treatment at the Puskesmas with management standards according to regulations, as well as the low number of people living with HIV who are monitored for viral load suppression. The inhibiting factor for implementing HIV management in Puskesmas is the attitude of health workers to delay treatment related to perceptions of HIV prevention policies that have not been well socialized. Not all service providers are trained,lack of viral load testing facilities in hospitals, inefficient HIV management records systems, and stigma are obstacles to implementing HIV management. The supporting factors for the implementation of PDP HIV are the attitude of the willingness of health workers to provide treatment related to the perception of peer support and the presence of trained officers in counseling and logisticalsupport for adequate drugs. Conclusion: Not all people living with HIV treated at the Puskesmas have received treatment according to regulations until viral load suppression is monitored. For this reason, it is necessary to increase the capacity of HIV counselingand management for all health workers involved in providing PDP services, adding viral load testing facilities at regional hospitals, and providing HIV stigma prevention programs for people living with HIV, families, communities and health services.

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“…Kondisi yang lebih memprihatinkan terjadi ketika anak dengan HIV tersebut kehilangan orang tuanya yang meninggal karena menderita HIV/AIDS. Hal ini juga turut mempengaruhi anak dengan HIV yang menjadi lebih rentan dalam akses pengobatan karena belum mandiri dan sering dianggap menjadi beban keluarga atau kerabat karena orang tuanya yang sudah meninggal (Yuniar & Handayani, 2019). Mereka seringkali mendapat labeling atau stigmatisasi dan perlakuan tidak menyenangkan dari masyarakat oleh karena keberadaan orang tuanya yang adalah orang yang hidup dengan HIV.…”

Section: Pendahuluanunclassified

Alat Bantu Edukasi Dan Intervensi Sebagai Upaya Perwujudan Inklusivitas Bagi Anak Dengan Hiv Dampingan Dari Organisasi Sosial Komunitas X

et al. 2021

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Children with HIV still get discrimination and negative stigma from the community. It shows that the principle of inclusiveness in Indonesia is still hard to achieve. This condition has also become the concern of X community as a social organization that assists children with HIV. X community still faces challenges in realizing inclusiveness in society. Discrimination still exists by various parties to children with HIV due to the lack of a comprehensive understanding of HIV. Needs analysis through interviews, observations, and questionnaires to the community and X community needs to be done to see the gap that causes the principle of inclusiveness for children with HIV has not been achieved. The needs analysis was followed up with creating educational aids and implementation of interventions to provide a proper understanding of the HIV issue. Thus, discrimination by the community is reduced, and caregivers are assisted in caring for children with HIV. Educational aids are made in two forms: podcasts published through Spotify and content posted through Instagram. The intervention was carried out in the form of a sharing session conducted in conjunction with the routine X community program, namely Peer Support Group (Kelompok Dukungan Sebaya), by discussing topics considered necessary based on the needs analysis. The evaluation of psychoeducation and intervention shows that various follow-ups are still needed to achieve inclusiveness for children with HIV. Keberadaan anak dengan HIV mendapat diskriminasi dan stigma negatif dari lingkungan sosial sehingga perwujudan prinsip inklusivitas di Indonesia masih sulit tercapai. Kondisi ini turut menjadi perhatian komunitas X sebagai komunitas sosial yang mendampingi anak dengan HIV. Meskipun komunitas X menjadi wadah yang menaungi anak dengan HIV bukan berarti tidak mengalami tantangan dalam mencapai inklusivitas masyarakat. Pada kenyataannya, diskriminasi tetap ada dan dilakukan oleh berbagai pihak kepada anak dengan HIV akibat kurangnya pemahaman yang komprehensif mengenai HIV. Analisis kebutuhan melalui wawancara, observasi, maupun kuesioner terhadap masyarakat dan pihak komunitas X dilakukan untuk melihat kesenjangan yang menyebabkan prinsip inklusivitas terhadap keberadaan anak dengan HIV belum dapat dicapai. Analisis kebutuhan ditindaklanjuti dengan pembuatan alat bantu edukasi dan pelaksanaan intervensi yang bertujuan memberi pemahaman yang tepat terhadap isu HIV. Dengan demikian diskriminasi yang dilakukan masyarakat berkurang dan pelaku rawat terbantu dalam pengasuhan anak dengan HIV. Alat bantu edukasi dibuat dalam dua bentuk, yaitu podcast melalui platform Spotify dan konten-konten melalui media sosial Instagram. Intervensi dilakukan dalam bentuk sharing session yang dilakukan bersamaan dengan program rutin komunitas X yaitu Kelompok Dukungan Sebaya (KDS) dengan membahas topik-topik yang dianggap penting berdasarkan analisis kebutuhan. Evaluasi dari psikoedukasi dan intervensi yang telah dilakukan menunjukkan masih diperlukannya berbagai tindak lanjut untuk mencapai inklusivitas terhadap anak dengan HIV.

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Challenges and social support provisions in the treatment of HIV infected children in Indonesia

Cited by 3 publications

References 19 publications

Prevalence of HIV Infection and Resistance Mutations in Patients Hospitalized for Febrile Illness in Indonesia

Prevalence of HIV Infection and Resistance Mutations in Patients Hospitalized for Febrile Illness in Indonesia

Implementasi Kebijakan Tatalaksana HIV di Puskesmas Kabupaten Sleman

Alat Bantu Edukasi Dan Intervensi Sebagai Upaya Perwujudan Inklusivitas Bagi Anak Dengan Hiv Dampingan Dari Organisasi Sosial Komunitas X

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