Generic placeholder image

Current HIV Research


ISSN (Print): 1570-162X
ISSN (Online): 1873-4251

Case Report

Community HIV Screening Among MSM in Three Indonesian Cities

Author(s): Rahmat Hidayat*, Daniel Marguari, Nany Hairunisa, Heru Suparno and Robert Magnani

Volume 17, Issue 1, 2019

Page: [65 - 71] Pages: 7

DOI: 10.2174/1570162X17666190321115419

Price: $65


Background: Indonesia lags behind its peers with regard to ART coverage of PLHIV. Insufficient HIV testing among MSM and other key affected populations remains a barrier to increasing ART coverage.

Objective: This report presents the results of the first government-endorsed implementation research study of a community screening approach to increasing the rate of HIV testing among MSM in three cities.

Methods: All new MSM outreach contacts meeting eligibility criteria during March-June 2017 were included in the study. HIV testing at a government health facility, which is required to qualify for government-supported ART, was advised for all new contacts. Men refusing formal testing were offered an HIV screening test in a community setting using a saliva-based rapid test and advised to get a confirmatory test at a health facility. All outreach contacts and testing activities were recorded on individual client records.

Results: Of 1,149 eligible MSM, 27% were willing to be referred to receive HIV testing at a health facility, among which 83% were confirmed to have been tested. Of the 838 study subjects refusing health facility testing, 38% accepted community screening. The screening positivity rate was 14.8%. Only 38% of men with reactive screening tests received a confirmatory test at a health facility, along with 8% of those with non-reactive tests.

Conclusion: While community screening resulted in more MSM knowing their HIV status, reluctance to avail government health facility-based services, or indeed to be tested at all, must be addressed if community screening is to accelerate progress in getting HIV-positive MSM onto treatment.

Keywords: ART, HIV community screening, MSM, Indonesia, MoH, PLHIV.

