Barriers and Enablers to HIV Care Among<i>Waria</i>(Transgender Women) in Indonesia: A Qualitative Study

Mitchell, Elke; Lazuardi, Elan; Rowe, Emily; Anintya, Irma; Wirawan, Dewa Nyoman; Wisaksana, Rudi; Subronto, Yanri Wijayanti; Prameswari, Hellen D.; Kaldor, John; Bell, Suzanne

doi:10.1521/aeap.2019.31.6.538

Cited by 14 publications

(24 citation statements)

References 38 publications

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“…CBOs worked closely with health services to deliver mobile testing in work and community locations convenient for sex workers, as well as in puskesmas. Our findings complement those from studies in other key populations in Indonesia, 35,36 which took place in parallel to this study, and are consistent with research involving female sex workers in south India. 24 Our findings also highlight the importance of implementing innovative testing services outside clinicsin work places, using social network-based approaches 9 at times and locations that fit with women's work and family commitments.…”

Section: Discussionsupporting

confidence: 91%

“…Consistent with global HIV guidelines that emphasise community involvement in national HIV responses, 42,43 our findings show that relations and practices involving female sex workers, community outreach workers, health workers and bosses enabled HIV testing among female sex workers in three urban settings in Indonesia. Our findings complement recent qualitative research around engagement with HIV care for testing and/or treatment among other key populations in Indonesia [35][36][37][38] which also illustrate how community mechanisms enhance engagement in HIV care. As such, our findings provide insight into the improvement of, and community participation and leadership in, HIV responses in Indonesia and other LMICs in the region.…”

Section: Discussionsupporting

confidence: 78%

“…This qualitative study was part of a larger implementation research project designed to evaluate strategies to improve the HIV care cascade among female sex workers, people who inject drugs, transgender women and men who have sex with men in Indonesia. [35][36][37][38][39] Women were eligible to participate in the study if they were currently engaged in sex work, aged 16 years and able to provide informed consent. Participants were sampled purposively 40 to ensure diverse experiences with engagement in HIV testing, treatment and care services along the HIV care cascade.…”

Section: Methodsmentioning

confidence: 99%

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Corrigendum to: A strengths-based analysis of social influences that enhance HIV testing among female sex workers in urban Indonesia

Whitford¹,

Mitchell²,

Lazuardi³

et al. 2021

Sex. Health

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Background: HIV prevalence among female sex workers in Indonesia remains high and large proportions of female sex workers have never been tested for HIV. International research highlights the importance of community-led strategies to increase HIV testing in this population. Little qualitative research has been conducted to address these issues in Indonesia or other Asia-Pacific countries. This paper documents social influences that enhance HIV testing among female sex workers in urban Indonesia. Methods: This was an interpretive qualitative study in Yogyakarta, Denpasar and Bandung. In total, 57 female sex workers participated in 11 focus group discussions, and four participated in individual semi-structured interviews. Deductive and inductive thematic analysis techniques were used to identify narratives of strengths pertaining to uptake of HIV testing. Results: Participants described supportive relationships with peers, community-based organisations and ‘bosses’. Participants reported trusted networks with peers within which to share information about HIV testing and receive emotional support. Relationships with community outreach workers facilitated HIV testing through reminders, accompanied visits, and emotional/informational support. Community-based organisations worked with health services to facilitate mobile, community-based testing to overcome employment- and family-related constraints that inhibited women’s clinic attendance. ‘Bosses’ employed a variety of practices to encourage HIV testing among their workers. Conclusions: Relationships, practices and action in community- and workplace-based settings outside formal health service spaces enhanced HIV testing among female sex workers. Community- or workplace-based HIV testing with outreach support from health services, peer-led HIV testing within existing social and work-based networks, and working with bosses to implement HIV prevention strategies can address low HIV testing rates in this key population.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 78%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Corrigendum to: A strengths-based analysis of social influences that enhance HIV testing among female sex workers in urban Indonesia

Whitford¹,

Mitchell²,

Lazuardi³

et al. 2021

Sex. Health

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“…Studi HATI menunjukkan integrasi layanan tes dan pengobatan dalam satu atap meningkatkan peluang untuk memulai pengobatan secara lebih cepat dan keberhasilan pengobatan lebih baik (Januraga et al, 2018). Sebelumnya, penelitian kualitatif yang dilakukan oleh para peneliti sosial dan antropologi sebagai bagian awal dari HATI melaporkan hambatan akses ke pelayanan kesehatan meliputi aspek sosial dan kontekstual seperti persepsi terhadap sehat dan pengobatan, aspek kerahasiaan, dukungan dan pertimbangan stigma (Mitchell et al, 2019;Lazuardi et al, 2020). Di sinilah sekali lagi pendekatan multi-disiplin berhasil dimanfaatkan untuk mengidentifikasi masalah program kesehatan termasuk memformulasi intervensi yang sesuai untuk mengatasi hambatan sosial dan kontekstual yang ada untuk akses layanan HIV-AIDS.…”

