Nugroho Adi, Erasmus Vicki, Krier Sarah E, Reviagana Kusnindyah P, Laksmono Pipiet A, Widihastuti Asti, Richardus Jan Hendrik
Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
School of Public Health, Faculty of Medicine, Lambung Mangkurat University, Banjarbaru, Indonesia.
Health Promot Int. 2020 Oct 1;35(5):916-924. doi: 10.1093/heapro/daz075.
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.
本研究探讨了印度尼西亚针对男男性行为者(MSM)和跨性别女性(变性女性或瓦里亚)推广艾滋病毒检测的外展方法中服务对象的观点。对32名个人(21名男男性行为者和11名瓦里亚)进行了半结构化定性访谈,这些人在印度尼西亚五个城市接受了外展工作者(OWs)的服务。本研究的参与者报告了在外展方法方面的积极经历,并将外展工作者视为他们进行艾滋病毒检测以及获得艾滋病毒护理和治疗的推动者。外展工作者提供了易于理解的艾滋病毒信息。服务对象期望外展工作者接受良好培训并在开展外展工作时更具创造性。他们认为互联网和社交媒体极大地帮助他们与外展工作者保持联系。然而,他们表示这种虚拟联系不能简单地取代面对面接触,尤其是对瓦里亚而言。此外,服务对象建议以外展工作者以更有吸引力的方式开展工作,例如通过开展有助于服务对象学习专业或生活技能的活动。他们还断言,作为一种艾滋病毒预防方法,外展工作需要采用更积极的框架,并且超越艾滋病毒和健康内容,主要针对年轻人。未来的外展项目应便于外展工作者根据服务对象所需支持的水平和类型提供量身定制的服务,并在使用在线和虚拟平台进行外展工作时采用不同比例和复杂程度。
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