Daily struggle to take antiretrovirals: a qualitative study in Papuans living with HIV and their healthcare providers

Sianturi, Elfride Irawati; Latifah, Elmiawati; Probandari, Ari; Effendy, Christantie; Taxis, Katja

doi:10.1136/bmjopen-2020-036832

Cited by 10 publications

(17 citation statements)

References 39 publications

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“…That HIV stigma is a major impediment to ART adherence is well established in the literature [ 9 , 13 , 39 ], as is the fact that HIV stigma in health care is highly prevalent and highly detrimental for PLHIV [ 40 , 41 , 42 , 43 ]. As such, our findings dovetail with previous studies reporting that stigma in any form hinders treatment adherence [ 3 , 11 , 27 , 30 , 31 , 32 , 42 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 ]. PLHIV also often experience intersectional stigma or stigmatization due to multiple identities within marginalized groups (e.g., gender or sexual orientation) [ 60 , 61 ].…”

Section: Discussionsupporting

confidence: 91%

Barriers and Facilitators to HIV Treatment Adherence in Indonesia: Perspectives of People Living with HIV and HIV Service Providers

2023

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HIV treatment adherence in Indonesia is a major challenge. Although previous studies have demonstrated several barriers and facilitators to adherence, studies providing a comprehensive analysis from both PLHIV and HIV service providers’ perspectives are limited, especially in Indonesia. In this qualitative study with 30 people living with HIV on treatment (PLHIV-OT) and 20 HIV service providers (HSPs), we explored, via online interviews, the barriers and facilitators to antiretroviral therapy (ART) adherence using a socioecological approach. Both PLHIV-OT and HSPs reported stigma as a major barrier at each socioecological level, including public stigma at the societal level, stigma in healthcare settings, and self-stigma at the intrapersonal level. Stigma reduction must therefore be prioritized. PLHIV-OT and HSPs also reported support from significant others and HSPs as the foremost facilitators to ART adherence. The enablement of support networks is thus an important key to improved ART adherence. Overall, the societal level and health system barriers to ART adherence should be addressed in order to remove barriers and enhance the facilitators at the subordinate socioecological levels.

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Section: Discussionsupporting

confidence: 91%

Barriers and Facilitators to HIV Treatment Adherence in Indonesia: Perspectives of People Living with HIV and HIV Service Providers

2023

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“…Since this study was conducted on HIV patients, HIV patients living in France had better consistency in completing the questionnaire than those living in Indonesia [24]. It may be explained that Indonesian patients may have more complex [33]. Similar way, the level of education was significantly different from the overuse subscale.…”

Section: 61mentioning

confidence: 88%

Adaptation and Validation of the Beliefs about Medicines Questionnaire (BMQ) in HIV Out-patients in Indonesia

Sianturi

Gunawan

Perwitasari

2021

J. Manaj. dan Pelayanan Farm.

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This study aimed to translate and cross-cultural adapt the version of the Beliefs about Medicines Questionnaire (BMQ) into Indonesia language, and explored its psychometric properties, and establish preliminary norms. We followed the guideline for forward-backward translation and 201 HIV out-patients were recruited. They all completed BMQ-general and BMQ-specific scales that were previously culturally adapted and translated into the Indonesian language. All participants were patients visiting a referral hospital in Papua Province, Indonesia. One-third of participants were indigenous Papuans, and the majority were female. The overall Cronbach's alpha of BMQ was acceptable (0.80) however each domain of BMQ was lower than the original study. The Cronbach alpha value for each section of BMQ-Indonesian version was as follows: BMQ Specific-Necessity 0.56; BMQ Specific-Concerns 0.50; BMQ General-Overuse 0.65; and BMQ General-Harm 0.53. The reasons for the distinction between this study to original may be complex and HIV associates with the problem in neurological and cognitive symptoms at a later stage. Since the Cronbach alpha in this study was within the range of the original study the BMQ-Indonesian version is applicable to be used in Indonesia, especially among HIV patients but caution is still needed in this questionnaire.

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“…Data were analyzed using the Atlas Ti Version 8.4 software with transcripts coded by 2 analysts adopting a similar approach as reported in a previous study (11). All transcripts were read and re-read to develop an initial framework which was re ned during coding.…”

Section: Discussionmentioning

confidence: 99%

“…Papuans discovered that there is no additional information about these drugs to convince them that HIV is a manageable disease. The health care providers in this area conveyed the lack of knowledge and misperception of ART because they also had similar perceptions (11). This leads to skepticism that there is no hope after being diagnosed with HIV, thereby making the situation crucial with the need for immediate recti cation.…”

Section: Discussionmentioning

confidence: 99%

Understanding Reasons for Lack of Acceptance in HIV Programs Among Indigenous: a Qualitative Study in Indonesia

Sianturi

Latifah

Soltief³

et al. 2021

Preprint

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Background: Melanesians are Indigenous Papuans that are racially and culturally different from most Indonesians. Poverty and inequalities remain high in this region despite having the highest revenues. Furthermore, Papua has the highest HIV prevalence rate, which is 24 times higher than other regions. Therefore, this study aimed to develop an understanding of the acceptance of HIV programs among Papuans.Methods: This is a qualitative study carried out using the grounded theory with data collected from 23 Papuans through semi-structured face-to-face interviews. All interviews were conducted in Bahasa Indonesia, audio-recorded, summarized, and transcribed for analysis.Results: The results showed that to “keep being a good Papuan," emerges from 4 interconnected categories, including 1) Culture and Religion, 2) Dealing with modernisms, 3) Tailoring program and 4) Stigma reduction. As a substantive theory underpinning the experiences of indigenous people with the programs, “Keep being a good Papuan” was a way of overcoming a series of problems and dealing with modernism to eliminating HIV. This is largely focused on the local culture, therefore any adjustment needs to balance keeping their tradition and welcoming modernism.Conclusions: Therefore, the future of the programs needs to be agreed upon, funded, implemented, measured, and achieved. One of the strategies used to achieve this is by elaborating a supportive culture and community-based interventions. Further, implementation needs to be prioritized to integrate and improve the quality of the programs due to the needs of the community and the available resources.

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Daily struggle to take antiretrovirals: a qualitative study in Papuans living with HIV and their healthcare providers

Cited by 10 publications

References 39 publications

Barriers and Facilitators to HIV Treatment Adherence in Indonesia: Perspectives of People Living with HIV and HIV Service Providers

Barriers and Facilitators to HIV Treatment Adherence in Indonesia: Perspectives of People Living with HIV and HIV Service Providers

Adaptation and Validation of the Beliefs about Medicines Questionnaire (BMQ) in HIV Out-patients in Indonesia

Understanding Reasons for Lack of Acceptance in HIV Programs Among Indigenous: a Qualitative Study in Indonesia

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