« Previous
Graphical Abstract
WHO Regional Office for South-East AsiaProgress report on HIV in the WHO South-East Asia region 2016. India: World Health Organization Regional Office for South-East Asia 2016.
Ministry of HealthEstimates and Projections of HIV/AIDS in Indonesia 2015–2030. Jakarta: Ministry of Health 2016.
Ministry of Health Laporan Perkembangan HIV-AIDS & Infeksi Menular Seksual Triwulan 4 2018. Jakarta: MoH. 2018.
UNAIDSGlobal AIDS Update 2018. Geneva: UNAIDS 2018.
Campbell CK, Lippman SA, Moss N, Lightfoot M. Strategies to increase HIV testing among MSM: A synthesis of the literature. AIDS Behav 2018; 22: 2387-412.
Beyrer C, Baral SD, van Griensven F, et al. Global epidemiology of HIV infection in men who have sex with men. Lancet 2012; 380(9839): 367-77.
Jürgensen M, Tuba M, Fylkesnes K, Blystad A. The burden of knowing: balancing benefits and barriers in HIV testing decisions. a qualitative study from Zambia. BMC Health Serv Res 2012; 12(1): 1.
Prestage G, Brown G, Keen P. Barriers to HIV testing among Australian gay men. Sex Health 2012; 9(5): 453-8.
Schwarcz S, Richards TA, Frank H, et al. Identifying barriers to HIV testing: personal and contextual factors associated with late HIV testing. AIDS Care 2011; 23(7): 892-900.
Logie CH, Lacombe-Duncan A, Brien N, et al. Barriers and facilitators to HIV testing among young men who have sex with men and transgender women in Kingston, Jamaica: a qualitative study. J Int AIDS Soc 2017; 20(1): 21385.
Golub SA, Gamarel KE. The impact of anticipated HIV stigma on delays in HIV testing behaviors: findings from a community-based sample of men who have sex with men and transgender women in New York City. AIDS Patient Care STDS 2013; 27(11): 621-7.
Malebranche DJ, Peterson JL, Fullilove RE, Stackhouse RW. Race and sexual identity: perceptions about medical culture and healthcare among Black men who have sex with men. J Natl Med Assoc 2004; 96(1): 97.
United Nations. Joint statement on scaling up voluntary community- based HIV testing and counseling for key populations in Asia and the Pacific. 2013; 1-3. [Cited 2015 Dec 23]. Available from: testing_ in_AP.pdf
Sharma M, Ying R, Tarr G, Barnabas R. Systematic review and meta-analysis of community and facility-based HIV testing to address linkage to care gaps in sub-Saharan Africa. Nature 2015; 528(7580): S77-85.
Reyes-Uruena J, Breveglieri M, Furegato M, Fernandez-Lopez L, Agusti C, Casabona J. Heterogeneity of community-based voluntary, counselling and testing services for HIV in Europe: the HIV-COBATEST survey. Int J STD AIDS 2015; 28(1): 28-38.
Suthar AB, Ford N, Bachanas PJ, et al. Towards universal voluntary HIV testing and counselling: a systematic review and meta-analysis of community based approaches. PLoS Med 2013; 10(8): e1001496.
Doherty T, Tabana H, Jackson D, et al. Effect of home based HIV counselling and testing intervention in rural South Africa: cluster randomised trial. BMJ 2013; 346: f3481.
Fylkesnes K, Sandøy IF, Jürgensen M, Chipimo PJ, Mwangala S, Michelo C. Strong effects of home-based voluntary HIV counselling and testing on acceptance and equity: a cluster randomized trial in Zambia. Soc Sci Med 2013; 86(2013): 9-16.
Coates TJ, Kulich M, Celentano DD, et al. Effect of community-based voluntary counselling and testing on HIV incidence and social and behavioural outcomes (NIMH Project Accept; HPTN 043): a cluster-randomised trial. Lancet Glob Health 2014; 2(5): e267-77.
Ezeanolue EE, Obiefune MC, Ezeanolue CO, et al. Effect of acongregation-based intervention on uptake of HIV testing and linkage to care in pregnant women in Nigeria (baby shower): a cluster randomised trial. Lancet Glob Health 2015; 3(11): e692-700.
Labhardt ND, Motlomelo M, Cerutti B, et al. Home-based versus mobile clinic HIV testing and counseling in rural Lesotho: a cluster-randomized trial. PLoS Med 2014; 11(12): 1-11.
Zhang T, Tian X, Ma F, et al. Community based promotion on VCT acceptance among rural migrants in Shanghai, China. PLoS One 2013; 8(4): e60106.
Sweat M, Morin S, Celentano D, et al. Increases in HIV testing and case detection from NIMH project ACCEPT (HPTN 043) among 16-32 years olds: a randomized community-based intervention in Tanzania, Zimbabwe and Thailand. Lancet Infect Dis 2011; 11(7): 525-32.
Sulat JS, Prabandari YS, Sanusi R, Hapsari ED, Santoso B. The impacts of community-based HIV testing and counselling on testing uptake: A systematic review. J Health Res 2018; 32(2): 152-63.
Lorente N, Preau M, Vernay-Vaisse C, et al. Expanding access to non-medicalized community-based rapid testing to men who have sex with men: an urgent HIV prevention intervention (the ANRS-DRAG study). PLoS One 2013; 8(4): e61225.
Meulbroek M, Ditzel E, Saz J, et al. BCN Checkpoint, a community-based centre for men who have sex with men in Barcelona, Catalonia, Spain, shows high efficiency in HIV detection and linkage to care. HIV Med 2013; 14(S3): 25-8.
Qvist T, Cowan SA, Graugaard C, Helleberg M. High linkage to care in a community-based rapid HIV testing and counseling project among men who have sex with men in Copenhagen. Sex Transm Dis 2014; 41(3): 209-14.
Thornton A, Delpech V, Kall M, Nardone A. HIV testing in community settings in resource-rich countries: a systematic review of the evidence. HIV Med 2012; 13(7): 416-26.
Belza M, Hoyos J, Fernandez-Balbuena S, Diaz A, Bravo M, dela Fuente L. Assessment of an outreach street-based HIV rapid testing programme as a strategy to promote early diagnosis: a comparison with two surveillance systems in Spain, 2008-2011. Euro Surveill 2015; 20(14): 23-33.
de la Fuente L, Delgado J, Hoyos J, et al. Increasing early diagnosis of HIV through rapid testing in a street outreach program in Spain. AIDS Patient Care STDS 2009; 23(8): 625-9.
