TY - JOUR
T1 - Barriers and Facilitators to HIV Treatment Adherence in Indonesia
T2 - Perspectives of People Living with HIV and HIV Service Providers
AU - Hutahaean, Bona S.H.
AU - Stutterheim, Sarah E.
AU - Jonas, Kai J.
N1 - Funding Information:
This research was funded by Indonesia Endowment Fund for Education or LPDP (Lembaga Pengelola Dana Pendidikan).
Publisher Copyright:
© 2023 by the authors.
PY - 2023/2/24
Y1 - 2023/2/24
N2 - 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.
AB - 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.
KW - HIV
KW - antiretroviral (ARV)
KW - antiretroviral treatment (ART)
KW - adherence
KW - socioecological approach
KW - Indonesia
KW - FEMALE SEX WORKERS
KW - STATUS DISCLOSURE
KW - ANTIRETROVIRAL THERAPY
KW - MEDICATION ADHERENCE
KW - TRANSGENDER WOMEN
KW - STIGMA
KW - HIV/AIDS
KW - CARE
KW - INTERVENTIONS
KW - COUNTRIES
U2 - 10.3390/tropicalmed8030138
DO - 10.3390/tropicalmed8030138
M3 - Article
C2 - 36977140
SN - 2414-6366
VL - 8
JO - Tropical Medicine and Infectious Disease
JF - Tropical Medicine and Infectious Disease
IS - 3
M1 - 138
ER -