Background. Background Method Results Lesson Learned

Transkripsi

1 SHARING EXPERIENCE FROM HEALTH PROVIDERS; HIV STIGMA AND DISCRIMINATION IN SERIRIT, BULELENG, BALI Putu Theni Aryasih Dwi Hendrayani Sintha Kurnia Dewi Udayana University, Denpasar, Bali Corresponding author : theni_ar@yahoo.co.id Background Method Results Lesson Learned Background

2 Pattern of HIV epidemic in Bali children Partners Clients FSW Clients Partners HIV PMTCT: 1. Case findings 2. VCT 3. ANC 4. Referring PMTCT decrease MTCT Source: Wirawan, D.N, 2010 children The study was conducted in Kecamatan Seririt (subdisctrict), Buleleng regency. 60% of pregnant women in Bali are seeking ANC services at midwives

3 Buleleng regency ranked 2nd in the highest number of HIV cases in Bali. Seririt, ranked 3rd in the highest number of HIV cases among sub-disctricts after Gerokgak and Sawan. Midwives in Seririt already received training on basic knowledge on HIV and PMTCT. Method Qualitative study 3 Focus Group Discussion with 21 Midwives in-depth interviews with eight pregnant women who refuse VCT and one pregnant women who HIV positive Results

4 The barriers faced by midwives in casefinding and when referring pregnant women for HIV tests were: the community the health provider (midwives) Stigma from the Community 1. There were stigma in the community on HIV (be excommunicated) There were stigma in the community on HIV (be excommunicated) later if other people know that I am positive then no one will never mingle with me that, according to me, is one of the factors why we could not encourage people to have the self-conscience to test themselves FGD 3. ( nanti kalau orang lain itu tahu saya positif saya pasti tidak ada yang mengajak bergaul.itu sebenarnya kalau menurut saya itu mungkin penyebabnya kenapa kita susah untuk menjaring orang atau menggiring orang untuk mempunyai kesadaran memeriksakan diri FGD 3.) Stigma from the Community 2. Stigma on HIV that affect access to VCT (people will assume someone HIV+ when visit VCT clinic)

5 Stigma on HIV that affect access to VCT.other people will assume differently when someone visit the clinic (VCT clinic) it is really scary FGD 1. Stigma from Health Provider (midwives) 1. Concerns of decreasing number of patient visits (.pandangan orang begitu masuk ke kliniknya itu juga beda dah pasti ngeri dah FGD 1). Worries of decreasing number of patient visits if midwives suggest their patients to undergo HIV test once there was a patient whom I thought was at risk.. I told her to do HIV test..uuh.. then after that she never comes again.. if this keeps on happening, I ll be losing patients.. FGD 3. ( pernah dulu pasien yang saya anggap berisiko saya kasitau untuk tes HIV ehhh ndak datang-datang dia kalau sering gitu gimana ya kan hilang ye pasien saya. FGD 3). Stigma from Health Provider (midwives) 2. Concerns in getting infected

6 Concerns in getting infected "... the same with my friends in the service... fear..." FGD 2. (.sama dengan teman-teman ketakutan dalam pelayanan FGD 2.) "... yes... there is a sense of fear especially the increasing cases of hiv..." FGD 1. (.ya ada rasa ketakutan apalagi semakin meningkatnya kasus dari hiv ini,, FGD 1.) Lesson learned In order to increase the potential role of midwives, there should be : Regular training, monitoring and refreshment (especially how to approach client, and encourage pregnant women to do HIV test). Provide HIV AIDS education through health promotion involving cross-sectoral cooperation and community leaders or public figures to reduce stigma and discrimination in the community. Thank You