1-U=U at government/national level
The government has not mainstreamed or implemented U=U campaign in Indonesia. There is hesitaion on using the term.
2-Sensitization/ Training of PLHIVs, community advocates, service providers and/or CBOs
It has been felt that it is important to raise awareness of U=U principle, especially with health care workers, because they’re the ones who get in touch with the users / patients; there is a need to have more integrated campaign for health care workers. LINKAGES have developed strategies for health care workers for ease of tracking the number of PLHIV who tested for viral load.
3-Incorporating U=U messages in relevant community outreach, education info and social media campaigns
Some organisations have initiated the use of social media to give information about U=U.
4-Country Challenges and Barriers
Indonesia had already prepared a framework for the introduction of PrEP in 2017, but it was halted by stigma. The stigma toward PrEP comes from public officials and even NGOs.”
Several preliminary studies in Jakarta and Bali showed low literacy on PrEP amongst MSM and transgender communities, although PrEP was well accepted by the communities. The low PrEP literacy could be caused by the lack of PrEP literature in the local language, Bahasa Indonesia. There are many myths and misconceptions about the benefits and use of this powerful HIV prevention method. Stigma and prejudice of PrEP users and prescribers may occur to some degree.
Barriers to access HIV test services, according to several reports, consist of lack of money, time, stigma, discrimination, low-risk perception, fear, lack of accessibility, reluctance of health service providers to offer HIV testing and limited human resources.
Given that sexually transmitted infections (STIs), including HIV, are highly stigmatised in Indonesia, and accessing health care through private pharmacies or street vendors provides easy access to a service with little fear of being interrogated with embarrassing questions.
In regard to HIVST, regulatory process remains opaque, with a lack of clarity about which authorities are responsible for the registration of HIVST products and lengthy in-country validation and registration processes for products even after they have achieved WHO PQ status.
An issue that has arisen with respect to U=U is that many people believe if they have undetectable viral load it means that they are free to have unprotected sex.
- Desak Nyoman Widyanthini, Pande Putu Januraga, Rudi Wisaksana, Yanri Wijayanti Subronto, Evi Sukmaningrum, Nur Aini Kusmayanti, Helen Dewi, Matthew Law, John M. Kaldor & Dewa Nyoman Wirawan (2021) HIV self-testing for men who have sex with men: an implementation trial in Indonesia, AIDS Care, DOI: 10.1080/09540121.2021.1883509
- Wulandari, L.P.L., Kaldor, J. & Guy, R. Uptake and acceptability of assisted and unassisted HIV self-testing among men who purchase sex in brothels in Indonesia: a pilot intervention study. BMC Public Health 20, 730 (2020). https://doi.org/10.1186/s12889-020-08812-4
- PrEP innovation and implementation in Asia and the Pacific: Meeting Report, UNAIDS, Unitaid and WHO in association with the Institute of HIV Research and Innovation (IHRI), December 2020 (https://unitaid.org/assets/PrEP-innovation-and-implementation-in-Asia-and-the-Pacific-Meeting-Report-2020.pdf)
- HIV Self-Testing Strategic Framework A Guide For Planning, Introducing And Scaling Up, WHO, October 2018 (https://apps.who.int/iris/bitstream/handle/10665/275521/9789241514859-eng.pdf)
- HIV and AIDS in Asia & The Pacific: Regional Overview (https://www.avert.org/professionals/hiv-around-world/asia-pacific/overview#HIV_testing_and_counselling_(HTC)_in_Asi)
- WHO, Unitaid, and UNAIDS meeting on HIV self-testing and innovative testing approaches in Asia and the Pacific Region: Country progress and plans (December 2020)
- UNAIDS Data 2020 (https://www.unaids.org/sites/default/files/media_asset/2020_aids-data-book_en.pdf)
- Asia-Pacific Regional Expert Group Meeting on Reviewing Implementation of Commitments from the Asia-Pacific Intergovernmental Meeting on HIV AIDS Beyond 2015, ESCAP, 2018 (https://www.unescap.org/events/asia-pacific-regional-expert-group-meeting-reviewing-implementation-commitments-asia-pacific)
- WHO and partners urge countries to fast-track implementation and scale-up of HIV self-testing and other innovative HIV testing approaches in Asia and the Pacific, March 2021 (https://www.who.int/news/item/16-03-2021-who-and-partners-urge-countries-to-fast-track-implementation-and-scale-up-of-hiv-self-testing-and-other-innovative-hiv-testing-approaches-in-asia-and-the-pacific)
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