Client perspectives on an outreach approach for HIV prevention targeting Indonesian MSM and transwomen

Abstract

This study explored clients’ perspective on an outreach approach to promote HIV testing in Indonesia targeting men who have sex with men (MSM) and transgender women (transwomen or waria). Semi-structured qualitative interviews were conducted with 32 individuals (21 MSM and 11 waria) who had received services from outreach workers (OWs) in five cities in Indonesia. Participants in this study reported positive experiences with the outreach approach and perceived OWs as their motivators in accessing HIV testing as well as HIV care and treatment. OWs provided easy-to-understand HIV information. Clients expected OWs to be well-trained and more creative in performing outreach. They perceived that the Internet and social media have helped them considerably to stay in touch with OWs. Yet, they expressed that such virtual contacts could not simply replace the face-to-face contact, especially for waria. Furthermore, clients suggested outreach to be delivered in a more appealing manner, for example through activities that may facilitate clients learning professional or life skills. They also asserted that as an HIV prevention approach, outreach needs to use more positive framing and go beyond HIV and health contents, chiefly for the youth. Future outreach programmes should facilitate OWs in providing tailored services based on the level and type of support that the clients need, and in applying varied proportion and levels of sophistication in the use of online and virtual platforms for outreach.

Chasing targets in a pandemic: The impact of COVID-19 on HIV outreach workers for MSM (men who have sex with men) in Jakarta, Indonesia

“…Final version before copyediting -Global Public Health on specific physical locations in which significant numbers of people identified as MSM congregate or live (see Nugroho et al, 2019, for an ethnographic account see Hegarty, in press).…”

“…This shift been further consolidated since 2019, when the Indonesian Ministry of Health introduced the requirement that local, government-funded healthcare clinics provide anti-retroviral therapy free of charge (Lazuardi, 2019, p. 2). As a result of this emphasis, community-based outreach workers therefore play an important role in mediating between MSM and healthcare workers, including providing assistance to newly diagnosed HIV positive individuals to navigate complex health bureaucracies (Hegarty, Nanwani, and Praptoraharjo, 2020;Nugroho et al, 2019). The role of communitybased outreach workers thus extends beyond prevention alone, comprising the role vital care workers.…”

The Biosocial Body: HIV Visibility in an Age of Pharmaceutical Treatment in Indonesia

“…Bergembira is one of several funded outreach programs whose primary objective is to support clients to access HIV testing and treatment that is usually available at primary healthcare clinics. Although there is a degree of heterogeneity, the programs undertaken by non-governmental organizations such as Bergembira have increasingly focused on -hard to reach‖ key populations, who are at both a higher risk of contracting HIV and who are more likely to be -lost to follow up‖ or test positive and subsequently cease to take treatment (for accounts of programs for MSM and transgender women in Indonesia, see Lazuardi et al 2019;Nugroho et al 2019). Given that HIV infection is life-long and requires anti-retroviral medication administered consistently to prevent a weakened immune system and subsequent infection, a significant proportion of outreach work involves closely attending to those with a positive diagnosis to make sure that they are retained in treatment.…”