Challenges and Support to HIV Care and Treatment of Female Sex Workers Living with HIV in Indonesia: A Mixed Method Study

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Lia Andriyani
Arina Arina
Asti Widihastuti
Adi Nugroho

Abstract

This study aims to describe the experience of female sex workers (FSWs) living with HIV in Indonesia during the care and treatment cascade, including the challenges and support associated with them. It was initiated by a trained community study team from OPSI, a national network for FSW community in the country. A mixed-method design was used, consisting of a cross-sectional survey and qualitative interviews conducted in four large cities in May and June 2019. Quantitative data were collected from 80 FSWs living with HIV, while qualitative interviews were conducted for 9 FSWs previously involved in the survey. Most of the FSWs were diagnosed with HIV at facility-based HIV testing services. While most FSWs delayed initiating their treatment, majority eventually commenced it. Overall treatment retention was fairly good, but some were being inconsistent or even stopped. However, individuals that have access to viral load test was low, leading to a small number of those confirming their viral suppression status. Conclusively, interventions directed to strengthen individuals’ literacy in HIV treatment and stigma management is recommended, as well as identification of maximum potential support systems around the FSWs.

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Author Biographies

Lia Andriyani, Organisasi Perubahan Sosial Indonesia (OPSI), Jakarta, Indonesia

Scopus ID: 57211711451

Arina Arina, Organisasi Perubahan Sosial Indonesia (OPSI), Jakarta, Indonesia

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Asti Widihastuti, United Nations for Population Fund Agency (UNFPA), Indonesia, Jakarta, Indonesia

Scopus ID: 36895500100

 

Adi Nugroho, School of Public Health, Faculty of Medicine, Universitas Lambung Mangkurat, Banjarbaru, Indonesia

Scopus ID: 57189875212

Scholar Google ID

How to Cite
Andriyani, L., Arina, A., Widihastuti, A., & Nugroho, A. (2021). Challenges and Support to HIV Care and Treatment of Female Sex Workers Living with HIV in Indonesia: A Mixed Method Study. Unnes Journal of Public Health, 10(2), 169-179. https://doi.org/10.15294/ujph.v10i2.40037

References

Aho, J., Nguyen, V.K., Diakité, S.L., Sow, A., Koushik, A. & Rashed, S. 2012. High Acceptability of HIV Voluntary Counselling and Testing among Female Sex Workers: Impact of Individual and Social Factors. HIV Medicine, 13: 156–65. https://doi.org/10.1111/j.1468-1293.2011.00951.x.
Alary, M., Lowndes, C.,M., van de Perre, P., Behanzin, L., Batona, G. et al. 2013. Scale-up of Combination Prevention and Antiretroviral Therapy for Female Sex Workers in West Africa: Time for Action. AIDS, 27 (9): 1369–1374. https://doi.org/10.1097/QAD.0b013e32835fd7bd.
Baral, S., Beyrer, C., Muessig, K., Poteat, T., Wirtz, A.L. et al. 2012. Burden of HIV among Female Sex Workers in Low-income and Middle-income Countries: a Systematic Review and Meta-analysis. The Lancet Infectious Disease, 12 (7): 538–549. https://doi.org/10.1016/S1473-3099(12)70066-X.
Bezabhe, W.M., Chalmers, L., Bereznicki, L.R., Peterson, G.M., Bimirew, M.A. & Kassie, D.M. 2014. Barriers and Facilitators of Adherence to Antiretroviral Drug Therapy and Retention in Care among Adult HIV-positive Patients: a Qualitative Study from Ethiopia. PLoS ONE, 9 (5): 1-10. https://doi.org/10.1371/journal.pone.0097353.
Bukenya, D., Mayanja, B.N., Nakamanya, S. et al. 2019. What Causes Non-adherence among Some Individuals on Long Term Antiretroviral Therapy? Experiences of Individuals with Poor Viral Suppression in Uganda. AIDS Research and Therapy, 16: 2: 1-9. https://doi.org/10.1186/s12981-018-0214-y.
Celletti, F., Wright, A., Palen, J., Frehywot, S., Markus, A., Greenberg, A., de Aguiar, R.A.T., Campos, F., Buch, E. & Samb, B. 2010. Can the Deployment of Community Health Workers for the Delivery of HIV Services Represent an Effective and Sustainable Response to Health Workforce Shortages? Results of a Multicountry Study. AIDS, 24 (1): S45-S57. https://doi.org/10.1097/01.aids.0000366082.68321.d6.
Chanda, M.M., Amaya, G., Perez, B., Ortblad. K.F., Mwale, M., Chongo, S., Kamungoma, N., Kanvhele, C., Fullem, A., Barresi, L., Bärnighausen, T. & Oldenburg, C.E. 2017. Barriers and Facilitators to HIV Testing among Zambian Female Sex Workers in Three Transit Hubs. AIDS Patient Care STDs, 31 (7): 290-296. https://doi.org/10.1089/apc.2017.0016.
Chime, O.H., Arinze-Onyia, S.U. & Obionu, C.N. 2018. Do Peer Support Groups Have an Effect on Medication Adherence? A Study among People Living with HIV/AIDS in Enugu State, Nigeria. Proceedings of Singapore Healthcare, 27 (4): 256–264. https://doi.org/10.1177/2010105818760923.
Chirambo, L., Valeta, M., Banda Kamanga, T.M. et al. 2019. Factors Influencing Adherence to Antiretroviral Treatment among Adults Accessing Care from Private Health Facilities in Malawi. BMC Public Health 19 (1382): 1-11. https://doi.org/10.1186/s12889-019-7768-z.
Delva, W., Eaton J.W, Meng, F., Fraser, C., White, R.G. et al. 2012. HIV Treatment as Prevention: Optimising the Impact of Expanded HIV Treatment Programmes. PLoS Medicine/ Public Library of Science, 9 (7): 1-12. https://doi.org/10.1371/journal.pmed.1001258.
Denison, J.A., O’Reilly, K.R., Schmid, G.P., Kennedy, C.E. & Sweat, M.D. 2008. HIV Voluntary Counseling and Testing and Behavioral Risk Reduction in Developing Countries: a Meta-analysis, 1990-2005. AIDS and Behavior, 12 (3): 363-373. https://doi.org/10.1007/s10461-007-9349-x.
Dourado, I., Guimarães, M.D.C., Damacena, G.N. et al. 2019. Sex Work Stigma and Non-disclosure to Health Care Providers: Data from a Large RDS Study among FSW in Brazil. BMC International Health and Human Rights, 19 (8): 1-8. https://doi.org/10.1186/s12914-019-0193-7.
Dugas, M., Bédard, E., Batona, G., Kpatchavi, AC., Guédou, F.A., Dubé, E., et al. 2015. Outreach Strategies for the Promotion of HIV Testing and Care: Closing the Gap between Health Services and Female Sex Workers in Benin. Journal of Acquired Immune Deficiency Syndromes, 68 (2): 198–205. https://doi.org/10.1097/QAI.0000000000000463.
Fatukasi, T.V., Cole, S.R., Moore, R.D., Mathews, W.C., Edwards, J.K. et al. 2017. Risk Factors for Delayed Antiretroviral Therapy Initiation among HIV-seropositive Patients. PLOS ONE, 12 (7): 1-12. https://doi.org/10.1371/journal.pone.0180843.
He, Q., Du, X., Xu, H. et al. 2019. Intention to Initiate Antiretroviral Therapy (ART) among People Living with HIV in China Under the Scaling-up of ART: The Role of Healthcare Workers’ Recommendations. BMC Health Service Research, 19 (314): 1-10. https://doi.org/10.1186/s12913-019-4143-9.
Horter, S., Thabede, Z., Dlamini, V., Bernays, S., Stringer, B., Mazibuko, S., Dube, L., Rusch, B. & Jobaputra, K. 2017. Life is so Easy on ART, Once You Accept It: Acceptance, Denial and Linkage to HIV Care in Shiselweni, Swaziland. Social Science and Medicine, 176: 52-59. https://doi.org/10.1016/j.socscimed.2017.01.006.
Hull, M.W., Wu, Z., Montaner, J. & S., G. 2012. Optimizing the Engagement of Care Cascade: a Critical Step to Maximize the Impact of HIV Treatment as Prevention. Current Opinion in HIV & AIDS, 7 (6): 579–586. https:doi.org/10.1097/COH.0b013e3283590617.
Indonesian Ministry of Health. 2017. Estimasi Populasi Kunci HIV di Indonesia 2016. Jakarta: Direktorat Jenderal Pengendalian & Pencegahan Penyakit, Kementerian Kesehatan Republik Indonesia.
Indonesian Ministry of Health. 2019. STBP: Survey Terpadu Biologi dan Perilaku 2018-2019. Jakarta, Indonesia: Kementerian Kesehatan Republik Indonesia.
Kheswa, J.G. 2017. Exploring the Factors and Effects of Non-adherence to Antiretroviral Treatment by People Living with HIV/ AIDS. Indo-Pacific Journal of Phenomenology, 17 (1): 1-11. https://dx.doi.org/10.1080/20797222.2017.1280923.
Knodel, J., Kespichayawattana, J., Saengtienchai, C. & Wiwatwanich, S. 2010. The Role of Parents and Family Members in ART Treatment Adherence: Evidence from Thailand. Research on Aging, 32 (1): 19–39. https://doi.org/10.1177/0164027509348130.
Kranzer, K., Govindasamy, D., Ford, N., Johnston, V. & Lawn S.D. 2012. Quantifying and Addressing Losses along the Continuum of Care for People Living with HIV Infection in Sub-Saharan Africa: a Systematic Review. Journal of the International AIDS Society, 15: 17383. https://doi.org/10.7448/IAS.15.2.17383.
Marino, P., Simoni, J.M. & Silverstein, L.B. 2007. Peer Support to Promote Medication Adherence among People Living with HIV/ AIDS: The Benefits to Peers. Social Work in Health Care, 45 (1): 67–80. https://doi/10.1300/J010v45n01_05.
Martins, T.A., Kerr, L., Macena, R., Mota, R.S., Dourado, I., Brito, A.M. & Kendall, C. 2018. Incentives and Barriers to HIV Testing among Female Sex Workers in Ceará. Revista de Saude Publica, 52 (64): 1-8. https://doi.org/10.11606/S1518-8787.2018052000300.
McCoy, S.I., Strauss, R.P., MacDonald, P.D.M., Leone, P.A., Eron, J.J. & Miller, W.C. 2009. Social Support and Delays Seeking Care After HIV Diagnosis, North Carolina, 2000-2006. AIDS Care – Psychological and Sosio-Medical Aspects of AIDS/ HIV, 21 (9): 1148–1156. https://doi.org/10.1080/09540120902730021.
Montague, B., Vuylsteke, B. & Buve, A. 2011. Sustainability of Programs to Reach High Risk and Marginalized Populations Living with HIV in Resource Limited Settings: Implications for HIV Treatment and Prevention. BMC Public Health, 11 (701): 1-2. https://doi.org/10.1186/1471-2458-11-701.
Mugavero, M.J., Amico, K.R., Westfall, A.O., Crane, H.M., Zinski, A., Willig, J.H., Dombrowski, J.C., Norton, W.E., Raper, J.L., Kitahata, M.M. & Saag, M.S. 2012. Early Retention in HIV Care and Viral Load Suppression: Implications for a Test and Treat Approach to HIV Prevention. Journal of Acquired Immune Deficiency Syndromes, 59 (1): 86-93. https://doi.org/10.1097/qai.0b013e318236f7d2.

Nnko, S., Kuringe, E., Nyato, D. et al. 2019. Determinants of Access to HIV Testing and Counselling Services among Female Sex Workers in Sub-Saharan Africa: a Systematic Review. BMC Public Health, 19 (15): 1-12. https://doi.org/10.1186/s12889-018-6362-0.
Nyato, D., Nnko, S., Komba, A., Kuringe, E., Plotkin, M. et al. 2019. Facilitators and Barriers to Linkage to HIV Care and Treatment among Female Sex Workers in a Community-based HIV Prevention Intervention in Tanzania: A Qualitative Study. PLOS ONE, 14 (11): 1-14. https://doi.org/10.1371/journal.pone.0219032.
Oku, A.O., Owoaje, E.T., Oku, O.O. & Monjok, E. 2013. Prevalence and Determinants of Adherence to Highly Active Antiretroviral Therapy (HAART) amongst a Cohort of HIV Positive Women Accessing Treatment in a Tertiary Health Facility in Southern Nigeria. BMC Infectious Diseases, 2 (1): 1–8. https://doi.org/10.1186/1471-2334-13-401.
Parnell, H.E., Berger, M.B., Gichane, M.W. et al. 2019. Lost to Care and Back Again: Patient Anda Navigator Perspectives on HIV Care Re-engagement. AIDS Behavior; 23(1): 61. https://doi-org.eur.idm.oclc.org/10.1007/s10461-017-1919-y.
Scambler, G. & Paoli, F. 2008. Health Work, Female Sex Workers and HIV/ AIDS: Global and Local Dimensions of Stigma and Deviance as Barriers to Effective Interventions. Social Science Medicine, 66 (8): 1848–1862. https://doi.org/10.1016/j.socscimed.2008.01.002.
Setiani, L.E. & Tardimanto, Y. 2020. Kesadaran Hukum Masyarakat terhadap Kepemilikan E-KTP di Desa Marawan Lama Kecamatan Dusun Utara Kabupaten Barito Selatan. Jurnal Pendidikan Ilmu Pengetahuan Sosial (JPIPS), 12 (1): 22-27. https://doi.org/10.37304/jpips.v12i1.1160.
Sulat, J., Prabandari, Y., Sanusi, R., Hapsari, E. & Santoso, B. 2018. The Impacts of Community-based HIV Testing and Counselling on Testing Uptake: A Systematic Review. Journal of Health Research, 32 (2): 152-163. https://doi.org/10.1108/JHR-01-2018-015.
Surratt, H.L., O’Grady, C., Kurtz, S.P., Levi-Minzi, M.A. & Chen, M. 2014. Outcomes of a Behavioral Intervention to Reduce HIV Risk among Drug-involved Female Sex Workers. AIDS Behavior, 18 (4): 726-739. https://dx.doi.org/10.1007%2Fs10461-014-0723-1.
Susyanti, A.L., Handayani, R.S., & Sugiharti. 2017. Keterjangkauan Biaya untuk Mendapatkan Pengobatan pada Anak dengan HIV AIDS dan Infeksi Oportunistik. Media Penelitian dan Pengembangan Kesehatan, 27 (3): 161-168. http://dx.doi.org/10.22435/mpk.v27i3.6773.161-168.
Tokar, A., Broerse, J.E.W., Blanchard, J. & Roura, M. 2018. HIV Testing and Counseling among Female Sex Workers: a Systematic Literature Review. AIDS Behavior, 22 (8): 2435-2457. https://dx.doi.org/10.1007%2Fs10461-018-2043-3
UNFPA Indonesia. 2018a. Buku Pedoman Pelaksanaan Penjangkauan untuk Program Pencegahan pada Wanita Pekerja Seks di Indonesia. Jakarta, Indonesia: UNFPA Indonesia.
UNFPA Indonesia. 2018b. The 2018 Annual Achievement for the Female Sex Workers Programme in Indonesia with Support of the Global Fund (Dashboard Data). Jakarta, Indonesia: UNFPA.
Vickerman, P., Foss, A.M., Pickles, M., Deering, K., Verma, S. et al. 2010. To What Extent is the HIV Epidemic in Southern India Driven by Commercial Sex? A Modelling Analysis. AIDS, 24 (16): 2563–2572. https://doi.org/10.1097/qad.0b013e32833e8663.
Wells, C., Schwartz, S., Mafuya, N.P., Lambert, A., Kose, Z., Mcingana, M., Hausler, H., Rao, A., Yah, C.S., Ketende, S. & Baral, S. 2018. Characterizing the Patterns of HIV Disclosure to Clients among South African Female Sex Workers in Port Elizabeth. AIDS and Behavior, 22: 3924-3932. https://doi.org/10.1007/s10461-018-2199-x.
WHO. 2010. Antiretroviral Therapy for HIV Infection in Adults and Adolescents: Recommendations for a Public Health Approach (2010 revision). Geneva, Switzerland: World Health Organization.