Department of Health, UNICEF Indonesia, Jakarta, Indonesia.
Department of Research and Community Centre, AIDS Research Center, Atmajaya University, Jakarta, Indonesia.
J Prev Med Public Health. 2023 May;56(3):238-247. doi: 10.3961/jpmph.22.516. Epub 2023 Apr 11.
Low adherence to antiretroviral (ARV) therapy in pregnant women with human immunodeficiency virus (HIV) increases the risk of virus transmission from mother to newborn. Increasing mothers' knowledge and motivation to access treatment has been identified as a critical factor in prevention. Therefore, this research aimed to explore barriers and enablers in accessing HIV care and treatment services.
This research was the first phase of a mixed-method analysis conducted in Kupang, a remote city in East Nusa Tenggara Province, Indonesia. Samples were taken by purposive sampling of 17 people interviewed, consisting of 6 mothers with HIV, 5 peer facilitators, and 6 health workers. Data were collected through semi-structured interviews, focus group discussions, observations, and document review. Inductive thematic analysis was also performed. The existing data were grouped into several themes, then relationships and linkages were drawn from each group of informants.
Barriers to accessing care and treatment were lack of knowledge about the benefits of ARV; stigma from within and the surrounding environment; difficulty in accessing services due to distance, time, and cost; completeness of administration; drugs' side effects; and the quality of health workers and HIV services.
There was a need for a structured and integrated model of peer support to improve ARV uptake and treatment in pregnant women with HIV. This research identified needs including mini-counseling sessions designed to address psychosocial barriers as an integrated approach to support antenatal care that can effectively assist HIV-positive pregnant women in improving treatment adherence.
艾滋病毒（HIV）感染孕妇抗逆转录病毒（ARV）治疗依从性低会增加母婴病毒传播的风险。提高母亲获取治疗的知识和积极性已被确定为预防的关键因素。因此，本研究旨在探讨获取艾滋病毒护理和治疗服务的障碍和促进因素。
本研究是在印度尼西亚东努沙登加拉省偏远城市古邦进行的混合方法分析的第一阶段。通过对 17 名受访者进行的目的性抽样，包括 6 名艾滋病毒感染母亲、5 名同伴促进者和 6 名卫生工作者，采集了样本。通过半结构化访谈、焦点小组讨论、观察和文件审查收集数据。还进行了归纳主题分析。现有数据被分为几个主题，然后从每个信息组中得出关系和联系。
获取护理和治疗的障碍包括对 ARV 益处的认识不足；来自内部和周围环境的污名；由于距离、时间和费用而难以获得服务；行政管理不完整；药物的副作用；以及卫生工作者和艾滋病毒服务的质量。
需要建立一种结构化和综合的同伴支持模式，以提高艾滋病毒感染孕妇对 ARV 的接受度和治疗效果。本研究确定了一些需求，包括设计用于解决心理社会障碍的迷你咨询会议，作为支持产前护理的综合方法，可以有效地帮助艾滋病毒阳性孕妇提高治疗依从性。
