Overcoming Barriers to HIV Care Linkage in Indonesia

The Journal of Multidisciplinary Healthcare recently published an article investigating the complex factors influencing linkage to HIV care in Bandung, Indonesia. Utilizing a descriptive qualitative framework, researchers conducted interviews with 17 strategically selected participants from the HIV care network. The study reveals multi-level barriers and facilitators, examining individual, interpersonal, system, and community influences on accessing care effectively.

Individual and Interpersonal Influences

Psychological readiness, perceptions, clinical status, and socioeconomic conditions significantly impact individuals' access to care. The study emphasizes the importance of interpersonal support from family, peers, and healthcare providers in navigating the care continuum. On a systemic level, access to care is uneven, often hindered by resource constraints and primary care gaps, with stigma in healthcare settings delaying timely treatment initiation.

Systemic and Community Strategies

Community engagement plays a pivotal role, with community health volunteers assisting in overcoming administrative and financial challenges. This aligns with global strategies advocating for community-led service delivery to enhance treatment access and uptake. The study highlights the need for a coordinated approach, involving expanded primary care services, increased community participation, and structured professional guidance to improve care linkage and achieve the UNAIDS 95-95-95 goals.

Globally, about 87% of HIV-positive individuals are aware of their status, yet progress towards UNAIDS targets, such as viral suppression, remains uneven. Indonesia faces significant barriers in care linkage, exacerbated by rapid epidemic growth. The study suggests that innovations in service delivery models, including digital health technologies, are crucial for overcoming barriers in HIV care pathways and improving health outcomes.