Evidence indicates widespread stigmatization of persons living with HIV (PLWH) in Indonesia. Such attitudes among health care workers could impede the country’s policies for effective diagnosis and medical treatment of PLWH. Nonetheless, research to guide interventions to reduce stigma in health care settings is lacking. Also, the contributions of workplace, religion, and HIV knowledge to nurses’ HIV-related stigma are poorly understood. Our cross-sectional study aimed to describe factors associated with nurses’ stigmatizing attitudes toward PLWH. Four hundred nurses recruited from 4 hospitals in Jakarta, Indonesia, were surveyed using the Nurse AIDS Attitude Scale (NAAS) to measure stigma. Stigmatizing attitudes were significantly predicted by education, HIV training, perceived workplace stigma, religiosity, Islamic religious identification, and affiliation with the Islamic hospital. HIV knowledge was not a significant predictor of stigmatizing attitudes. Organization changes fostering workplace diversity are likely to substantially reduce stigmatizing attitudes in nurses.

Background In Indonesia, incarceration of people who inject drugs (PWID) and access to drugs in prison potentiate within-prison drug injection (WP-DI), a preventable and extremely high-risk behavior that may contribute substantially to HIV transmission in prison and communities to which prisoners are released. Aims This mixed method study examined the prevalence, correlates, and social context of WP-DI among HIV-infected male prisoners in Indonesia. Methods 102 randomly selected HIV-infected male prisoners completed semi-structured voice-recorded interviews about drug use changes after arrest, drug use cues within prison, and impact of WP-DI on HIV and addiction treatment. Logistic regression identified multivariate correlates of WP-DI and thematic analysis of interview transcripts used grounded-theory. Results Over half (56%) of participants reported previous WP-DI. Of those, 93% shared injection equipment in prison, and 78.6% estimated sharing needles with ≥10 other prisoners. Multivariate analyses independently correlated WP-DI with being incarcerated for drug offenses (AOR=3.29, 95%CI=1.30–8.31, p=0.011) and daily drug injection before arrest (AOR=5.23, 95%CI=1.42–19.25, p=0.013). Drug availability and proximity to drug users while incarcerated were associated with frequent drug craving and escalating drug use risk behaviors after arrest. Energetic heroin marketing and stigmatizing attitudes toward methadone contribute to WP-DI and impede addiction and HIV treatment. Conclusions Frequent WP-DI and needle sharing among these HIV-infected Indonesian prison inmates indicate the need for structural interventions that reduce overcrowding, drug supply, and needle sharing, and improve detection and treatment of substance use disorders upon incarceration to minimize WP-DI and associated harm.

Negative attitudes toward HIV medications may restrict utilization of antiretroviral therapy (ART) in Indonesian prisons where many people living with HIV (PLH) are diagnosed and first offered ART. This mixed-method study examines the influence of medication attitudes on ART utilization among HIV-infected Indonesian prisoners. Randomly-selected HIV-infected male prisoners (n = 102) completed face-to-face in-depth interviews and structured surveys assessing ART attitudes. Results show that although half of participants utilized ART, a quarter of those meeting ART eligibility guidelines did not. Participants not utilizing ART endorsed greater concerns about ART efficacy, safety, and adverse effects, and more certainty that ART should be deferred in PLH who feel healthy. In multivariate analyses, ART utilization was independently associated with more positive ART attitudes (AOR = 1.09, 95 % CI 1.03–1.16, p = 0.002) and higher internalized HIV stigma (AOR = 1.03, 95 % CI 1.00–1.07, p = 0.016). Social marketing of ART is needed to counteract negative ART attitudes that limit ART utilization among Indonesian prisoners.

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This study aims to determine the effectiveness of Isometric Handgrip Exercise and Slow Respiratory Respiratory Exercise. Quasi Experimental Research design with research design Two Group Pretest Postest Design on 32 respondents. The results showed that there was systolic and diastolic after Handgrip Isometric Exercise intervention (t = 8,279, p = 0,000), (t = 6,154, p = 0,000), and the importance was done after Slow Deep Slow Deep Respiratory Exercise (t = 3,632 , p = 0.002), (t = 4.226, p = 0.001). Thus, it can be concluded that good or slow isometric exercise exercises in breathing exercises can reduce blood pressure. The results of the study were handgrip isometric training and slow slow breathing exercises as nursing interventions that can be carried out independently in providing nursing care for patients with hypertension. Keywords: Hypertension, Isometric Handgrip Exercise, Slow Deep Breathing Exercise,   Blood Pressure.

