Journal of Preventive Medicine and Public Health

Original Articles

HIV-related Perceptions, Knowledge, Professional Ethics, Institutional Support, and HIV/AIDS-related Stigma in Health Services in West Sumatra, Indonesia: An Empirical Evaluation Using PLS-SEM: Vivi Triana, Nursyirwan Effendi, Brian Sri Pra Hastuti, Cimi Ilmiawati, Dodi Devianto, Afrizal Afrizal, Adang Bachtiar, Rima Semiarty, Raveinal Raveinal; J Prev Med Public Health. 2024;57(5):435-442. Published online July 15, 2024; DOI: https://doi.org/10.3961/jpmph.23.503

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Abstract Summary PDF: Objectives
The aim of this study was to investigate the significance of associations between knowledge, professional ethics, institutional support, perceptions regarding HIV/AIDS, and HIV/AIDS-related stigma among health workers in West Sumatra, Indonesia.
Methods
We conducted a cross-sectional study involving health workers at public hospitals and health centers in West Sumatra in June 2022. The Health Care Provider HIV/AIDS Stigma Scale was employed to assess the stigma associated with HIV/AIDS. To estimate and evaluate the model’s ability to explain the proposed constructs, we utilized the standardized partial least squares structural equation model (PLS-SEM).
Results
In total, 283 individuals participated in this study (average age, 39 years). The majority were female (91.2%), nearly half were nurses (49.5%), and 59.4% had been working for more than 10 years. The study revealed that HIV/AIDS-related stigma persisted among health workers. The PLS-SEM results indicated that all latent variables had variance inflation factors below 5, confirming that they could be retained in the model. Knowledge and professional ethics significantly contributed to human immunodeficiency virus (HIV)-related stigma, with an effect size (f²) of 0.15 or greater. In contrast, perceived and institutional support had a smaller impact on HIV-related stigma, with an effect size (f²) of at least 0.02. The R 2 value for health worker stigma was 0.408, suggesting that knowledge, professional ethics, institutional support, and perceived support collectively explain 40.8% of the variance in stigma.
Conclusions
Improving health workers’ understanding of HIV, fostering professional ethics, and strengthening institutional support are essential for reducing HIV-related stigma in this population.; Summary

Key Message
This study explores the relationships between HIV knowledge, professional ethics, institutional support, perceptions of HIV/AIDS, and HIV/AIDS-related stigma among healthcare workers in West Sumatra, Indonesia. Using a PLS-SEM model, the analysis reveals that HIV knowledge and professional ethics significantly reduce HIV-related stigma, while the effects of perceptions and institutional support are less pronounced. The model explains 40.8% of the variance in stigma, highlighting the critical role of improving HIV knowledge, fostering ethical conduct, and strengthening institutional support. These findings suggest that comprehensive strategies addressing these factors are essential to reducing HIV/AIDS stigma in healthcare settings.

Assessing COVID-19 Vulnerability Among HIV-positive Men Who Have Sex With Men in Korea: The Role of Vaccination and Sexual Behaviors: Minsoo Jung; J Prev Med Public Health. 2024;57(4):370-378. Published online June 24, 2024; DOI: https://doi.org/10.3961/jpmph.24.196

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Abstract Summary PDF: Objectives
Comorbidities increase susceptibility to severe coronavirus disease 2019 (COVID-19) infections, but limited information has been published regarding human immunodeficiency virus (HIV) and COVID-19 co-infections. This study explored the relationships among socioeconomic characteristics, sexual behaviors, and COVID-19 infection rates among Korean men who have sex with men (MSM) who are also living with HIV.
Methods
Data were collected through a web survey aimed at members of the largest gay portal site in Korea, supported by the National Research Foundation of Korea (n=1005). The primary independent variables included COVID-19-related vaccinations and sexual behaviors. The dependent variable was the incidence of COVID-19 infection among respondents during the pandemic. For statistical analysis, hierarchical multiple logistic regression was performed, controlling for potential confounding variables.
Results
Model I indicated that older MSM were less likely to contract COVID-19 (adjusted odds ratio [aOR], 0.98; 95% confidence interval [CI], 0.96 to 0.99). Model II demonstrated that HIV-positive MSM were nearly twice as likely to be infected with COVID-19 compared to their HIV-negative counterparts (aOR, 1.97; 95% CI, 1.14 to 3.41). Furthermore, even after accounting for COVID-19 vaccination status in model III, HIV-positive MSM continued to show a higher risk of infection (aOR, 1.93; 95% CI, 1.12 to 3.35).
Conclusions
The findings of this study indicate that HIV-positive MSM are at an increased risk of contracting COVID-19, even when their vaccination status is considered. Therefore, it is essential to prioritize the prevention of COVID-19 infections in HIV-positive individuals by administering appropriate antiretroviral therapy and ensuring adherence to public health guidelines.; Summary

Korean summary
이 연구는 한국의 HIV 양성인 남성 동성애자(MSM)가 코로나-19 백신접종을 했어도 HIV 음성인 MSM에 비하여 COVID-19에 감염될 위험이 더 높다는 것을 보여주었다. 이러한 결과는 항레트로바이러스 요법의 준수나 촉진과 더불어 이들 취약 계층을 위한 COVID-19 예방조치 강화와 맞춤형 공중보건 전략의 필요성을 강조한다.

Key Message
This study found that HIV-positive men who have sex with men (MSM) in Korea are at a heightened risk of contracting COVID-19 compared to HIV-negative individuals, even when vaccination status is accounted for. This finding underscore the necessity of targeted public health strategies, including the promotion of adherence to antiretroviral therapy and the reinforcement of COVID-19 prevention measures for this vulnerable population.

A Peer-support Mini-counseling Model to Improve Treatment in HIV-positive Pregnant Women in Kupang City, East Nusa Tenggara, Indonesia: Artha Camellia, Plamularsih Swandari, Gusni Rahma, Tuti Parwati Merati, I Made Bakta, Dyah Pradnyaparamita Duarsa; J Prev Med Public Health. 2023;56(3):238-247. Published online April 11, 2023; DOI: https://doi.org/10.3961/jpmph.22.516

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Abstract PDF

Objectives
Low adherence to antiretroviral (ARV) therapy in pregnant women with human immunodeficiency virus (HIV) increases the risk of virus transmission from mother to newborn. Increasing mothers’ knowledge and motivation to access treatment has been identified as a critical factor in prevention. Therefore, this research aimed to explore barriers and enablers in accessing HIV care and treatment services.
Methods
This research was the first phase of a mixed-method analysis conducted in Kupang, a remote city in East Nusa Tenggara Province, Indonesia. Samples were taken by purposive sampling of 17 people interviewed, consisting of 6 mothers with HIV, 5 peer facilitators, and 6 health workers. Data were collected through semi-structured interviews, focus group discussions, observations, and document review. Inductive thematic analysis was also performed. The existing data were grouped into several themes, then relationships and linkages were drawn from each group of informants.
Results
Barriers to accessing care and treatment were lack of knowledge about the benefits of ARV; stigma from within and the surrounding environment; difficulty in accessing services due to distance, time, and cost; completeness of administration; drugs’ side effects; and the quality of health workers and HIV services.
Conclusions
There was a need for a structured and integrated model of peer support to improve ARV uptake and treatment in pregnant women with HIV. This research identified needs including mini-counseling sessions designed to address psychosocial barriers as an integrated approach to support antenatal care that can effectively assist HIV-positive pregnant women in improving treatment adherence.

Summary

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Letter to the Editor: Supporting the Sick and the Vulnerable
Fides A. del Castillo
Journal of Preventive Medicine and Public Health.2023; 56(4): 392. CrossRef
Author Response: Supporting the Sick and the Vulnerable
Artha Camellia, Gusni Rahma
Journal of Preventive Medicine and Public Health.2023; 56(4): 394. CrossRef

Open Communication About Reproductive Health Is Associated With Comprehensive HIV Knowledge and a Non-stigmatising Attitude Among Indonesian Youth: A Cross-sectional Study: Gede Benny Setia Wirawan, Ni Luh Zallila Gustina, Pande Putu Januraga; J Prev Med Public Health. 2022;55(4):342-350. Published online June 13, 2022; DOI: https://doi.org/10.3961/jpmph.21.581

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160 Download
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Abstract PDF

Objectives
Human immunodeficiency virus (HIV) prevention among youth seems under-prioritised compared to other key populations. HIV knowledge and stigma are important parts of HIV prevention. To inform HIV prevention among youths, this study quantitatively analysed the associations between open communication regarding sexuality and sexual health, comprehensive HIV knowledge, and non-stigmatising attitudes in Indonesia.
Methods
This study used data from the Indonesian Demographic and Health Survey (IDHS) 2017. The analysis included unmarried men and women aged 15-25 years old. Comprehensive HIV knowledge and a stigmatising attitude were defined according to the IDHS 2017. Open communication about sexuality and sexual health was defined as the number of people with whom participants could openly discuss these topics in their direct network of friends, family, and service providers, with a scale ranging from 0 to a maximum of 7. Primary analysis used binomial logistic regression with weighting adjustments.
Results
The final analysis included 22 864 respondents. Twenty-two percent of youth had no one in their direct network with whom to openly discuss sexual matters, only 14.1% had comprehensive HIV knowledge, and 85.9% showed stigmatising attitudes. Youth mostly discussed sex with their friends (55.2%), and were less likely to discuss it with family members, showing a predominant pattern of peer-to-peer communication. Multivariate analysis showed that having a larger network for communication about sexuality and sexual health was associated with more HIV knowledge and less stigmatising attitudes.
Conclusions
Having more opportunities for open sex communication in one’s direct social network is associated with more HIV knowledge and less stigmatising attitudes.

Summary

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A Scoping Review of Knowledge, Awareness, Perceptions, Attitudes, and Risky Behaviors of Sexually Transmitted Infections in Southeast Asia
Vimala Balakrishnan, Kok Khuen Yong, Chiong Kian Tiong, Nicholas Jian Shen Ng, Zhao Ni
Healthcare.2023; 11(8): 1093. CrossRef

Prevalence and Factors Affecting Discrimination Towards People Living With HIV/AIDS in Indonesia: Rimawati Aulia Insani Sadarang; J Prev Med Public Health. 2022;55(2):205-212. Published online March 24, 2022; DOI: https://doi.org/10.3961/jpmph.21.502

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Abstract PDF

Objectives
This study aimed to identify the behaviors associated with discrimination towards people living with HIV/AIDS (PLHA) in Indonesia and to determine the factors affecting discrimination.
Methods
Secondary data from the 2017 Indonesia Demographic and Health Survey were analyzed using a cross-sectional design. Discrimination was assessed based on the questions (1) “Should children infected with HIV/AIDS be allowed to attend school with non-infected children?” and (2) “Would you buy fresh vegetables from a farmer or shopkeeper known to be infected with HIV/AIDS?” Multivariable logistic regression was used to determine the factors affecting discrimination, with adjusted odds ratio (aOR) and 95% confidence interval (CIs) used to show the strength, direction, and significance of the associations among factors.
Results
In total, 68.9% of 21 838 individuals showed discrimination towards PLHA. The odds of discrimination were lower among women (aOR, 0.63; 95% CI, 0.55 to 0.71), rural dwellers (aOR, 0.81; 95% CI, 0.75 to 0.89), those who understood how HIV is transmitted from mother to child (aOR, 0.81; 95% CI, 0.73 to 0.89), and those who felt ashamed of their own family’s HIV status (aOR, 0.56; 95% CI, 0.52 to 0.61). The odds were higher among individuals who knew how to reduce the risk of getting HIV/AIDS (aOR, 1.27; 95% CI, 1.15 to 1.39), how HIV/AIDS is transmitted (aOR, 3.49; 95% CI, 3.09 to 3.95), and were willing to care for an infected relative (aOR, 2.78; 95% CI, 2.47 to 3.13). A model consisting of those variables explained 69% of the variance in discrimination.
Conclusions
Gender, residence, knowledge, and attitudes related to HIV/AIDS were explanatory factors for discrimination against PLHA. Improvements in HIV/AIDS education programs are needed to prevent discrimination.

Summary

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Employment Discrimination for People Living with HIV in China: The Challenges of Law vs. Practice
Ziyi Xie, Zhizhuang Duan
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HIV-related Perceptions, Knowledge, Professional Ethics, Institutional Support, and HIV/AIDS-related Stigma in Health Services in West Sumatra, Indonesia: An Empirical Evaluation Using PLS-SEM
Vivi Triana, Nursyirwan Effendi, Brian Sri Pra Hastuti, Cimi Ilmiawati, Dodi Devianto, Afrizal Afrizal, Adang Bachtiar, Rima Semiarty, Raveinal Raveinal
Journal of Preventive Medicine and Public Health.2024; 57(5): 435. CrossRef
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A Peer-support Mini-counseling Model to Improve Treatment in HIV-positive Pregnant Women in Kupang City, East Nusa Tenggara, Indonesia
Artha Camellia, Plamularsih Swandari, Gusni Rahma, Tuti Parwati Merati, I Made Bakta, Dyah Pradnyaparamita Duarsa
Journal of Preventive Medicine and Public Health.2023; 56(3): 238. CrossRef

Special Article

Trends of the Global Hepatitis C Disease Burden: Strategies to Achieve Elimination: Nathalie Brunner, Philip Bruggmann; J Prev Med Public Health. 2021;54(4):251-258. Published online June 24, 2021; DOI: https://doi.org/10.3961/jpmph.21.151

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Abstract PDF

Hepatitis C infection is responsible for high morbidity and mortality rates globally as well as for significant indirect costs. The disease burden caused by the hepatitis C virus (HCV) is comparable to the one caused by human immunodeficiency virus or tuberculosis. Today, simple detection methods, highly effective and easy to administer therapies and efficient preventative measures are available to combat hepatitis C. Nevertheless, in most countries around the world, the World Health Organization target of eliminating this infectious disease and its consequences by 2030 are not being met. Significant gaps in care for hepatitis C sufferers still exist, the shortcomings ranging from education and treatment to aftercare. Hepatitis C infection was and still is not on the radar of most politicians and health authorities. National programmes and strategies to combat the disease exist or are being developed in many countries. However, for these to be implemented efficiently and successfully, clear political commitment, strong civil society actors, well-functioning public health structures and the relevant support from global donors are needed.

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Original Articles

The Effects of Socio-demographic Characteristics on Indonesian Women’s Knowledge of HIV/AIDS: A Cross-sectional Study: Putu Erma Pradnyani, Arief Wibowo, Mahmudah; J Prev Med Public Health. 2019;52(2):109-114. Published online February 28, 2019; DOI: https://doi.org/10.3961/jpmph.18.256

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Abstract PDF

Objectives
The purpose of this study was to characterize Indonesian women’s knowledge of HIV/AIDS and to investigate the effects of socio-demographic characteristics thereupon with the goal of supporting the prevention and early detection of HIV/AIDS.
Methods
This cross-sectional study was conducted using secondary data from the standard Indonesian Demographic and Health Survey (IDHS) in 2012. A total of 34 984 subjects ranged in age from 15 years to 49 years. Data were analyzed using the chi-square test and logistic regression to identify the effects of socio-demographic characteristics on Indonesian women’s knowledge of HIV/AIDS.
Results
All socio-demographic characteristics except marital status were related to knowledge of HIV/AIDS among Indonesian women in the univariate analysis (p<0.05). Multivariate analysis revealed that only age group, education level, location of residence, and wealth index were related to Indonesian women’s knowledge of HIV/AIDS (p<0.05).
Conclusions
Indonesian women’s insufficient knowledge related to HIV/AIDS shows that the provision of accurate and comprehensive information related to HIV/AIDS are components of prevention and control interventions that should be improved. With greater knowledge, women are expected to be more likely to determine their own and their partners’ human immunodeficiency virus status and to take appropriate preventive steps.

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Satveer Dhillon, Daniel Amoak, George N. Chidimbah Munthali, Yujiro Sano, Roger Antabe, Isaac Luginaah
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Male to Female Heterosexual Transmission of HIV in Korea: Transmission Rate and Risk Factors.: Unyeong Go, Mee Kyung Kee, Byeong Sun Choi, Chun Kang, Kyoung Mee Do, Ju Hyun Lee, Joo Shil Lee; Korean J Prev Med. 1999;32(2):228-235.