Lipsitz MC, Segura ER, Castro JL, et al. Bringing testing to the people–benefits of mobile unit HIV/syphilis testing in Lima, Peru, 2007-2009. Int J STD AIDS 2014; 25(5): 325-31.
RüüTel K, Ustina V, Parker RD. Piloting HIV rapid testing in community-based settings in Estonia. Scand J Public Health 2012; 40: 629-33.
Marcus U, Ort J, Grenz M, Eckstein K, Wirtz K, Wille A. Riskfactors for HIV and STI diagnosis in a community-based HIV/STI testing and counselling site for men having sex with men (MSM) in a large German city in 2011-2012. BMC Infect Dis 2015; 15(1): 14.
Mdodo R, Thomas PE, Walker A, et al. Rapid HIV testing at gay pride events to reach previously untested MSM: US, 2009-2010. Public Health Rep 2014; 129(4): 328-34.
Yan H, Zhang R, Wei C, et al. A peer-led, community-based rapid HIV testing intervention among untested men who have sex with men in China: an operational model for expansion of HIV testing and linkage to care. Sex Transm Infect 2014; 90(5): 388-93.
Snyder H, Yeldandi VV, Prem Kumar G, et al. Field-based video pre-test counseling, oral testing, and telephonic post-test counseling: implementation of an HIV field testing package among high-risk Indian men. AIDS Educ Prev 2012; 24(4): 309-26.
Fernández-Balbuena S, Belza MJ, Zulaica D, et al. Widening the access to HIV testing: the contribution of three in-pharmacy testing testing programmes in Spain. PLoS One 2015; 10(8): e0134631.
Calderon Y, Cowan E, Rhee JY, Brusalis C, Leider J. Counselorbased rapid HIV testing in community pharmacies. AIDS Patient Care STDS 2013; 27(8): 467-73.
Darin KM, Klepser ME, Klepser DE, et al. Pharmacist-provided rapid HIV testing in two community pharmacies. J Am Pharm Assoc 2015; 55(1): 81-8.
Knight V, Wand H, Gray J, Keen P, McNulty A, Guy R. Convenient HIV testing service models are attracting previously untested gay and bisexual men; a cross-sectional study. JAIDS 2015; 69: e147-55.
Krause J, Subklew-Sehume F, Kenyon C, Colebunders R. Acceptability of HIV self-testing: a systematic literature review. BMC Public Health 2013; 13(1): 1.
Pai NP, Sharma J, Shivkumar S, et al. Supervised and unsupervised self-testing for HIV in high-and low-risk populations: a systematic review. PLoS Med 2013; 10(4): e1001414.
Bustamante MJ, Konda KA, Davey DJ, et al. HIV self-testing in Peru: questionable availability, high acceptability but potential low linkage to care among men who have sex with men and transgender women. Int J STD AIDS 2016; 28: 133-7.
Eaton LA, Driffin DD, Smith H, Conway-Washington C, White D, Cherry C. Black men who have sex with men, sexual risk taking, and willingness to use rapid home HIV tests. Prev Sci 2015; 16(2): 321-9.
Lippman SA, Périssé AR, Veloso VG, et al. Acceptability of self-conducted home-based HIV testing among men who have sex with men in Brazil: data from an on-line survey. Cad Saude Publica 2014; 30(4): 724-34.
Myers JE, Bodach S, Cutler BH, Shepard CW, Philippou C, Branson BM. Acceptability of home self-tests for HIV in New York City, 2006. Am J Public Health 2014; 104(12): e46-8.
Oldenburg CE, Biello KB, Perez-Brumer AG, et al. HIV testing practices and the potential role of HIV self-testing among men who have sex with men in Mexico. Int J STD AIDS 2016; 28: 242-9.
Pérez GM, Cox V, Ellman T, et al. ‘I know that I do Have HIV but nobody saw me’: oral HIV self-testing in an informal settlement in South Africa. PLoS One 2016; 11(4): e0152653.
Marlin RW, Young SD, Bristow CC, et al. Piloting an HIV self-test kit voucher program to raise serostatus awareness of high-risk African Americans, Los Angeles. BMC Public Health 2014; 14: 1226.
Woods WJ, Lippman SA, Agnew E, Carroll S, Binson D. Bathhouse distribution of HIV self-testing kits reaches diverse, high-risk population AIDS Care 2016; 28(sup1): 111-3
Carballo-Diéguez A, Frasca T, Balan I, Ibitoye M, Dolezal C. Use of a rapid HIV home test prevents HIV exposure in a high risk sample of men who have sex with men. AIDS Behav 2012; 16(7): 1753-60.
Chiu CJ, Young SD. Correlates of requesting home HIV self-testing kits on online social networks among African-American and Latino men who have sex with men. AIDS Care 2016; 28(3): 289-93.
Rosengren AL, Huang E, Daniels J, Young SD, Marlin RW, Klausner JD. Feasibility of using Grindr™ to distribute HIV self-test kits to men who have sex with men in Los Angeles, California. Sex Health 2016; 13: 389-92.
Volk JE, Lippman SA, Grinsztejn B, et al. Acceptability and feasibility of HIV self-testing among men who have sex with men in Peru and Brazil. Int J STD AIDS 2015; 27: 531-6.
Tao J, M-y. Li, Qian H-Z, et al. Home-based HIV testing for men who have sex with men in China: a novel community-based partnership to complement government programs. PLoS One 2014; 9(7): e102812.
Zhong F, Tang W, Cheng W, et al. Acceptability and feasibility of a social entrepreneurship testing model to promote HIV self-testing and linkage to care among men who have sex with men. HIV Med 2016; 18: 376-82.
Bavinton BR, Brown G, Hurley M, et al. Which gay men would increase their frequency of HIV testing with home self-testing? AIDS Behav 2013; 17(6): 2084-92.
Chen M, Bilardi J, Lee D, Cummings R, Bush M, Fairley C. Australian men who have sex with men prefer rapid oral HIV testing over conventional blood testing for HIV. Int J STD AIDS 2010; 21(6): 428-30.
WHOGuidelines on HIV Self-Testing and Partner Notification. Supplement to Consolidated Guidelines on HIV Testing Services 2016.
Kojima N, Klausner JD. Accelerating epidemic control: the role of HIV self-testing. Lancet HIV April 24, 2018; 5(6): e266-7.
National AIDS CommissionNational Consultation in Legal and Policy Barriers to HIV in Indonesia (Bandung, Indonesia, 12-12 September 2013). Jakarta: UNDP 2013.

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy