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A Qualitative Exploration of Family, Work, Community, and Health Service Influences on HIV Treatment Uptake and Adherence Among Female Sex Workers in Three Cities in Indonesia.

Mitchell E, Lazuardi E, Anintya I, Rowe E, Whitford K, Wirawan DN, Wisaksana R, Subronto YW, Prameswari HD, Kaldor J, Bell S

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  • Journal AIDS education and prevention : official publication of the International Society for AIDS Education

  • Published 17 Sep 2020

  • Volume 32

  • ISSUE 3

  • Pagination 243-259

  • DOI 10.1521/aeap.2020.32.3.243

Abstract

Qualitative data were collected from 34 Indonesian female sex workers to understand their engagement with HIV treatment. Influences that enhanced treatment initiation and adherence included women's desires to stay healthy to continue working to provide for families; awareness of the biomedical benefits of treatment; support from bosses, outreach workers, and peer support groups; and flexible, nonjudgmental HIV service provision. Influences inhibiting treatment initiation and adherence included concerns about unwanted disclosure in the workplace and side effects of medication on women's capacity to earn money through sex work; geographical location of services; discrimination and confidentiality concerns in HIV care services. To improve HIV treatment initiation and adherence among Indonesian female sex workers, future responses should explore health promotion messages that engage with women's family and livelihood obligations; increased funding for community-based peer outreach workers; community-based treatment initiation and supply; and advocacy in work environments to secure support for treatment initiatives.