Usage of Voluntary Counseling And HIV Testing Services in Puskesmas Kelurahan Kampung Bali Jakarta And Its Relation With The Government Policy Regarding Access of Antiretroviral For All.

Vernawati SA. THESIS, Faculty of Medicine University of Indonesia, Jakarta, 2005

Background.
Problem of HIV infection is increased related to unsafe sex behavior and usage of NAPZA injection. Estimation of HIV/AIDS cases in Indonesia was around 90.000 to 130.000. Since December 01, 2003 WHO has implemented the 3 by 5 program with the purpose of therapy access for all and since September 01, 2004 government has provided ARV for free. In accessing ARV therapy, Voluntary Counseling and HIV Testing (VCT) is an essential way and service in basic level (e,g Society Health Center/Puskesmas) has to be prepared as it will be the backbone of the service. It is hoped that numbers of VCT will increase in line with the guarantee of ARV access.

Objective
To know numbers of VCT services, CD4 and usage of ARV in Puskesmas Kampung Bali after the implementation of free ARV policy, characteristics and reasons that could hinder the high risk group for VCT beside dugs cost.

Methodology
Research on VCT program services, test CD4 and ARV access was conducted for 5 months. All people who have done VCT in Puskesmas Kampung Bali and 100 high risk people aged > 15 years who haven’t done VCT, chosen with cluster system and met the inclusion criteria, were participated in the research conducted on November 2004 Maret 2005 and went through guided interview and scoring for HIV/AIDS knowledge and attitudes.

Result
In 8 months before the implementation of the policy, there were 18 peoples and then in 5 months after the policy implementation there were 27 peoples have done VCT. There’s increase of ARV usage. No increase ‘in amount of CD4 test. Majority of respondent who haven’t and have done VCT, are male aged 20 30 years, mid level education, no permanent job and low income. Out of 100 respondents who haven’t done VCT, 64% has mid level knowledge, 48% knows the availability of free ARV, 89% has routine injection and 34% practice unsafe sex behavior. The reason for not having VCT is feeling healthy, afraid of being known to have HIV and urisafe secret show the lack of awareness and motivation. Reason of cost of treatment transportation in general was not ensured yet. Out of 13 respondents who has done VCT, majority are married, 12 people has mid level of knowledge, 7 has still routine injection and 10 has unsafe sex behavior. Reason for having VCT is know mg the risk.

Summary
Numbers of VCT 8 month prior and 5 month after the implementation of the policy were 18 and 27 peoples.The ARV usage is also increases. Knowledge on HIV/AIDS and availability of free ARV is enough but majority has still active having injection and practice unsafe sex behavior. Lack of awareness, motivation and afraid of HIV/AIDS social consequences are reasons that could hinder VCT. Reason of cost of transaction/transportation in general hasn’t been ensured yet.

Key words: HIV, Counseling, ARV, Kampung Bali

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