Knowledge, Attitude, Behavior, and Socioeconomic Conditions of People Living with HIV in Indonesia During the COVID-19 Pandemic: A Cross-Sectional Study

Abstract

Purpose This study aimed to analyze the knowledge, attitude, and behavior of people living with HIV (PLWH) during the COVID-19 pandemic and the pandemic’s impact on their socioeconomic conditions, antiretroviral adherence, and worries. Materials and Methods This cross-sectional study was conducted in May–August 2020 at the Integrated HIV Center of Dr. Cipto Mangunkusumo General Hospital, Indonesia. The data were collected using an online questionnaire and an offline paper-based questionnaire. Results A total of 545 subjects participated in this study, 72.8% (397) of which were male. Most subjects were middle-aged (36–55 years old) (66.5%). Many subjects reported to have experienced reduced incomes (49.2%) or losses of income (22.4%), while 15.6% reported losing their job during the COVID-19 pandemic. Most subjects (97%) wished to continue treatment despite the many obstacles, and the subjects’ knowledge about COVID-19 and its prevention was considerably good. More than 70% of subjects reported that they have been implementing the general precautions of the COVID-19 pandemic: maintaining distance, wearing a mask, washing hands, and avoiding crowds. Conclusion This study provides an overview of what PLWH are experiencing, which will allow for policy-making that can help them continue their treatment with consideration of the possibility of having to live a “new normal” future.

The impacts of COVID-19 pandemic on service delivery and treatment outcomes in people living with HIV: a systematic review

“…The studies carried out among PLHIV reported alterations in ART uptake as follows: a rate of 33.7%,less-than-excellent and 1.7% under-average adherence to antiretrovirals medications [ 22 ], an increase of 7% (from 5 to 12%) in the rate of non-adherence to HIV medications [ 23 ], a 23.1% decrease in obtaining antiretroviral medication[ 24 ], a rate of 8.2% one-dose-ART-medication miss and 13.2% ART uptake avoidance [ 25 ], 5% to 26% increase in the chance of ART supply failure [ 26 ], a 36% temporary non-adherence due to inadequate ART supply [ 27 ], a 13.25% rate of running out of ART medication during pandemic [ 28 ], a 27.4% rate of missing visits for the antiretroviral stock refill [ 29 ], a 3% decrease in ART uptake [ 30 ], a 24.0% rate of missing at least one dose of HIV medications [ 31 ], and a 3.6% of ART refill failure [ 21 ]. In addition, one study conducted among providers reported a 67.25% rate of ART-application-service suspension or postponement due to the COVID-19 pandemic [ 32 ].…”

“…Many patients had missed their HIV clinical visits, recovery support meetings, follow-up tests, and counseling services. The main causes of this general decline in clinical appointments were reported as follows: inadequate transport, police abuse, insufficient transportation funds to avoid exposure to COVID-19 [ 27 ], lockdowns [ 28 ], limited access to health services, reduced income, and inability to afford traveling to the health facility, being unable to get facemask, fear of COVID-19 [ 29 ], and fear of visiting hospitals [ 30 ]. Similarly, two studies conducted among healthcare providers reported disruptions in HIV services amid the pandemic.…”

“…While due to COVID-19 pandemic restrictions many PLHIVs are at great risk of missing clinical follow-ups and healthcare provisions, which eventually would lead to ART interruption. Many studies included in this review reported a form of disruption in HIV and general healthcare services as follows; HIV clinical visit misses [ 21 , 24 , 26 – 29 , 31 , 43 ], fear of visiting hospitals[ 30 ], and HIV clinic disruptions due to nationwide restrictions and healthcare diversion [ 32 , 42 ]. A study carried out in Northwest Ethiopia reported a significant decrease in HIV services including HIV voluntary counseling and testing (VCT), and Provider-Initiated HIV Testing & Counseling (PITC) in 2020 compared to 2019 [ 35 ].…”

“…The evidence indicated that these challenges could also be experienced by PLHIV even during the pandemic [ 22 , 27 ]. Interestingly, studies have reported that PLHIVs were obliged to change their health center and reported losing their jobs and even being denied health services during the pandemic [ 29 , 30 ]. Hence, there is still the need to probe further into structural causes and possible interventions in dealing with the stigma associated with HIV status.…”

The Symptom Experience and Management in People with HIV Who Underwent Antiretroviral Therapy During the Covid-19 Pandemic in Bali, Indonesia

“…In Indonesia, particularly during the COVID-19 pandemic, research on symptom experience and symptom management of the impact of ARV therapy on PWH has not been widely studied. During the COVID-19 pandemic in Indonesia, Karjadi et al (2021) performed a study on the knowledge, attitudes, and behavior of PWH, but did not particularly address symptoms or symptom management behavior. Previous research has exclusively focused on symptom management in cardiovascular, neurologic, and cancer patients (Voss, 2013).…”