Title:
A Socio-Ecological View of Factors Influencing ART Adherence Among Women Living With HIV in Bali, Indonesia
Authors:
Lestari, Ni Ketut
Place:
Amsterdam, The Netherlands
Publisher:
KIT - Royal Tropical Institute [etc.]
Year:
2024
PAGE:
ix, 44
Language:
En
Subject:
Governance & HIV and AIDS
Keywords:
ART adherence, HIV, Women Living with HIV, Bali, Indonesia
Abstract:
Background: Indonesia faces major challenges in HIV diagnosis, treatment, and viral load control, with significant gaps from the UNAIDS 95-95-95 targets. By 2022, only 79% of people living with HIV were aware of their status, 41% were receiving Antiretroviral Therapy (ART), and 19% had achieved viral load suppression. The number of new HIV infections among women increased from 12,573 in 2015 to 17,839 in 2021. Women represent 35% of the 540,000 people living with HIV in Indonesia, and ART coverage for women was just 29% in 2022. In Bali, approximately 27,000 people are living with HIV, with women making up 31% of this population. Women living with HIV (WLHIV) in Bali faces unique challenges impacting ART adherence. This study investigates the factors influencing ART adherence among WLHIV in Bali using a socio-ecological framework. Methodology: Employing a socio-ecological model, this study analysed individual, interpersonal, community, health system, and policy-level factors affecting ART adherence. Data were gathered through key informant interviews with healthcare providers and a review of relevant literature. Results: The study identified a range of factors impacting ART adherence among WLHIV in Bali. At the individual level, education level, income and mental health were significant. Positive interpersonal relationships, including support from family, partners and healthcare providers, were associated with higher adherence. Community-level, stigma and societal norms were major barriers, while health system factors such as access to services and quality of care were critical determinants. Policy factors, including supportive ART policies and health insurance schemes, played a role in improving adherence. Conclusion: Addressing ART adherence in Bali requires a multi-faceted approach. Recommendations include integrating mental health support, enhancing interpersonal support, combating stigma, improving healthcare access, and reinforcing supportive policies to improve ART adherence and treatment outcomes for WLHIV.
Organization:
KIT - Royal Tropical Institute , VU - Vrije Universiteit Amsterdam
Institute:
KIT (Royal Tropical Institute)
Country:
Indonesia
Region:
Southeast Asia
Training:
Master of Science in International Health
Category:
Research
Right:
@ 2024 Lestari
Document type:
Thesis/dissertation
File:
U4tHGYVABq_20241105132427985.pdf