In Indonesia, the syndemic nature of HIV, drug use, and incarceration may influence experiences of stigma for HIV-infected prisoners. This mixed method study explores HIV stigma in prisoners living with HIV in Indonesia. Randomly selected male HIV-infected prisoners (n = 102) from two large prisons in Jakarta completed in-depth interviews and a structured HIV stigma survey. Quantitative results found 4 groups of HIV-infected prisoners with significantly higher HIV stigma levels, including those: (a) with drug-related offenses, (b) seeking help to decrease drug use, (c) diagnosed with HIV before the current incarceration, and (d) who had not disclosed their HIV status to family members or friends. Qualitative results highlighted the prominent role of HIV stigma in decisions to disclose HIV status to family members, partners, and other prisoners. Interventions should address HIV stigma in HIV-infected prisoners in Indonesia to achieve HIV treatment as prevention goals.

AbstrakHIV/AIDS mengancam eksistensi manusia, sehingga perlu dilakukan tindakan pencegahan penularannya. Tujuan penelitian adalah mengidentifikasi faktor-faktor yang memengaruhi tindakan pencegahan penularan HIV oleh ODHA. Desain penelitian adalah deskriptif analitik cross sectional. Teknik pengambilan sampel adalah consecutive sampling. Penelitian dilakukan pada dua rumah sakit Pemerintah dan satu Klinik Yayasan Sosial di Sorong Papua Barat. Jumlah responden yang diperoleh 75 orang. Hasil penelitian menunjukkan bahwa faktor yang berhubungan dengan tindakan pencegahan penularan HIV adalah umur (p= 0,040; α= 0,05). Pada analisis regresi logistik ganda diketahui bahwa umur merupakan faktor yang paling memengaruhi tindakan pencegahan penularan HIV (p= 0,031; α= 0,05; 95% CI: 1,169-26,423). Umur muda berisiko menularkan HIV karena cenderung melakukan seks tidak aman. Perawat dalam memberikan asuhan keperawatan harus berfokus pada intervensi konseling bagaimana menghindari perilaku seks tidak aman. (p= 0.040; α= 0.05). In multiple logistic regression analysis it is known that age is a factor that most influences the actions of prevention of HIV transmission (p= 0.031; α= 0.05;. The young age due to become infected with HIV were more likely to perform unsafe sex. The provision of nursing care shlould be focused on the interventions counseling how to avoid unsafe sex. Kata kunci: ODHA, pencegahan, penularan HIV Abstract Age People with HIV AIDS (PLWHA) Precautions in Connection with HIV Infection. HIV/AIDS has threaten the human existence, so it necessary to actions to prevent the HIV transmissions. The aim of this study was to determine the factors that influence the act of HIV transmission prevention by

Objectives HIV-related mortality is increasing in Indonesia, where prisons house many people living with HIV and addiction. We examined all-cause mortality in HIV-infected Indonesian prisoners within prison and up to 24 months post-release. Materials and Methods Randomly selected HIV-infected male prisoners (n=102) from two prisons in Jakarta, Indonesia completed surveys in prison and were followed up for 2 years (until study completion) or until they died or were lost to follow-up. Death dates were determined from medical records and interviews with immediate family members. Kaplan-Meier and Cox proportional hazards regression models were analyzed to identify mortality predictors. Results During 103 person-years (PYs) of follow-up, 15 deaths occurred, including ten in prison. The crude mortality rate within prison (125.2 deaths per 1,000 PYs) was surpassed by the crude mortality rate in released prisoners (215.7 deaths per 1,000 PYs). HIV-associated opportunistic infections were the most common probable cause of death. Predictors of within-prison and overall mortality were similar. Shorter survival overall was associated with being incarcerated within a specialized “narcotic” prison for drug offenders (hazard ratio [HR] 9.2, 95% confidence interval [CI] 1.1–76.5; P=0.03), longer incarceration (HR 1.06, 95% CI 1.01–1.1; P=0.01), and advanced HIV infection (CD4+ T-cell count<200cells/μL; HR 4.8, 95% CI 1.2–18.2; P=0.02). Addiction treatment was associated with longer survival (HR 0.1, 95% CI 0.01–0.9; P=0.03), although treatment with antiretroviral therapy (ART) or methadone was not. Conclusions Mortality in HIV-infected prisoners is extremely high in Indonesia, despite limited provision of ART in prisons. Interventions to restore immune function with ART and provide prophylaxis for opportunistic infections during incarceration and after release would likely reduce mortality. Narcotics prisons may be especially high-risk environments for mortality, emphasizing the need for universal access to evidence-based HIV treatments.