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Abstract PDF: OBJECTIVES
Despite the importance of human immunodefi-ciency virus(HIV) transmission through heterosexual contact, the features of heterosexual transmission has not been well studied in Korea. So we conducted a cross sectional study to determine the transmission rates in married couples and assess risk factors for male to female heterosexual transmission of HIV. METHODS: 169 HIV-infected males and their female sex partners were recruited from 1985 to June 1998. We examined female sex partners HIV infection status and interviewed male index partners and their female sex partners about demographic characteristics and sexual practices. We analysed heterosexual transmission rate by epidemiologic characteristics, disease status and sexual practices. And we assessed risk factors for HIV infection by univariate and multivariate analysis. RESULTS: 30 female sex partners were infected at enrollment, yielding an transmission rate of 17.8%. Among couples who had used condoms consistently, none of the female sex partners was infected with HIV. In univariate analysis the significant risk factors were full blown AIDS status (OR=4.1, 95% CI: 1.49-11.43) and low CD4 T cell count of index partners at enrollment (OR=7.8, 95% CI: 2.19-27.80). In multivariate analysis HIV-1 RNA levels was significant risk factor when adjusted by CD4 T cell counts and mean sexual contacts per month (OR=19.2, 95% CI: 1.03-357.59) CONCLUSION: The risk of male to female heterosexual transmission increased with advanced stages of HIV infection in the index male partners.; Summary

Epidemiological characteristics of HIV infected homosexuals in Korea(1992).: Young Keol Cho, Yung Oh Shin, Young Bong Kim; Korean J Prev Med. 1993;26(4):541-550.

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Abstract PDF: In order to investigate psychological and behavioral characteristics homosexuals and to present evidence that homosexuals are in danger of HIV infection in Korea, this study was done by self-administered questionnaire and then direct interview with the 28(35%) HIV infected homosexual/bisexuals of 79 HIV infected persons reported in 1992. Homosexuals without heterosexual activity were 9 and the others were bisexuals. Sixty-five percent of respondents had a guilty conscience for their homosexual activity. Twenty(71%) were in twenties and 5(18%) in thirties. Twelve(43%) were detected via health card checking by health office, 21% by blood donation, 18% by hospital visit, and 7% by partner notification. Motivations for homosexual activity were curiosity(36%), temptation or recommendation(14%) and compulsion(11%). Eighteen(72%) never used condom on anal sex. Nine of 26 respondents had experience for anal sex with foreigners. Fourteen(54%) of 26 respondents had history for sexually transmitted diseases. Fightly percent did not have sexual contact after HIV infection and the others usually used condom. It was confirmed that over 57% of the respondents were infected within 1 year before HIV diagnosis and over 82% within 2 years. These data suggest that HIV infection among homosexual group is rapidly spreading.; Summary

Sexual Behavioral Characteristics and the Knowledge of HIV/AIDS among Men who have Sex with Men in Republic of Korea.: Mee Kyung Kee, Chul Min Park, Chang Gok Chang, Un Yeong Go; J Prev Med Public Health. 2004;37(3):220-224.

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Abstract PDF: OBJECTIVES
To investigate the sexual behavioral characteristics and HIV/AIDS knowledge among men who have sex with men (MSM), one of the HIV high risk groups. METHODS: A three month survey among individuals who were able to be contacted was carried out over the entire Republic of Korea, between May and August, 2001. 348 individuals completed a self-administered questionnaire. The data collected included demographic information, sexual behavior and AIDS knowledge. RESULTS: Eighty-seven and ninety-two per cent of the 348 MSM were aged 20-39 years and had never been married, respectively. Fifty-five per cent of participants reported at least one sexual contact with women, and a quarter of the MSM surveyed had engaged in high-risk sexual behavior (more than 6 partners) during the previous year. About twenty per cent of the MSM had anal sex as their favorite way of having sex, and seventy-four per cent did not use condoms regularly due to loss of enjoyment, and were more likely to be engaged in risky behaviors. Only ten per cent had a regular HIV test history, and most had obtained knowledge or information on HIV/AIDS through the mass media. CONCLUSIONS: A large proportion of the MSM in Korea still remain at an elevated risk for contracting HIV infection. Change in high-risk sexual behaviors will prevent the spread of HIV infection among the MSM population, which requires public health education for preventive interventions, and should be culturally and socially specific in order to be effective.; Summary

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