Objectives Low adherence to antiretroviral (ARV) therapy in pregnant women with human immunodeficiency virus (HIV) increases the risk of virus transmission from mother to newborn. Increasing mothers’ knowledge and motivation to access treatment has been identified as a critical factor in prevention. Therefore, this research aimed to explore barriers and enablers in accessing HIV care and treatment services.
Methods This research was the first phase of a mixed-method analysis conducted in Kupang, a remote city in East Nusa Tenggara Province, Indonesia. Samples were taken by purposive sampling of 17 people interviewed, consisting of 6 mothers with HIV, 5 peer facilitators, and 6 health workers. Data were collected through semi-structured interviews, focus group discussions, observations, and document review. Inductive thematic analysis was also performed. The existing data were grouped into several themes, then relationships and linkages were drawn from each group of informants.
Results Barriers to accessing care and treatment were lack of knowledge about the benefits of ARV; stigma from within and the surrounding environment; difficulty in accessing services due to distance, time, and cost; completeness of administration; drugs’ side effects; and the quality of health workers and HIV services.
Conclusions There was a need for a structured and integrated model of peer support to improve ARV uptake and treatment in pregnant women with HIV. This research identified needs including mini-counseling sessions designed to address psychosocial barriers as an integrated approach to support antenatal care that can effectively assist HIV-positive pregnant women in improving treatment adherence.
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Objectives Human immunodeficiency virus (HIV) prevention among youth seems under-prioritised compared to other key populations. HIV knowledge and stigma are important parts of HIV prevention. To inform HIV prevention among youths, this study quantitatively analysed the associations between open communication regarding sexuality and sexual health, comprehensive HIV knowledge, and non-stigmatising attitudes in Indonesia.
Methods This study used data from the Indonesian Demographic and Health Survey (IDHS) 2017. The analysis included unmarried men and women aged 15-25 years old. Comprehensive HIV knowledge and a stigmatising attitude were defined according to the IDHS 2017. Open communication about sexuality and sexual health was defined as the number of people with whom participants could openly discuss these topics in their direct network of friends, family, and service providers, with a scale ranging from 0 to a maximum of 7. Primary analysis used binomial logistic regression with weighting adjustments.
Results The final analysis included 22 864 respondents. Twenty-two percent of youth had no one in their direct network with whom to openly discuss sexual matters, only 14.1% had comprehensive HIV knowledge, and 85.9% showed stigmatising attitudes. Youth mostly discussed sex with their friends (55.2%), and were less likely to discuss it with family members, showing a predominant pattern of peer-to-peer communication. Multivariate analysis showed that having a larger network for communication about sexuality and sexual health was associated with more HIV knowledge and less stigmatising attitudes.
Conclusions Having more opportunities for open sex communication in one’s direct social network is associated with more HIV knowledge and less stigmatising attitudes.
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Objectives This study aimed to identify the behaviors associated with discrimination towards people living with HIV/AIDS (PLHA) in Indonesia and to determine the factors affecting discrimination.
Methods Secondary data from the 2017 Indonesia Demographic and Health Survey were analyzed using a cross-sectional design. Discrimination was assessed based on the questions (1) “Should children infected with HIV/AIDS be allowed to attend school with non-infected children?” and (2) “Would you buy fresh vegetables from a farmer or shopkeeper known to be infected with HIV/AIDS?” Multivariable logistic regression was used to determine the factors affecting discrimination, with adjusted odds ratio (aOR) and 95% confidence interval (CIs) used to show the strength, direction, and significance of the associations among factors.
Results In total, 68.9% of 21 838 individuals showed discrimination towards PLHA. The odds of discrimination were lower among women (aOR, 0.63; 95% CI, 0.55 to 0.71), rural dwellers (aOR, 0.81; 95% CI, 0.75 to 0.89), those who understood how HIV is transmitted from mother to child (aOR, 0.81; 95% CI, 0.73 to 0.89), and those who felt ashamed of their own family’s HIV status (aOR, 0.56; 95% CI, 0.52 to 0.61). The odds were higher among individuals who knew how to reduce the risk of getting HIV/AIDS (aOR, 1.27; 95% CI, 1.15 to 1.39), how HIV/AIDS is transmitted (aOR, 3.49; 95% CI, 3.09 to 3.95), and were willing to care for an infected relative (aOR, 2.78; 95% CI, 2.47 to 3.13). A model consisting of those variables explained 69% of the variance in discrimination.
Conclusions Gender, residence, knowledge, and attitudes related to HIV/AIDS were explanatory factors for discrimination against PLHA. Improvements in HIV/AIDS education programs are needed to prevent discrimination.
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Objectives The purpose of this study was to characterize Indonesian women’s knowledge of HIV/AIDS and to investigate the effects of socio-demographic characteristics thereupon with the goal of supporting the prevention and early detection of HIV/AIDS.
