Perceptions of and barriers to HIV testing of women in Indonesia

Najmah, Najmah; Andajani, Sari; Davies, Sharyn Graham

doi:10.1080/26410397.2020.1848003

Cited by 18 publications

(22 citation statements)

References 22 publications

(31 reference statements)

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“…Some of the reasons included being unable to make an informed decision, having no right to secrecy and privacy, facing continuing discrimination, and having no access to prompt HIV testing. Indonesia, therefore, needs to dramatically increase its rate of HIV screening and ART [ 46 ].…”

Section: Discussionmentioning

confidence: 99%

The Optimization of HIV Testing in Eastern Indonesia: Findings from the 2017 Indonesian Demographic and Health Survey

et al. 2022

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There is a concerning increase in human immunodeficiency virus (HIV) incidence in eastern Indonesia. HIV testing rates in this area are the lowest in the country. This study aimed to analyze the determinants of HIV testing in the Public Health Centers (PHCs) in eastern Indonesia. A cross-sectional study design was utilized using secondary data from the 2017 Indonesian Demographic and Health Survey (IDHS). We focused the survey on eastern Indonesia (Sulawesi, Maluku, and Papua) with PHC settings. After we weighted and removed missing data, we obtained 2118 surveys (425 males and 1693 females aged 14–54 years). Chi-square and binary logistic regression were used to analyze the determinants of HIV testing optimization in eastern Indonesia with a significance level of p < 0.05. The HIV testing coverage at the PHCs in eastern Indonesia was found to be 28.28%. From the survey, we found that respondents from the province of Papua (AOR: 1.45; 95% CI: 1.09–1.91), those who were female (AOR: 2.37; 95% CI: 1.75–3.12), and those with more information on HIV (AOR: 1.88; 95% CI: 1.41–2.51) were more likely to undergo HIV testing at the PHCs. Meanwhile, the wealthiest respondents (AOR: 0.61; 95% CI: 0.42–0.89) and the respondents who engaged in the perpetuation of stigmatization (AOR: 0.65; 95% CI: 0.42–1.02) were less likely to undergo HIV testing at the PHCs. The coverage of HIV testing in eastern Indonesia needs special attention from the Indonesian government. Increasing equity, distributing information regarding HIV and acquired immunodeficiency syndrome (AIDS) through social media, and creating accessible HIV testing in rural areas are vital for developing appropriate interventions.

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Section: Discussionmentioning

confidence: 99%

The Optimization of HIV Testing in Eastern Indonesia: Findings from the 2017 Indonesian Demographic and Health Survey

et al. 2022

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“…They also pointed to the cultural belief that Indonesian women traditionally are subordinate to and dependent upon their male partners. They prophesied that women in more socially conservative marriages or sexual partnerships might require additional APN assistance to overcome social and legal barriers to HIV testing, and treatment [40]. To assist clients in minimizing risk while informing others, providers described some of the strategies that they had coached clients to consider.…”

Section: Discussionmentioning

confidence: 99%

“You can’t do that; they’ll throw the cooking pot at you!” A qualitative study of healthcare providers’ attitudes toward assisted partner notification for people with HIV in Indonesia

Levy

Earnshaw

Milanti

et al. 2022

Preprint

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Assisted partner notification (APN) is recommended as a public health strategy to increase HIV testing in people exposed to HIV. Yet its adoption globally remains at an early stage. This qualitative study sought the opinions of HIV health service providers regarding the appropriateness and feasibility of implementing APN in Indonesia where such services are on the cusp of adoption. Focus group discussions were held with 40 health service providers to consider APN as an innovative concept and to share their reactions regarding its potential implementation in Indonesia. Voice-recorded discussions were conducted in Bahasa, transcribed verbatim, and analyzed. Participants recognized APN’s potential in contacting and informing the partners of HIV-positive clients of possible viral exposure. They also perceived APN’s value as a client-driven service permitting clients to select which of three partner notification methods would work best for them across differing partner relationships and settings. Nonetheless, participants also identified personal and health system challenges that could impede successful APN adoption including medical and human resource limitations, the need for specialized APN training, ethical and equity considerations, and lack of sufficient clarity concerning laws and government policies regulating 3rd party disclosures. They also pointed to the job-overload, stress, personal discomfort, and the ethical uncertainty that providers might experience in delivering APN. Overall, providers of HIV services embraced the concept of APN but forecast practical difficulties in key service areas where investments in resources and system change appeared necessary to ensure effective and equitable implementation.

