The Characteristics and Perspectives of HIV-Positive Individuals among the Key and Vulnerable Populations in Surabaya, Indonesia
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Abstract
There is an ongoing challenge of promoting HIV testing uptake and sustained treatment adherence among key and vulnerable populations. This study aimed to determine the characteristics and perspectives of HIV-positive individuals among the key and vulnerable populations in Surabaya, Indonesia. This was a cross-sectional study with a mixed-methods in HIV-positive key and vulnerable populations. Clinical and laboratory data were obtained from medical records. A questionnaire collected data on sociodemographic characteristics, behavior, sexual practices, cognitive function, depression, and quality of life. The study indicated that 52.8% of participants were HIV-late diagnosis with several characteristics: being male (p=0.021); having lower BMI (p=0.001), lower lymphocyte count (p<0.001), poor knowledge of HIV cause (p=0.016), low quality of life on physical health (p<0.001), psychological health (p=0.020), and social relationship (p<0.001); lower cognitive function (p<0.001); and moderate to severe depression (p<0.001) than non-HIV late diagnosis. The interviews revealed that most participants hid their HIV status from their families and experienced stigma. NGO staff played a crucial role in educating, encouraging, and assisting them in accessing relevant health services. More than half of the participants were diagnosed late. Improving community-based programs, expanding mental health resources, and reducing stigma are the key strategies for enhancing HIV-related outcomes.
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References
Ministry of Health of the Republic of Indonesia. Executive report on HIV AIDS and sexually transmitted disease, semester 1, 2024 [Internet]. Jakarta: Ministry of Health of the Republic of Indonesia; 2024 [cited 2025 Jun 1]. Available from: https://hivaids-pimsindonesia.or.id/download/file/Laporan_Semester1_TW1_TW2_HIVPIMS.pdf
Ministry of Health of the Republic of Indonesia. Executive report on the progress of HIV AIDS and sexually transmitted infections, third quarter 2022 [Internet]. Jakarta: Ministry of Health of the Republic of Indonesia; 2022 [cited 2023 Jul 12]. Available from: https://siha.kemkes.go.id/portal/files_upload/Laporan_TW_3_2022.pdf
Ministry of Health of the Republic of Indonesia. Supplement of IBBS report specific analysis 2018–2019 [Internet]. Jakarta: Ministry of Health of the Republic of Indonesia; 2020 [cited 2023 Sep 3]. Available from: https://hivaids-pimsindonesia.or.id/download/file/2018-2019_IBBS_Report_Supplement_eng.pdf
Croxford S, Stengaard AR, Brännström J, Combs L, Dedes N, Girardi E, et al. Late diagnosis of HIV: an updated consensus definition. HIV Med. 2022;23(11):1202–8.
Collins S, Namiba A, Sparrowhawk A, Strachan S, Thompson M, Nakamura H. Late diagnosis of HIV in 2022: why so little change? HIV Med. 2022;23(11):1118–26.
Riono P, Challacombe SJ. HIV in Indonesia and in neighbouring countries and its social impact. Oral Dis. 2020;26(S1):28–33.
Jacobi CA, Atanga PN, Bin LK, Fru AJC, Eppel G, Mbome VN, et al. “My friend with HIV remains a friend”: HIV/AIDS stigma reduction through education in secondary schools—a pilot project in Buea, Cameroon. J Int Assoc Provid AIDS Care. 2020;19:2325958219900713.
Kimera E, Vindevogel S, Reynaert D, Justice KM, Rubaihayo J, De Maeyer J, et al. Experiences and effects of HIV-related stigma among youth living with HIV/AIDS in Western Uganda: a photovoice study. PLoS One. 2020;15(4):e0232359.
Shorten A, Smith J. Mixed methods research: expanding the evidence base. Evid Based Nurs. 2017;20(3):74–5.
Creswell JW, Creswell JD. Research design: qualitative, quantitative, and mixed methods approaches. 5th ed. London: Sage Publications Ltd.; 2018.
Sharma S, Mudgal S, Thakur K, Gaur R. How to calculate sample size for observational and experiential nursing research studies? Natl J Physiol Pharm Pharmacol. 2020;10(1):1–8.
Panentu D, Irfan M. Validity and reliability test of examination items with the Indonesian version of the Montreal Cognitive Assessment (MoCA-INA) in post-stroke recovery phase. J Fisioterapi. 2013;13(1):55–67.
Ginting H, Näring G, Van Der Veld WM, Srisayekti W, Becker ES. Validating the Beck Depression Inventory-II in Indonesia’s general population and coronary heart disease patients. Int J Clin Health Psychol. 2013;13(3):235–42.
Muhammad NN, Shatri H, Djoerban Z, Abdullah M. Validity and reliability test of Indonesian version of World Health Organization Quality of Life-HIV BREF questionnaire to measure the quality of life patients with HIV/AIDS. J Penyakit Dalam Indones. 2017;4(3):112–8.
Mishra P, Pandey C, Singh U, Keshri A, Sabaretnam M. Selection of appropriate statistical methods for data analysis. Ann Card Anaesth. 2019;22(3):297–301.
Sutton J, Austin Z. Qualitative research: data collection, analysis, and management. Can J Hosp Pharm. 2015;68(3):226–31.
Creswell JW, Creswell JD. Research design: qualitative, quantitative, and mixed methods approaches. 5th ed. London: Sage Publications Ltd.; 2018.
Ministry of Health of the Republic of Indonesia. Executive report on the development of HIV/AIDS and sexually transmitted infection diseases quarter II of 2022 [Internet]. Jakarta: Ministry of Health of the Republic of Indonesia; 2022 [cited 2022 May 20]. Available from: https://siha.kemkes.go.id/portal/files_upload/Laporan_TW_2_2022.pdf
Beyene MB, Beyene HB. Predictors of late HIV diagnosis among adult people living with HIV/AIDS who undertake an initial CD4 T cell evaluation, Northern Ethiopia: a case-control study. PLoS One. 2015;10(10):e0140004.
Rahmalia A, Wisaksana R, Laga M, Van Crevel R, Peeters Grietens K. Facilitators and barriers to status disclosure and partner testing of women living with HIV in Indonesia: a mixed methods study. Sex Reprod Health Matters. 2022;30(1):2028971.
Ministry of Health of the Republic of Indonesia. HIV/AIDS and sexually transmitted infection control program at the first level health facility. Jakarta: Ministry of Health of the Republic of Indonesia; 2017.
Nabikande S, Namutundu J, Nangendo J, Okello T, Agwang W, Tusabe J, et al. Men’s late presentation for HIV care in Eastern Uganda: the role of masculinity norms. PLoS One. 2022;17(11):e0277534.
Baraki AG, Gezie LD, Zeleke EG, Awoke T, Tsegaye AT. Body mass index variation over time and associated factors among HIV-positive adults on second-line ART in north-west Ethiopia: a retrospective follow-up study. BMJ Open. 2019;9(9):e033393.
Maretalinia, Buston E, Sari MHN, Nuraeni T, Sulyastini NK, Sholihat S. Factors associated with knowledge of mother-to-child transmission (MTCT) of HIV/AIDS among young adults in Indonesia: analysis of IYARHS. Public Health Indones. 2023;9(3):96–104.
Hulu VT, Ginting R, Manalu P, Samosir FJ, Hartono H, Siregar SD, et al. The impact of tuberculosis on people living with HIV: scoping review. Public Health Indones. 2024;10(3):262–73.
Wisaksana R, Hinduan ZR, Pohan MN. Integrated biological-behavioral surveillance survey among adolescent and young people who inject drugs, female sex workers, males who have sex with males, and male to female transgender persons [Internet]. Jakarta: Ministry of Health of the Republic of Indonesia and UNICEF Indonesia; 2019 [cited 2023 Jul 6]. Available from: https://www.unicef.org/indonesia/media/8496/file/IBBS%20Report%20YKAP%202019.pdf
Rocha Filho PAS, Brito-Marques PR, Cabral-Filho JE, Briano IO, Milet GMM, Silva CE, et al. Comparison between the Mini-Mental State Examination and Montreal Cognitive Assessment as a cognitive screening tool in patients with human immunodeficiency virus-associated neurocognitive disorders. J Bras Soc Trop Med. 2019;52:e20190473.
Deshmukh NN, Borkar AM, Deshmukh JS. Depression and its associated factors among people living with HIV/AIDS: can it affect their quality of life? J Family Med Prim Care. 2017;6(3):549–53.
Tao J, Vermund SH, Qian H. Association between depression and antiretroviral therapy use among people living with HIV: a meta-analysis. AIDS Behav. 2018;22(5):1542–50.
Popping S, Kall M, Nichols BE, Stempher E, Versteegh L, Van de Vijver DAMC, et al. Quality of life among people living with HIV in England and the Netherlands: a population-based study. Lancet Reg Health Eur. 2021;8:100177.
Seguiti C, Salvo PF, Di Stasio E, Lamonica S, Fedele AL, Manfrida S, et al. Health-related quality of life (HRQoL) from HIV patients’ perspective: comparison of patient-reported outcome (PRO) measures among people living with HIV and other chronic clinical conditions. J Patient Rep Outcomes. 2022;6(1):1–9.
United Nations Joint Programme on HIV/AIDS. 2025 AIDS targets [Internet]. New York: UNAIDS; 2022 [cited 2025 May 1]. Available from: https://www.unaids.org/sites/default/files/2025-AIDS-Targets_en.pdf
Martinez O. HIV-related stigma as a determinant of health among sexual and gender minority Latinxs. HIV Spec. 2019;11(2):14–7.
Lippman SA, Pettifor A, Dufour MK, Kabudula CW, Twine R, Peacock D. A community mobilisation intervention to improve engagement in HIV testing, linkage to care, and retention in care in South Africa: a cluster-randomised controlled trial. Lancet HIV. 2022;9:617–43.
Wong CS, Wei L, Kim YS. HIV late presenters in Asia: management and public health challenges. AIDS Res Treat. 2023;2023:9488051.