The role of fear as a barrier and facilitator to antiretroviral therapy initiation in Indonesia

Insights from patients and providers

Datos Bibliográficos

ID19438837
AutoresBona Sardo Hasoloan Hutahaean (University of Indonesia, autor de correspondencia), Sarah E Stutterheim (0000-0001-9336-5022, Maastricht University), Karen Jonas (0000-0001-6607-1993, Maastricht University), Kai J Jonas (Maastricht University)
Año2025
Volumen37
Número1
Páginas161-177
Fecha de publicación2025-01-02
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaAIDS Care (JOURNAL)
Identificadores de la revistaISSN: 0954-0121 • E-ISSN: 1360-0451
EditorialInforma UK Limited (PUBLISHER • GB)
DOI10.1080/09540121.2024.2414080
PMID39402857
OpenAlexW4403439075
IdiomaEN
Citas recibidas2
Referencias citadas79

Initiating antiretroviral therapy (ART) in Indonesia poses major challenges, with limited studies on specific ART initiation barriers and facilitators. Using a socioecological approach, we explored, through semi-structured interviews, the perspectives of 67 participants: 17 people with HIV not (yet) on ART, 30 people with HIV on treatment, and 20 HIV service providers (HSPs). Fears emerged as pervasive barriers to initiation encompassing, at the intrapersonal level, (irrational) fears of negative medical and non-medical consequences. At the health system level, fears were linked to concerns about bureaucracy and insufficient universal coverage. On a societal level, fears stemmed from prevalent myths, misinformation on social media, and the impact of COVID-19. Interestingly, fear also served as a facilitator to initiation. At the intrapersonal level, initiation was driven by a fear of deteriorating health or death due to AIDS-related conditions. At the interpersonal level, buddies and HSPs leveraged to motivate initiation. At the societal level, accurate yet fear-inducing information on social media stimulated initiation. Perspectives differed between people with HIV and HSP, with people with HIV emphasizing barriers on intrapersonal to health system levels, while HSP focused mostly on intrapersonal and interpersonal barriers, albeit recognizing the crucial role of health systems

Facilitator · Interpersonal communication · Intrapersonal communication · Misinformation · Political science · Adolescent Sexual and Reproductive Health · HIV, Drug Use, Sexual Risk · HIV/AIDS Research and Interventions · Medicine · Psychology · Social Psychology