Faculty of Arts, School of Social and Political Sciences, The University of Melbourne, Melbourne, Australia.
University Centre of Excellence - ARC Health Policy and Social Innovation, Atma Jaya Catholic University of Indonesia (UCoE - ARC HPSI AJCUI), Jakarta, Indonesia.
Glob Public Health. 2021 Nov;16(11):1681-1695. doi: 10.1080/17441692.2021.1980599. Epub 2021 Sep 23.
The COVID-19 pandemic has had a significant impact on HIV services globally, including community-based outreach programmes. This article draws on a qualitative study of HIV outreach workers for men who have sex with men (MSM) in Jakarta, Indonesia undertaken between July and September 2020. The research documented the impact of the COVID-19 pandemic on HIV outreach programmes for MSM based on interviews, focus group discussions and video diaries collected from outreach workers. As a result of the pandemic, and in response to the guidelines issued by international donors and the Indonesian government, outreach workers shifted activities to 'virtual outreach' where possible. However, outreach workers consistently performed in-person work to address what they referred to as 'urgent' cases (e.g. required them to attend the clinic). Regardless of delivery mode, the steps comprising outreach work during the pandemic aligned with the 'cascade of care', which forms the dominant policy narrative for the management of HIV. Outreach work during the pandemic therefore continued to be based primarily on the objective of maintaining testing and treatment rates. Although outreach workers responded innovatively to the pandemic, including to the risk of COVID-19 infection, they were limited by the prevailing emphasis on targets in HIV programmes.
新冠疫情对全球的艾滋病防治服务产生了重大影响，包括社区外展项目。本文借鉴了 2020 年 7 月至 9 月期间在印度尼西亚雅加达开展的一项针对男男性行为者（MSM）的艾滋病外展工作者的定性研究。该研究记录了新冠疫情对 MSM 艾滋病外展项目的影响，研究方法是对来自外展工作者的访谈、焦点小组讨论和视频日记进行分析。由于疫情的影响，以及为了响应国际捐助者和印度尼西亚政府发布的指导方针，外展工作者尽可能地将活动转向“虚拟外展”。然而，外展工作者始终会进行面对面的工作，以解决他们所说的“紧急”情况（例如，需要他们去诊所）。无论采用何种服务提供模式，疫情期间外展工作的步骤都与“关怀链”一致，关怀链是管理艾滋病的主要政策叙述。因此，疫情期间的外展工作仍然主要基于保持检测和治疗率的目标。尽管外展工作者对疫情做出了创新应对，包括应对新冠感染的风险，但他们受到了艾滋病防治项目中以目标为导向的做法的限制。