Methods This cross-sectional study was conducted using secondary data from the standard Indonesian Demographic and Health Survey (IDHS) in 2012. A total of 34 984 subjects ranged in age from 15 years to 49 years. Data were analyzed using the chi-square test and logistic regression to identify the effects of socio-demographic characteristics on Indonesian women’s knowledge of HIV/AIDS.
Results All socio-demographic characteristics except marital status were related to knowledge of HIV/AIDS among Indonesian women in the univariate analysis (p<0.05). Multivariate analysis revealed that only age group, education level, location of residence, and wealth index were related to Indonesian women’s knowledge of HIV/AIDS (p<0.05).
Conclusions Indonesian women’s insufficient knowledge related to HIV/AIDS shows that the provision of accurate and comprehensive information related to HIV/AIDS are components of prevention and control interventions that should be improved. With greater knowledge, women are expected to be more likely to determine their own and their partners’ human immunodeficiency virus status and to take appropriate preventive steps.
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OBJECTIVES Despite the importance of human immunodefi-ciency virus(HIV) transmission through heterosexual contact, the features of heterosexual transmission has not been well studied in Korea. So we conducted a cross sectional study to determine the transmission rates in married couples and assess risk factors for male to female heterosexual transmission of HIV. METHODS: 169 HIV-infected males and their female sex partners were recruited from 1985 to June 1998. We examined female sex partners HIV infection status and interviewed male index partners and their female sex partners about demographic characteristics and sexual practices. We analysed heterosexual transmission rate by epidemiologic characteristics, disease status and sexual practices. And we assessed risk factors for HIV infection by univariate and multivariate analysis. RESULTS: 30 female sex partners were infected at enrollment, yielding an transmission rate of 17.8%. Among couples who had used condoms consistently, none of the female sex partners was infected with HIV. In univariate analysis the significant risk factors were full blown AIDS status (OR=4.1, 95% CI: 1.49-11.43) and low CD4 T cell count of index partners at enrollment (OR=7.8, 95% CI: 2.19-27.80). In multivariate analysis HIV-1 RNA levels was significant risk factor when adjusted by CD4 T cell counts and mean sexual contacts per month (OR=19.2, 95% CI: 1.03-357.59) CONCLUSION: The risk of male to female heterosexual transmission increased with advanced stages of HIV infection in the index male partners.
In order to investigate psychological and behavioral characteristics homosexuals and to present evidence that homosexuals are in danger of HIV infection in Korea, this study was done by self-administered questionnaire and then direct interview with the 28(35%) HIV infected homosexual/bisexuals of 79 HIV infected persons reported in 1992. Homosexuals without heterosexual activity were 9 and the others were bisexuals. Sixty-five percent of respondents had a guilty conscience for their homosexual activity. Twenty(71%) were in twenties and 5(18%) in thirties. Twelve(43%) were detected via health card checking by health office, 21% by blood donation, 18% by hospital visit, and 7% by partner notification. Motivations for homosexual activity were curiosity(36%), temptation or recommendation(14%) and compulsion(11%). Eighteen(72%) never used condom on anal sex. Nine of 26 respondents had experience for anal sex with foreigners. Fourteen(54%) of 26 respondents had history for sexually transmitted diseases. Fightly percent did not have sexual contact after HIV infection and the others usually used condom. It was confirmed that over 57% of the respondents were infected within 1 year before HIV diagnosis and over 82% within 2 years. These data suggest that HIV infection among homosexual group is rapidly spreading.
OBJECTIVES To investigate the sexual behavioral characteristics and HIV/AIDS knowledge among men who have sex with men (MSM), one of the HIV high risk groups. METHODS: A three month survey among individuals who were able to be contacted was carried out over the entire Republic of Korea, between May and August, 2001. 348 individuals completed a self-administered questionnaire. The data collected included demographic information, sexual behavior and AIDS knowledge. RESULTS: Eighty-seven and ninety-two per cent of the 348 MSM were aged 20-39 years and had never been married, respectively. Fifty-five per cent of participants reported at least one sexual contact with women, and a quarter of the MSM surveyed had engaged in high-risk sexual behavior (more than 6 partners) during the previous year. About twenty per cent of the MSM had anal sex as their favorite way of having sex, and seventy-four per cent did not use condoms regularly due to loss of enjoyment, and were more likely to be engaged in risky behaviors. Only ten per cent had a regular HIV test history, and most had obtained knowledge or information on HIV/AIDS through the mass media. CONCLUSIONS: A large proportion of the MSM in Korea still remain at an elevated risk for contracting HIV infection. Change in high-risk sexual behaviors will prevent the spread of HIV infection among the MSM population, which requires public health education for preventive interventions, and should be culturally and socially specific in order to be effective.