The Optimization of HIV Testing in Eastern Indonesia: Findings from the 2017 Indonesian Demographic and Health Survey.

Kusman Ibrahim,Hasniatisari Harun,Hidayat Arifin,Yusshy Kurnia Herliani,Siti Ulfah Rifa’Atul Fitri,Agus Setiawan,Bih-O Lee

doi:10.3390/healthcare10030533

Abstract

There is a concerning increase in human immunodeficiency virus (HIV) incidence in eastern Indonesia. HIV testing rates in this area are the lowest in the country. This study aimed to analyze the determinants of HIV testing in the Public Health Centers (PHCs) in eastern Indonesia. A cross-sectional study design was utilized using secondary data from the 2017 Indonesian Demographic and Health Survey (IDHS). We focused the survey on eastern Indonesia (Sulawesi, Maluku, and Papua) with PHC settings. After we weighted and removed missing data, we obtained 2118 surveys (425 males and 1693 females aged 14–54 years). Chi-square and binary logistic regression were used to analyze the determinants of HIV testing optimization in eastern Indonesia with a significance level of p < 0.05. The HIV testing coverage at the PHCs in eastern Indonesia was found to be 28.28%. From the survey, we found that respondents from the province of Papua (AOR: 1.45; 95% CI: 1.09–1.91), those who were female (AOR: 2.37; 95% CI: 1.75–3.12), and those with more information on HIV (AOR: 1.88; 95% CI: 1.41–2.51) were more likely to undergo HIV testing at the PHCs. Meanwhile, the wealthiest respondents (AOR: 0.61; 95% CI: 0.42–0.89) and the respondents who engaged in the perpetuation of stigmatization (AOR: 0.65; 95% CI: 0.42–1.02) were less likely to undergo HIV testing at the PHCs. The coverage of HIV testing in eastern Indonesia needs special attention from the Indonesian government. Increasing equity, distributing information regarding HIV and acquired immunodeficiency syndrome (AIDS) through social media, and creating accessible HIV testing in rural areas are vital for developing appropriate interventions.

Highlights

The incidence of human immunodeficiency virus (HIV) is growing steadily in Indonesia, with over 670,000 HIV-infected individuals recorded in 2015 [1]
It became known that 92.35% of respondents were working; 86.83% received earnings; 67.75% did not engage in stigmatizing behavior related to HIV; and 71.39% of respondents had more knowledge of HIV, while 42.02% responded that they had some information of HIV (Table 1)
This study analyzed the current information regarding the optimizing of HIV testing in eastern Indonesia from Public Health Centers (PHCs) settings as the first-level health facility in Indonesia

Summary

Introduction

The incidence of HIV is growing steadily in Indonesia, with over 670,000 HIV-infected individuals recorded in 2015 [1]. The Joint United Nations Programme on HIV/AIDS (UNAIDS) has a relevant program with SDGs for ending HIV/AIDS that aims to end poverty, end hunger, ensure healthy lives, ensure quality education, achieve gender equality, reduce inequality, and promote peaceful and inclusive societies among PLHIV [4]. Based on the Indonesian Health Profile data [5], the number of HIV-positive reports in adults remains high. We compared this with the data in 2018 when there were 50,282 HIVpositive cases recorded in Indonesia. The most afflicted include areas in eastern Indonesia, such as the province of Papua, where the transmission rate was 15 times greater than the national average in 2014 [5,6]. Papua makes up just over 1% of Indonesia’s population, 30% of Indonesia’s official HIV/AIDS cases occur there [7]

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Discussion

Conclusion