A Content Analysis Study: Concerns of Indonesian Women Infected With HIV by Husbands Who Used Intravenous Drugs

Intimate partner violence and factors influencing HIV status disclosure among women living with HIV in Indonesia: a cross-sectional study

The disclosure of HIV status poses challenges, and women living with HIV often face intimate partner violence as a result of revealing their HIV status. This study aims to investigate the prevalence of intimate partner violence and HIV status disclosure among women living with HIV in Indonesia, as well as the factors associated with disclosure. A total of 283 women with HIV participated in an online survey, and descriptive and logistic regression analyses were performed. The findings revealed that women reported experiencing physical (9.54%), sexual (6.01%), mental (23.67%), and economic (14.49%) abuse. HIV status disclosure varied among different individuals, with higher rates observed for partners (71.2%), other family members (65.02%), close friends (37.10%), and lower rates for health workers (1.77%). Factors such as employment status and partner's HIV status influenced disclosure to partners, while the duration of knowing one's HIV status, experiences of intimate partner violence, and perceived barriers influenced disclosure to both family and non-family members. To mitigate the negative consequences of HIV status disclosure, targeted health promotion efforts should prioritize partners, family members, and non-family members, focusing on enhancing knowledge and awareness about HIV, including the impact of violence.

Feasibility of Lantern Using WhatsApp to Improve Antiretroviral Therapy Adherence

This pilot study tested the feasibility of Lantern program, an adherence program to HIV medications using WhatsApp, a secure social media messaging application from Meta, for a smartphone-based platform to enhance medication-taking adherence of antiretroviral therapy among people living with HIV in Indonesia. Thirty participants were recruited for this 8-week study. We recruited persons if they had taken antiretroviral therapy for at least 3 months prior to the study, had a smartphone, Internet access, and could use Lantern with WhatsApp. Here, we report the results from the focus group discussions, with the participants evaluating the qualitative aspects of the experiences. The WhatsApp platform was found to be safe, practical, and relatively inexpensive and provided confidentiality for the participants. Three themes emerged from the focus groups: the study motivated participants to take their antiretroviral therapy medications on time, they still set medication reminder alarms, and being in the study made them feel supported. The Lantern program indicated good feasibility and acceptability for adherence to antiretroviral therapies among people living with HIV. Future research should examine on how community organizations and healthcare providers can take advantage of the WhatsApp program to improve adherence to antiretroviral therapies.

Understanding coping strategies of mothers living with HIV who care for children living with HIV: a qualitative study in Indonesia

HIV infection and its sequelae continue to be a significant challenge among women and their families in developing countries despite the progress that has been made in the prevention and treatment of HIV. This paper describes the strategies employed by mothers with HIV to cope with the various challenges experienced following their own and their children's HIV diagnosis. This paper uses previously unpublished data collected for a study that sought to explore the mental health challenges and coping strategies of mothers living with HIV (MLHIV) (n = 23) who have children living with HIV (CLHIV). Data collection was conducted using in-depth interviews, and participants were recruited using the snowball sampling technique. The concept of meaning-making was used to guide the conceptualisation, analysis, and discussion of the findings. Our analysis showed that meaning-making such as the awareness of how important mothers were to their children/CLHIV and families and religious meaning were used by participants to cope with HIV-related and mental health challenges they faced. The meaning of mother-child relationship which was supported and maintained through the provision of time, attention and fulfillment of CLHIV's needs were also coping strategies employed by these women. Additional coping strategies used were to link their CLHIV to groups and activities of CLHIV. The connections made through these links enabled their children to know other CLHIV, build relationships, and share experiences. These findings are useful evidence that can inform policies and practices and indicate the need for the development of intervention programs that address the needs of MLHIV and their families to cope with HIV-related challenges of their children. Future large-scale studies involving MLHIV who have CLHIV are recommended to have a comprehensive understanding of strategies they employ to cope with HIV-related challenging circumstances and mental health issues that they continue to face.

Mental Health Challenges and the Associated Factors in Women Living with HIV Who Have Children Living with HIV in Indonesia: A Qualitative Study

Women living with HIV (WLHIV) are vulnerable to various mental health challenges. However, there is a paucity of studies globally and in the Indonesian context that have specifically explored mental health challenges among mothers living with HIV who also have children living with HIV (CLHIV). This qualitative study explored mental health challenges and the associated factors in mothers living with HIV who have CLHIV in Yogyakarta, Indonesia. In-depth interviews were employed to collect data from the participants (N = 23) who were recruited using the snowball sampling technique. A qualitative data analysis framework was used to guide the analysis of the findings. The findings showed that the mothers experienced a range of mental health issues due to their own, and their child’s diagnoses of stress, depression, anxiety, fear, sadness, and guilt. Lack of knowledge about HIV, fear of death, shame, not knowing whom to talk with and what to do after their own HIV diagnosis, and the HIV diagnosis of their children were factors that challenged their mental health. Difficulties in dealing with daily life or social activities of their CLHIV, dilemmas in addressing questions and complaints of their CLHIV about HIV treatment, and concerns about the health condition of their CLHIV and how their children cope with any potential negative social impacts also impacted the mothers’ mental health. Social factors such as unsympathetic expressions from friends towards them and their CLHIV and negatively worded religious-related advice from parents and relatives also contributed to their poor mental health. Our findings indicate the need for intervention programs that support mothers living with HIV and their CLHIV. Future large-scale studies involving mothers living with HIV who have CLHIV in Indonesia and other settings globally are needed to obtain a comprehensive understanding of mental health challenges and the associated factors they face.

Psychological and Social Impact of HIV on Women Living with HIV and Their Families in Low- and Middle-Income Asian Countries: A Systematic Search and Critical Review

Human Immunodeficiency Virus (HIV) infection adds a significant burden to women in Low- and Middle-Income Countries (LMICs), often leading to severe detrimental impact, not only on themselves, but also on their families and communities. Given that more than half of all people living with HIV globally are females (53%), this review seeks to understand the psychological and social impact of HIV infection on Women Living with HIV (WLHIV) and their families in LMICs in Asia, and the interrelationships between one impact and another. A systematic review was conducted to find literature using the following databases: Medline, PsycINFO, CINAL, Emcare, Scopus and ProQuest. Research articles included in this review were selected based on the following inclusion criteria: conducted in LMICs in Asia, published in English language between 1 January 2004 and 31 December 2021, had full text available, involved WLHIV (married and unmarried) and explored the psychological and social impacts of HIV on these women and their families. Critical appraisal tools developed by Joanna Briggs Institute (JBI) were used to assess the methodological quality of the studies, and thematic narrative synthesis was used to analyse the findings. A total of 17 articles met the inclusion criteria. The review showed that HIV has a range of negative psychological consequences on WLHIV, such as stress, fear, worry, anxiety and depression, as well as social impacts on the women and their families, including stigma, discrimination and family separation. The findings indicate the need for targeted interventions-specific to WLHIV-that address the psychological challenges, stigma and discrimination these women and their families face. These interventions should also incorporate education and sustainable support structures for WLHIV and their families.

Classifying stigma experience of women living with HIV in Indonesia through the social ecological model

Little is known how stigma theories apply to women living with HIV (WLWH). To apply stigma theories to WLWH, and locate within the dimensions of the Social-Ecological Model (SEM). Using a literature review and a theoretical subtraction to apply stigma forms to the SEM dimensions. WLWH begin to self-stigmatize, receive stigma based on fear from the family and community. Healthcare providers and society stigmatize WLWH by ascribing character flaws to them. The SEM allowed us to locate the dimensions of stigma and identify areas for future interventions for WLWH in Indonesia and other countries.

HIV disclosure, stigma, and stress impacting quality of life of housewives with HIV in Kupang, Indonesia: A cross-sectional study

The aim of this study was to determine the relationship between HIV disclosure, stigma, and stress on the quality of life of housewives with HIV in Kupang, Indonesia. A cross-sectional method was used, involving 120 respondent housewives. The participants were recruited at one of the outpatient voluntary counseling and testing (VCT) sites in Kupang. Respondents of the study are 120 respondents, 75% had a moderate level of stress, 51.7% had poor quality of life, and 66.7% have HIV disclosure to others. Stress (p=0.011) and stigma (p=0.001) were significantly and inversely correlated with quality of life. A moderate stress level of respondents was found to be the most significant contributing factor impacting quality of life (p=0.009; OR=7.667). Early assessment of the experience of stigma may help to decrease stress and improve the quality of life HIV housewives in Kupang, Indonesia.

Spousal intimacy, type of antiretroviral drug and antiretroviral therapy adherence among HIV patients in Bandung, Indonesia

Background

Antiretroviral Therapy (ART) has been proven effective in reducing the mortality rates among People Living With HIV/AIDS (PLWH). However, poor adherence to ART may result in treatment failure. Few studies examine the relationship between spousal intimacy, type of ART and ART adherence. This study aimed to investigate the association between spousal intimacy, type of ART and antiretroviral therapy adherence among PLWH in Bandung, Indonesia.

Design and Methods

A cross-sectional study was conducted involving 115 adult PLWH who were receiving ART at least for 6 months in RSUD Kota Bandung, they were selected with a consecutive sampling. The data were analyzed using chi-square test.

Results

The majority of PLWH (61.74%) reported had high level of spousal intimacy, about 93.91% PLWH used first line of ART, and 88.69% had high adherence in consuming ART. Spousal intimacy had a significant relationship to antiretroviral adherence (p value < 0.001) and type of ART (p value: 0.031, OR: 7.35) significantly associated with antiretroviral adherence.

Conclusions

PLWH who have high levels of spousal intimacy also have high levels of antiretroviral adherence. PLWH on firstline ART were 7.3 times more adherent on ART.

The relationship between HIV stigma and adherence to antiretroviral (ARV) drug therapy among women with HIV in Lampung, Indonesia

OBJECTIVE

The aim of our study was to examine the relationship between HIV stigma and adherence to antiretroviral (ARV) therapy among women with HIV.

METHOD

120 women with HIV involved in this cross-sectional study. The participant were outpatients at the Voluntary Counseling and Testing (VCT) Abdul Moeloek Hospital in Lampung, Indonesia.

RESULTS

We examined data from 120 patients. Through chi-squared tests, a statistically significant correlation between HIV stigma and adherence to ARV therapy was revealed (p-value=0.045; OR 2.274) women with low levels of stigma toward HIV demonstrated adherence to ARV treatment that was 2.27 times greater than that of women with high levels of stigma toward HIV.

CONCLUSIONS

One way to increase adherence to ARV therapy in women with HIV is by minimizing its stigma. This can be done by increasing their self-confidence and not differentiating between people living with HIV and others in the provision of health services.

HIV-related stigma, knowledge about HIV, HIV risk behavior and HIV testing motivation among women in Lampung, Indonesia

OBJECTIVE

This study aims to identify factors that influence HIV testing motivation among women at the Dr. H. Abdul Moeloek General Hospitalin Lampung, Indonesia.

METHOD

A cross-sectional method was used in this study that employed a consecutive sampling technique involving 120 women with HIV. The participants were outpatients at the Voluntary Counseling and Testing (VCT) Dr. H. Abdul Moeloek General Hospital. This study utilized three instruments: the Berger HIV Stigma Scale, HIV Knowledge Questionnaire (HIV-KQ-18) and Safe Sex Behavior Questionnaire (SSBQ).

RESULTS

The study examined factors that influence HIV testing motivation among women: HIV-related stigma, knowledge about HIV and HIV risk behavior. The results of the analysis showed that there is a significant relationship among the HIV-related stigma variable (p=0.019, OR=2.727), knowledge about HIV variable (p=0.011, OR=3.750) and HIV risk behavior variable (p=0.041, OR=2.381). The most dominant factor influencing HIV testing motivation is HIV risk behavior (p=0.016, ά=0.05 at 95% CI and OR=3.217). This indicates that Women Living With HIV (WLWH) who engage in risk HIV behavior demonstrate 3.2 times to HIV testing motivation.

CONCLUSION

HIV-related stigma, knowledge about HIV and HIV risk behavior influence HIV testing motivation for women.

RECOMMENDATION

Our findings have implications for nursing and healthcare practice as well as research, especially in supporting HIV testing for women who are at risk for HIV. Nurses should focus their attention on motivating women with a high risk of HIV to undergo early HIV testing.