Section: Menggunakan Inovasi Kedokteran Pencegahan Dalam Pendekatan Multi-disiplin Kesehatan Masyarakatunclassified

Pendekatan Multi-disiplin; Dari Sebuah Diskursus ke Arah Profesionalisme Riset dan Pendidikan Kesehatan Masyarakat

Januraga¹

2021

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Dibesarkan dalam disiplin positivisme pendidikan dokter yang kemudian tertarik pada aspek sosial kedokteran dalam bentuk pendidikan kesehatan masyarakat di jenjang magister dan doktor membawa saya menjalani adaptasi perjalanan keilmuan. Dimulai dengan mengenal dan memanfaatkan paradigma interpretivisme dan konstruktivisme dalam menganalisis masalah kesehatan dan kemudian mengembangkan intervensi kesehatan yang sesuai dengan konteks masalah dan subyek penerima tanpa melupakan pentingnya pendekatan obyektif dalam melakukan evaluasi keberhasilannya. Perjalanan karir akademik saya yang belum terlalu panjang sudah memberi kepastian pada keyakinan pribadi tentang aspek multi-dimensi kesehatan dan pentingnya pendekatan multi-disiplin dalam mengatasi masalah kesehatan masyarakat. Pengembangan penelitian secara inter-disiplin bahkan trans-disiplin diperlukan untuk mewujudkan studi implementasi yang berpusat pada pemberdayaan dan upaya mengatasi akar masalah kesehatan masyarakat. Hal ini sekaligus berfungsi mendorong penelitian dengan tingkat kesiapan teknologi yang tinggi sekaligus memicu pendidikan kesehatan yang responsif dan komprehensif (merdeka).

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“…Qualitative research provides insight into sociocultural practices, norms and beliefs that shape people's understanding and management of health issues, and their response to public health initiatives such as MDA [19][20][21]. It is therefore a crucial underpinning to the development of control and health promotion programs.…”

Section: Introductionmentioning

confidence: 99%

Community perspectives on scabies, impetigo and mass drug administration in Fiji: A qualitative study

et al. 2020

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Scabies is endemic in Fiji and is a significant cause of morbidity. Little is known about the sociocultural beliefs and practices that affect the occurrence of scabies and impetigo, or community attitudes towards the strategy of mass drug administration that is emerging as a public health option for scabies and impetigo control in Fiji and other countries. Data were collected during semi-structured interviews with 33 community members in four locations in Fiji’s Northern Division. Thematic analysis examined participants’ lived experiences of scabies and impetigo; community knowledge and perceptions about scabies and impetigo aetiology and transmission; community-based treatment and prevention measures; and attitudes towards mass drug administration. Many indigenous Fijian (iTaukei) participants noted extensive and ongoing experience of scabies and impetigo among children in their families and communities, but only one participant of Indian descent (Indo-Fijian) identified personal childhood experience of scabies. Scabies and impetigo were perceived as diseases affecting children, impacting on school attendance and families’ quality of sleep. Awareness of scabies and impetigo was considerable, but there were major misconceptions around disease causation and transmission. Traditional remedies were preferred for scabies treatment, followed by biomedicines provided by local health centres and hospitals. Treatment of close household contacts was not prioritised. Attitudes towards mass drug administration to control scabies were mostly positive, although some concerns were noted about adverse effects and hesitation to participate in the planned scabies elimination programme. Findings from this first study to document perspectives and experiences related to scabies and impetigo and their management in the Asia Pacific region illustrate that a community-centred approach to scabies and impetigo is needed for the success of control efforts in Fiji, and most likely in other affected countries. This includes community-based health promotion messaging on the social dynamics of scabies transmission, and a campaign of education and community engagement prior to mass drug administration.

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Barriers and Enablers to HIV Care AmongWaria(Transgender Women) in Indonesia: A Qualitative Study

Cited by 14 publications

References 38 publications

Corrigendum to: A strengths-based analysis of social influences that enhance HIV testing among female sex workers in urban Indonesia

Corrigendum to: A strengths-based analysis of social influences that enhance HIV testing among female sex workers in urban Indonesia

Pendekatan Multi-disiplin; Dari Sebuah Diskursus ke Arah Profesionalisme Riset dan Pendidikan Kesehatan Masyarakat

Community perspectives on scabies, impetigo and mass drug administration in Fiji: A qualitative study

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