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“…The normalisation of institutional stigma and discrimination is rampant in Indonesia’s health setting for women living with HIV, including disclosing HIV’s patient status and the low priority of health services for these women. 5 , 12 Therefore, they need to consider to whom they disclose their HIV status. Consequently, HIV-related stigma is considered the main factor behind the low uptake of adherence to HIV prevention and treatment services.…”

Section: Discussionmentioning

confidence: 99%

“…Consequently, HIV-related stigma is considered the main factor behind the low uptake of adherence to HIV prevention and treatment services. 2 , 4 – 6…”

Section: Discussionmentioning

confidence: 99%

“…These beliefs have a strong, negative emotional impact, causing women to feel dirty, unworthy, or shameful, despite the fact that they may not have been involved in any of these behaviours. Evidence suggests that most women are infected with HIV by their husbands 4,5 (Anindita et al, 2013;Rahmalia et al, 2015) 7,8 . Despite this, women who disclose their HIV status face discrimination in health services, including denial of confidentiality or privacy.…”

Section: Introductionmentioning

confidence: 99%

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‘It’s better to treat a COVID patient than a HIV patient’: using feminist participatory research to assess women’s challenges to access HIV care in Indonesia during the COVID-19 pandemic

Najmah

Davies

Kusnan

et al. 2021

Therapeutic Advances in Infection

Self Cite

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Background: Women living with HIV in Indonesia encounter challenging obstacles to healthcare, which is exacerbated by COVID-19. Access is difficult as there are limited numbers of poorly supported healthcare providers. Women also face significant stigma when disclosing their HIV-status. Objectives: Our main purpose is to give a voice to disempowered women living with HIV, by normalising the discussion of HIV, to empower health professionals to better understand the issues faced by women living with HIV, and develop improved treatment practices. Design: Our project was guided by a Feminist Participatory Action Research (FPAR) framework. FPAR refers to ‘a participatory and action-oriented approach to research that centres gender and women’s experiences both theoretically and practically’. It creates meaningful participation for women throughout the research process, ensuring a collective critical consciousness that challenges oppressive attitudes, beliefs, and practices that may be deeply embedded in society. Method: Purposive sampling and a thematic analysis was applied to focus group discussions with 20 women living with HIV and 20 women without HIV in Palembang, South Sumatra. Results: When women living with HIV face a difficult decision, do they disclose their status knowing that they may face stigma and even a refusal to be treated; or do they conceal their status and face not receiving the right care? In this article, we explore the stories of women living with HIV as they seek medical treatment during the COVID-19 pandemic. We show that there is no optimal solution for women as they lose whether they disclose their HIV status or not. Conclusion: Women’s stories around HIV and COVID-19 intersect with conditions such as poverty and discrimination, as well as embedded gender systems, creating overlapping barriers to treatment. Government must challenge this culture by introducing a comprehensive sex and HIV education programme. This would normalise discussions of HIV-related topics, leading to improved health outcomes.

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Perceptions of and barriers to HIV testing of women in Indonesia

Cited by 18 publications

References 22 publications

The Optimization of HIV Testing in Eastern Indonesia: Findings from the 2017 Indonesian Demographic and Health Survey

The Optimization of HIV Testing in Eastern Indonesia: Findings from the 2017 Indonesian Demographic and Health Survey

“You can’t do that; they’ll throw the cooking pot at you!” A qualitative study of healthcare providers’ attitudes toward assisted partner notification for people with HIV in Indonesia

‘It’s better to treat a COVID patient than a HIV patient’: using feminist participatory research to assess women’s challenges to access HIV care in Indonesia during the COVID-19 pandemic

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